juvederm filler

JUVÉDERM® Injectable Gel is the only Hyaluronic acid fillerthat is FDA approved to last up to 1 year.

What Is JUVÉDERM® Injectable Gel?
As we age, our skin changes. Over time, the natural volume of youthful skin begins to diminish as wrinkles and folds form. But, with Juvéderm™ injectable gel, you don't have to just sit back and let it happen!
JUVÉDERM® Injectable Gel is a smooth consistency gel made of hyaluronic acid—a naturally occurring substance in your skin that helps to add volume and hydration. JUVÉDERM® Injectable Gel is injected under the skin to instantly restore your skin's volume and smooth away facial wrinkles and folds, like your “smile lines” or “parentheses” (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth).
JUVÉDERM® Injectable Gel provides a smooth, natural look and feel—so everyone will notice (but no one will know)! In fact, studies show superior results of JUVÉDERM® Injectable Gel compared to a collagen-based dermal filler.†
JUVÉDERM® Injectable Gel is the first FDA-approved hyaluronic acid dermal filler that is proven to be safe and effective.

How JUVÉDERM®Injectable Gel Works
JUVÉDERM® Injectable Gel dermal filler is a nonsurgical treatment. JUVÉDERM® Injectable Gel is injected under the skin using a fine needle to augment, or fill, the soft tissue of the dermis—the dense inner layer of skin beneath the epidermis—to add volume and diminish wrinkles and folds. JUVÉDERM® Injectable Gel l is great for your "laugh lines," "smile lines" or "parentheses" (nasolabial folds), or "marionette lines" (oral commissures).
JUVÉDERM® Injectable Gel is a "next-generation" filler. It is made from hyaluronic acid—a naturally occurring substance in your skin that helps to hydrate and add volume. Hyaluronic acid may diminish with age, contributing to the formation of wrinkles and folds. JUVÉDERM® Injectable Gel works to correct this by restoring hyaluronic acid in your skin, helping to smooth wrinkles and folds

What to Expect During Treatment
Because JUVÉDERM® Injectable Gel is a simple, nonsurgical wrinkle treatment, there is minimal recovery or downtime. So you can make an appointment to stop by the office for treatment on the way home from work or the gym. Here's what to expect when you visit for treatment.

Before you go: Avoid any medications that can prolong bleeding, such as aspirin and non-steroidal anti-inflammatories (NSAIDs), for at least a week prior to treatment in order to reduce the risk of bruising and bleeding at the injection site. (Tylenol is okay).
When you arrive: If this is your first visit, Dr. will ask about your medical history, including any allergies you may have or medications you may take, and will tell you more about wrinkle treatment with JUVÉDERM® Injectable Gel . An allergy test is not required.

Determining your treatment needs: Dr. will examine the soft tissue of your face to assess the depth of wrinkles and folds to determine your treatment. JUVÉDERM® Injectable Gel is available in two formulations—Juvéderm™ Ultra for versatility in contouring and volumizing facial wrinkles and folds, and Juvéderm™ Ultra Plus, a robust formulation for volumizing and correcting deeper folds and wrinkles.

Before the procedure: Dr. will use topical and/or injectable anesthesia to numb the treatment area first.
The procedure: Dr. will ease the JUVÉDERM® Injectable Gel under your skin to augment, or fill, wrinkles and folds. Following the injection, he may gently massage the treated areas. The procedure is quick and easy. The injection itself usually takes only about 15 minutes.
After the procedure: With JUVÉDERM® Injectable Gel , there is minimal recovery or downtime.

For the first 24 hours following treatment, you should avoid strenuous exercise, excessive sun or heat exposure, and consumption of alcoholic beverages in order to help minimize the risks of temporary redness, swelling, and/or itching at the treatment sites. After the treatment, some temporary injection-related reactions may occur, including redness, pain, firmness, swelling, and bumps. Studies have shown that these are usually mild to moderate in nature and clear up on their own in 7 days or less. If you experience swelling at the injection site, you can apply an ice pack for a brief period.

Seeing results: You should see an immediate improvement in the treatment areas. Most patients need one treatment to achieve optimal wrinkle smoothing. And one treatment could smooth your lines and wrinkles for up to 1 year! However, results may vary and correction is temporary. Supplemental “touch up” treatments may be required to achieve and maintain optimal results.

body contouring

Body Contouring:
Contouring of the abdomen, arms, back, legs and total body can be obtained with mesotherapy. Lipodissolve agents are used to remove areas of fat by block the internal signal of fat uptake, trigger fat release inprove circulation, and burn energy, while vitamins and amino acids are used to tighten sagging skin, restore a more youthful and athletic appearance.
Many patients develop unevenness, divots, or lumps after undergoing liposuction. These areas can be successfully treated with Mesotherapy. The scar tissue that forms under the skin after liposuction is directly targeted and dissolved. Patients see and feel smoothing of divots and lumps, and the unevenness resolves.
Cellulite Reduction:The medical term of cellulite is "dermatomyoliposclerosis". Cellulite affects the majority of women over the 20. It is caused by poor circulation, fat herniation weakening of connective tissue, lymphatic congestion, and hormonal imbalance. Cellulite is not a disease of over weight. It appears in the subcutaneous level of skin tissue. Fat cells are arranged in chambers surrounded by connective tissue called sepatae. As water retained, fat cells held within the perimeters of this area expand and stretch the connective tissue. Eventually this connective tissue contracts and hardens (scelerosis) holding the skin at a non-flexible length, while the surrounding tissue continues to expand with weight or water gain. This result in areas of the skin being held down while other sections bulge outward, resulting in lumpy, orange peel appearance. It can be divided into 4 clinical stages:-
-Stage 0:- no visible cellulite, even when skin pricked or compress
-Stage 1:- no visible cellulite when standing or lying down, however present when skin is pricked or compressed.
-Stage 2:- visible cellulite when standing, but not appear when lying down
-Satage3:- visible all time.
Mesotherapy treatment is targeted to correct these problems by improving circulation, strengthening, connective tissues, remove fibro tic & hardening connective tissue, improve lymphatic drainage, and dissolve excess fat.
Hair Restoration :-Hair loss affects both affects both men and women. I6t’s resulted from poor circulation, nutritional imbalances and in men the excess of a hormone known as DHT (dihydrotestosterone) Mesotherapy can correct these problems, by stimulating scalp to naturally grow the lost hair.
Face and neck rejuvenation / mesolift:-
Aging, sagging and wrinkling of the skin occurs from accumulation of fat, loss or skin elasticity, and excessive free radical damage. Infusing potent antioxidants and amino acids by mesotherapy into dermis at level of contact with cellular matrix can reverse free radical damage, and tightening the loose skin. It can rejuvenate and revitalize the skin of face and neck without the unnatural appearance and downtime recovery period.
People who have had a "Mesolift" describe their skin as firm, radiant, youthful and glowing. The Mesolift is usually performed in an initial series of 2-4 treatments spaced a week apart. Results are maintained by twice a year touch up sessions.
Mesotherapy skin rejuvenation is a wonderful compliment to any of the other skin treatments we offer including, photo rejuvenation, chemical peels, BOTOX® and dermal fillers. But it also stands on it’s own as a powerful anti-aging therapy.
Facial Pigmentation:Facial pigmentation like Melasma ,post inflammatory pigmentation(following aggressive treatment with chemical and Lasers),Black discoloration around eyes and pigmentation due to sun damage can be effectively controlled by using specific mesotherapy solutions. The effect of these medicines is virtually dramatic.
Eye Bags:For the problem of buldging fat under the eyes Mesotherapy provides a very effective to surgical treatment called Blepharoplasty.
Double Chin:Infection lipolysis by mesotherapy using different fat dissolve solution treayts double chin effectively.The results are very quick in these cases since area to be treated is small.The combination of medicaments to tighten the skin together witgh lipolysis agent further compliments the treatment.

What is the treatment protocol?For cellulite, weight loss, and spot weight reduction, the medications are injected directly to the areas being treated. Treatments are administered weekly, and patients usually begin seeing results by the fourth treatment. After 10 treatments, patients see a significant decrease in size, improved skin tone, and smoothing of cellulite. Typically patients lose 4 to 10 inches in 10 weeks.
For facial rejuvenation weekly injections are given and usually 4-5 treatment sare sufficient to get the desired results.

chemical peels in acne

Peels in acne

Chemical peels using either alpha-hydroxy acid or beta-hydroxy acid are both highly effective in treating mild to moderately severe facial acne, researchers at the Saint Louis University School of Medicine have found the first study to compare the two different types of acid peels as therapies for the skin disorder.
Peels using beta-hydroxy acid (or BHA) had slightly fewer side effects and results that lasted a bit longer than did peels using alpha-hydroxy acid (or AHA), the study found. But overall, both types of treatments were similarly effective in reducing lesions caused by acne vulgaris, which affects some 85 percent of all people 12 to 24 years old.
AHA (which is also called glycolic acid) and BHA (also called salicylic acid) are frequently used by physicians to induce light skin peels, which help treat fine lines and wrinkles, acne and uneven texture and coloration. The peel removes a very thin layer of skin, which in turn promotes the growth of new, smoother skin.
Both types of acid are derived from organic compounds. AHA has the same active ingredient that's found in sugar cane juice, sour milk and tomato juice, while BHA is derived from salicin, which is closely related to the active ingredient in aspirin.
The study involved 20 patients with moderate to severe facial acne. Their average age was 24 years; 13 were women. Each was treated with a chemical peel every other week for six weeks, with follow-up visits one month and two months after the last treatment.
Each treatment involved applying alpha-hydroxy acid to one side of the face and beta-hydroxy acid to the other side. Neither the patient nor the person who later evaluated them were aware which side of the face had been treated with which acid.
The study found that both types of chemical peels significantly reduced acne lesions within two weeks of the first treatment, and patients continued to see a reduction in lesions through the first follow-up visit a month after the treatments had finished.
At the time of that first post-treatment visit, 94 percent of patients were judged to have had good or fair improvement in acne lesions on both sides of the face, as assessed by a blinded evaluator.
A month later, at the second post-treatment visit, 81 percent of the sides of the face treated with beta-hydroxy acid still showed good or fair improvement in acne lesions, compared with 75 percent of the sides of the face treated with alpha-hydroxy acid. However, the sides of the face treated with alpha-hydroxy acid had developed a few new lesions though this was judged not to be significant.
In general, both types of acid peels yielded the same side effects, which typically decreased over the course of the treatments. The most common of these included redness, peeling and scaling though with alpha-hydroxy acid, the degree of the peeling and scaling was judged to be greater.

HAIR CYCLE---TELOGEN EFFLUVIUM

The Hair Growth Cycle
To understand telogen effluvium, we need to have some knowledge of the hair growth cycle. Hair does not grow continuously on the human scalp. The anagen (growing) phase for terminal hair can extend 3 to 7 years and is a reflection of the size of the hair follicle. Catagen is the transitional portion of the hair growth cycle, between anagen and telogen and lasts only 1 to 2 weeks. During this time, there is a rapid involution and regression of the hair follicle. The hair follicle then enters the telogen phase, which is a relatively fixed period of time, approximately 100 days, regardless of the size of the hair follicle. There is no growth of the hair shaft during this phase. It is at the end of the telogen phase that the entire hair shaft, also often referred to as the club hair, will spontaneously shed, while a new hair shaft is forming within the hair canal. The white bulb at the end of the hair, along with the loosely attached collection of friable debris gives the shed hair its characteristic appearance.In the scalp of the healthy, young human adult, approximately 90% of the hair will be in the anagen (growth) phase and approximately 10% will be in the telogen (dormancy) phase. Less than 1% will be in the catagen (transitional) phase. When you consider that the scalp contains 100,000 hairs, with 10,000 in the telogen (dormancy) phase... and 1% of those hairs in the telogen phase will be at the end of the 100 day long phase, you can easily understand why it is normal to shed 100 hairs per day.

When excessive amounts of hair simultaneously switch from anagen (growth) into telogen (dormancy) and subsequently shed several months later, the phenomenon is referred to as a telogen effluvium. Rarely are more than 50% of the hairs on the head involved. Telogen effluviums can be acute or chronic. When the shedding lasts more than six months or persistently recurs, it is referred to as a chronic telogen effluvium. Chronic telogen effluviums have been reported mainly in women. No racial predilection exists.
Although telogen effluvium can affect hair on all parts of the body, generally, only loss of scalp hair is symptomatic. The exact prevalence is not known and getting accurate statistics would be very difficult, but the condition is quite common.
Telogen effluvium can occur at any age. It is likely that most adults have experienced an episode of telogen effluvium at some point in their lives and, unbeknownst to most people, everybody has experienced the phenomenon early in life. In fact, mothers have been more aware of telogen effluviums in newborns and babies than most doctors have ever been. It is typical for a band like area of occipital hair follicles to enter the first telogen close to the time of birth and for these hairs to shed 2 to 3 months later. In the human infant, waves of hair growth occur before establishment of the mosaic pattern, which is usually present by the end of the first postnatal year.
What causes Telogen Effluvium?
In order to cause a large number of hair follicles to simultaneously switch from the anagen (growing) phase into the telogen (resting) phase, the body has to undergo some systemic insult. A telogen effluvium is not caused by topical medications. But because there is a required time lapse of several months between the inciting cause and the excessive shedding of hair, the exact cause of the telogen effluvium is often not positively identified.
A typical and common case of telogen effluvium would be the episode of severe shedding of hair that may occur approximately 100 days after a woman has given birth. The inciting factor is probably the abrupt hormonal changes that occur at the end of pregnancy. All of the hair grows back within a year.
Other causes of telogen effluvium include illness, major physical trauma, menopause, crash diets, severe psychological stress, major surgery (especially with general anesthesia), hypo- or hyperthyroidism, anemia's, acute and severe blood loss, heavy metal poisoning, etc. Chronic illness such as malignancy, and any chronic debilitating illness, such as systemic lupus erythematosus, end-stage renal disease, or liver disease can cause telogen effluvium. Immunizations also have been reported to cause acute hair shedding. Even jet lag and job changes have been reported to cause a telogen effluvium. In the United States, oral medications may very well be the most common cause of telogen effluviums. The list of medications associated with telogen effluviums is extensive and includes retinoids, beta-blockers, anticoagulants, SSRI’s, non-steroidal anti-inflammatories, calcium channel blockers, etc. In any and all cases, the common factor is metabolic or physiologic stress several months before the start of the hair shedding.
How do I know if I have TE?
Making the diagnosis of a telogen effluvium is usually quite straightforward. A ‘hair pull’ will determine whether or not a disproportionate number of hair follicles are in the telogen phase. And this is a test, which the patient can do himself or herself. Pinch a bunch of hair between your thumb and middle finger. You will have approximately 25 to 30 hairs within the pinch. Give the bunch of hair a sharp tug. Repeat this tug in several places over the scalp. It would be normal to dislodge one or two hairs with each pull, because approximately 10% of the hairs on the scalp are in the telogen phase. The hairs that are dislodged should have a small, friable, whitish bulb on the scalp end. If you pull out more than 4 or 5 hairs in each pull, it’s likely that you are having a period of telogen effluvium. For an accurate pull test, it is important that you have washed your hair regularly, i.e. daily or every other day. With infrequent washing, more hair than normal may pull out giving an erroneous interpretation. Since a telogen effluvium is not limited to the hair follicles at risk for MPB or FPB, shedding can involve hair on any part of the scalp (and even body hair). The underlying scalp has a normal appearance without scarring or inflammation and there should not be any areas of complete alopecia. A close examination of the scalp may reveal a higher than expected number of short new hairs growing in.If there is an obvious history of an inciting event and the time elapsed between the inciting event and the excessive shedding is consistent with the approximate length of a telogen phase, laboratory studies are of little use in making the diagnosis. Although a scalp biopsy can be performed to confirm the diagnosis, it would seldom be necessary if the history is characteristic and a ‘hair pull’ produces numerous telogen hairs.
There are no signs or symptoms, which allow you to anticipate the shedding from a telogen effluvium.Treating Telogen EffluviumBecause acute telogen effluvium is in reality a normal process, which occurred prematurely in a synchronized manner to a large number of hair follicles, and which resolves spontaneously, treatment can be limited to reassurance. The identifiable inciting factor should be avoided or discontinued or treated, whichever is appropriate. Assuming there is no intervening pathological process, all of the hair will be replaced in six to twelve months and the replacement hair should be identical to the hair that was shed. Telogen Effluvium and Miniaturization
Unfortunately, a telogen effluvium can be the harbinger of the onset of Male Pattern Baldness or the initial event in a period of accelerated MPB. In these cases, which are fairly common, the hair also grows back, but the hair may be significantly finer and smaller, because the hair follicles affected have miniaturized by the MPB process. While 5% topical minoxidil is not proven to promote recovery of hair in telogen effluvium, this medication has a theoretical benefit because minoxidil acts directly on hair follicles and promotes anagen growth. Patients who are eager to play an active role in their treatment may wish to use a 5% minoxidil solution. The use of DHT inhibitors is not recommended for the treatment of telogen effluvium.
In ConclusionChronic telogen effluvium is more likely to be caused by a chronic metabolic abnormality and is less likely to resolve rapidly. The underlying cause or disorder should be avoided or discontinued or treated, whichever is appropriate, and the patient should have reassurances that the hair loss will not progress to baldness.Hair transplantation is not a recommended treatment for telogen effluvium.

how to take care of skin in acne

Gently Cleanse Acne-prone Skin
· Limit washing to twice a day – and after perspiring. Once in the morning and once at night as well as after perspiring heavily should be the limit. Perspiration, especially when wearing a hat or helmet, can make acne worse, so the skin should be gently cleansed as quickly as possible after perspiring.
· Use a gentle, non-abrasive cleanser. Wash the face and other acne-prone areas with a gentle, non-abrasive cleanser that does not contain alcohol.
· Use your fingertips. Apply the cleanser and wash with your fingertips. This reduces skin irritation. Using a washcloth, mesh sponge, or anything else can irritate the skin and lead to breakouts.
· Never scrub the skin. Scrubbing the skin clean does not clear acne. In fact, scrubbing irritates the skin and can make acne worse.
· Rinse with lukewarm water. Be sure to thoroughly rinse away the cleanser with lukewarm, not hot, water.
· Shampoo regularly. If you have oily hair, shampoo daily.
Avoid Acne Skin Care Taboos Astringents, rubbing alcohol, and tanning do not help clear acne nor keep acne-prone skin free from blemishes. Dermatologists recommend that their patients with acne and acne-prone skin avoid the following:
· Astringents, exfoliators, masks, and toners. These products do not help clear acne. In fact, these can aggravate the skin and make acne worse. These products also may make it more difficult to tolerate prescription acne medications, so it is best not to use these when treating acne.
· Greasy hair-care products. Oily hair-care products, such as oil-containing gels and pomades, can drip onto the skin and clog pores. This can cause acne.
· Picking, popping, and squeezing pimples. People pick and pop pimples to get rid of them quickly. The truth is this prolongs healing time and increases the risk of scarring.
· Rubbing alcohol. Some people apply rubbing alcohol in order to dry out the oily skin. This will not help clear acne nor prevent breakouts. It can irritate the skin and cause breakouts.
· Tanning. Some people claim that their acne clears with sun exposure. The truth is that tanning does not clear acne.



· Touching the skin throughout the day. Dermatologists advise their patients with acne and acne-prone skin not touch their skin frequently. This can cause flare-ups.
Select “Noncomedogenic” Cosmetics and Skin Care Products Many acne patients are surprised to learn that makeup, moisturizers, and sunscreen are okay to use while treating acne. The key is to select products labeled “noncomedogenic.” This means the product does not clog pores. Just because a product says “noncomedogenic” does not mean that it works for everyone. You may have to experiment with different noncomedogenic products before you find one that works for you.
Makeup. The truth is makeup can be worn when treating acne — even when using topical medications. Just be sure to follow these guidelines:
· Choose oil-free cosmetics that are labeled “noncomedogenic” (won’t clog pores).
· Apply makeup after applying acne medication.
· If you have trouble finding makeup that can be used with acne medication, consult a dermatologist.
Moisturizer. Did you know that moisturizer can help calm irritated acne-prone skin? If your skin feels dry and you want to moisturize, follow these guidelines:
· Use a moisturizer that is oil-free and says “noncomedogenic” (won’t clog pores).
· If you use a topical acne medication, apply the moisturizer after applying the acne medication. If your skin still feels dry or stings, try applying the moisturizer before applying the acne medication.
Practice Sun ProtectionDermatologists recommend sun protection, which includes but is not limited to regular use of sunscreen, for all their patients, including those with acne. Research shows that most cases of skin cancer can be prevented with sun protection. Sun protection also can help prevent sunburn in patients using topical retinoids, which increase the skin’s sensitivity to the sun. The American Academy of Dermatology recommends that everyone protect their skin by following these sun-protection practices:
· Generously apply sunscreen to all exposed skin. Use a sunscreen that has a Sun Protection Factor (SPF) of at least 30 and provides broad-spectrum protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Re-apply approximately every two hours, even on cloudy days, and after swimming or perspiring. People with acne or acne-prone skin should use a sunscreen labeled “noncomedogenic” (does not clog pores) and apply it after applying topical acne medication.
· Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, where possible.
· Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 4 p.m.
· Use extra caution near water, snow, and sand as they reflect the damaging rays of the sun, which can increase your chance of sunburn.
· Get vitamin D safely through a healthy diet that includes vitamin supplements. Don’t seek the sun.
· Avoid tanning beds. Ultraviolet light from the sun and tanning beds causes skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
· Check your birthday suit on your birthday. If you notice anything changing, growing, or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.
Shave with CareMen know that shaving when you have acne can be a challenge. Here are some dermatologists’ tips that can help give you a clean shave.
· Before shaving, soften the hairs. Wetting the face thoroughly with lukewarm water can help soften the hairs.
· Experiment. Try shaving with electric and safety razors to see which works best for you.
· Make sure the blade is sharp. This helps prevents nicks from a safety razor, which can irritate the skin and lead to breakouts.
· Shave lightly. This can help avoid nicking acne lesions, which can make acne worse.
· Never try to shave off the acne. This aggravates the condition and makes the acne worse.
If after following these guidelines, you are not satisfied with the results, be sure to see a dermatologist. Today, virtually every case of acne can be effectively treated.
If you are using a topical retinoid (adapalene, tretinoin, or tazarotene), it is especially important that you protect your skin from ultraviolet (UV) light. The sun, tanning booths, and sun lamps all emit UV light. It is important to avoid these because topical retinoids cause the top layer of skin to thin, making a person more sun sensitive. Stopping the medication for a few days does not eliminate the skin’s sensitivity to the sun. However, not applying the medication for a few days can reduce its effectiveness in treating acne.

pigmentation and treatment options-chemical peels

pigmentation in Indian skin


Post-Inflammatory Hyperpigmentation
Skin pigmentation conditions can be a problem for all women (and men) with brown skin - people of Asian, African, Latin or Native American background. While the natural pigmentation in brown skin provides many advantages—sun protection and slowed signs of aging—it is also more highly susceptible to skin discolorations, which can cause distress in social situations, as well as psychological stress.

Melanin
Melanin is the chemical that determines the color of skin. The more melanin there is in a person's skin, the darker that person's skin will be. Sometimes the cells that contain melanin are damaged or over stimulated. When this happens, the affected cells may begin to produce too much, or too little melanin. Too much melanin causes darker spots or patches, while too little causes lighter spots or patches. These lighter or darker spots appear on the surface of the skin, and can be unsightly. Unfortunately, these skin color problems are much more visible and common in people with skin of color.
There are many different conditions that can cause discoloration, but the most common are Post-Inflammatory Hyperpigmentation and Melasma.
post inflammatory hyperpigmentation
Post-inflammatory hyperpigmentation (PIH)Post-inflammatory hyperpigmentation (PIH) causes skin darkening and discoloration that show up as spots, or as large patches on a person's body. This is because cells that normally produce brown pigment evenly across your skin go into overdrive and produce too much melanin. This happens because of an inflammatory reaction in, or to an injury to, the skin. If the excess melanin is produced in the upper layer of skin (epidermis), the pigmentation color is a darker shade of brown. If the excess melanin is produced in the lower layer of skin (the dermis), a gray or blue discoloration becomes visible.
post inflammatory hyperpigmentation secondary to laser
Although PIH can occur in all skin types, it is more common in people of Africa, Asia, Latin, and indigenous Indian background, and can affect men and women equally. Areas of the skin affected by PIH correspond with areas of previous inflammation or injury. When dark changes in your skin's color remain after the underlying problem has gone away, you have PIH. The most common causes are injuries such as scratches, burns, cuts, or bruises. Rashes of any type can cause PIH (examples of which include eczema, psoriasis, pityriasis rosea, lichen planus, and fungal infections). Ordinary conditions such as acne or pimples are a very common cause of PIH in individuals with brown skin. PIH can also be caused by injury to the skin resulting from sunburns, surgery or lasers and cryotherapy (liquid nitrogen treatments).

Treatment
If you, or your doctor, suspect that you may have PIH, it is important to search for the underlying cause and treat that cause. For example, when the discoloration is caused by a problem such as acne, the acne must first be eliminated or treated before PIH can effectively be treated. Every time a new pimple develops and then resolves, a new area of PIH will develop. Therefore, it is crucial to minimize all new outbreaks with appropriate medications. Only then can the treatment for the PIH be effective.
It is also important to know that PIH will in many cases fade over time on its own. However, there are treatments available that can speed up the process.
Hydroquinone
For patients with PIH, the most common way to return the skin to its natural glowing complexion is through use of products containing Hydroquinone, a chemical lightening agent that is applied directly to the dark mark. Your dermatologist can determine if hydroquinone is appropriate for your skin. Many dermatologists consider hydroquinone to be the best treatment for PIH. Hydroquinone works by blocking an enzyme that is responsible for the production of the pigment melanin. By blocking the formation of melanin, the dark area will lighten. However, it is important to realize that you may need to use the hydroquinone medication for up to 6 months before clearing of the dark marks is seen.
Hydroquinone products can be purchased over the counter at 1% to 2% concentrations, or by prescription at 3% to 4% concentrations. The prescription products are stronger and hence more effective than the over-the-counter varieties. (see chart below) In either case, the hydroquinone product should be carefully applied to the dark marks—avoiding normal-appearing skin—once or twice a day. One scientific study demonstrated that 80% of individuals who used a 4% hydroquinone product combined with glycolic acid had an improvement in their PIH after 3-months time. Because the lightening agent can sometimes cause other skin conditions, your treatment should not exceed 6 months. There are many varieties of prescription hydroquinone products available for the treatment of PIH. Some of these products are combined with other agents or medications, such as: sunscreen, glycolic acid, retinol, vitamins C and E and tretinoin (Retin A) or cortisone to improve the effects.
Hydroquinone Products:
· HQ 3 cream
· HYDE cream
· EPILITE LOTION
· SKIN LITE cream
· HQ LITE ceam
· MELALITE cream
· MELALITE FORTE cream
Possible effects of hydroquinone products include redness, irritation and possible burning of the skin. It is also possible for your normal skin tone to become lighter in a ring around the dark discoloration. Should you notice any of these side effects, the product should be discontinued and you must notify your dermatologist.
Retinoids
For patients with PIH related to acne or pimples, prescription retinoids are another commonly used treatment for both the acne and PIH. Retinoids are derivatives of vitamin A and include Retin-A, Differin, and Tazorac. All retinoids are effective in the treatment of acne. For the treatment of PIH, Retin-A has been studied in individuals with brown skin. For these patients with acne and PIH, the retinoid is applied to the acne and PIH prone areas nightly.
Retinoids are to be used sparingly in brown skin. A small green-pea size amount is enough to cover the entire face. It is important to realize that this treatment can take up to 40 weeks for the dark marks to fade completely. A scientific study reported that 91% of individuals using the retinoid tretinoin (Retin-A) for a 40 week period had clearing of their PIH. Like many of the other treatments for PIH, retinoids can cause irritation, dryness and peeling of the skin. Consequently, it is important to begin treatment only under the direction of your dermatologist and to closely watch your skin’s appearance while using these products. Irritation, redness and burning are reasons to discontinue the treatment and notify the dermatologist who prescribed these medications.
Azelaic acid
Azelaic acid is another prescription treatment for both acne and PIH. It has anti-inflammatory, anti-bacterial, and skin lightening properties. A small amount of this cream is applied to the acne and PIH prone skin once or twice daily. It is particularly useful for individuals who are unable to tolerate the hydroquinone products. Improvement in the dark marks can be seen after 6 months. A scientific study comparing the lightening ability of azelaic acid and hydroquinone for the pigmentation problem, melasma, found both forms of therapy to be effective when used for a total of 24-weeks. Azeleic acid has the potential of producing the side effects of skin irritation, burning, itching and redness. It is important to check with your dermatologists to see if azeleic acid is appropriate for your skin.
Glycolic acid
Glycolic acid products are available over the counter and are also used as a treatment for PIH. These products work by gently exfoliating (removing) the upper-most layer of the skin and the dark marks with it. There are many products that contain glycolic acid. These include cleansers, lotions, gels, toners and creams. The concentration of glycolic acid contained in the products range from 5 to 20 percent. Products with the lower concentrations can be purchased in drugstores, but the products containing the higher concentrations must be acquired from a dermatologist’s office. Glycolic acid products should be considered medications, so it is important to consult with your dermatologist to determine if he or she thinks glycolic acid is appropriate for your skin. You will usually be instructed to wash with a glycolic cleanser and then follow-up with a glycolic acid cream, gel, or lotion. You will probably need to use the glycolic acid containing products for 3-6 month before seeing an improvement in the dark marks. You will see another benefit in your skin after only a few weeks--the glycolic acid treatments will leave your skin smooth and soft! Because glycolic acid can sometimes lead to skin irritation, it is important to keep an eye on your skin’s appearance while using these products.
Chemical Peels
Chemical Peels are a more intensive treatment used in cases of more persistent PIH or to hasten the lightening effects of the topical prescription products. Peels work by exfoliating the upper-most layer of your skin and the dark area with it. There are many different types of peels and they are usually solutions that the dermatologist applies to the skin. The peels that are used most often to treat PIH in brown skin are the alpha-hydroxy acid (glycolic acid) or beta-hydroxy acid (salicylic acid) peels.
Although the technique that your doctor may use to apply the peel may be slightly different, in general, the peel process is a follows. Prior to the peel, all make-up is removed and the skin is fully cleansed and prepared. The peel solution is applied to the skin and left on for anywhere from one to five minutes. During the peel you may experience a tingling, itching or burning sensation which is often minimized by using a fan that blows cool air onto the skin. Following the peel, a cold compress or spray is applied to soothe the skin. Immediately following the peel, the skin may appear red in color and over the next few days, you may see actual mild peeling of the skin sometimes you may not see visible peeling.
Most dermatologists recommend a total of 4-6 peels to observe maximal improvement in PIH. Peels are generally performed once every two to three weeks. Although peels are an investment in time and finances, they offer the benefit of improving PIH and overall skin clarity, and at the same time they uncover your soft, smooth, flawless skin.
Microdermabrasion
Microdermabrasion is a cosmetic procedure, performed in the dermatologist’s office, in which fine crystals are sprayed onto the skin’s surface to gently sand away the upper-most layers of the skin. As with chemical peels, microdermabrasion works by exfoliating the upper-most layer of your skin and the dark area with it. This procedure is particularly well suited for individuals who have sensitive skin (many individuals with brown skin) or those who have had a previous reaction to a chemical peeling agent. The procedure is performed with a machine that gently sprays the tiny crystals onto the skin’s surface and uses gentle suction to remove the dead superficial skin. The entire procedure takes about 20-30 minutes. You are then able to resume you normal activities.
Even though microdermabrasion is generally well tolerated in brown skin. Before having a microdermabrasion done, make sure that the person who performs the procedure is knowledgeable about brown skin.
The microdermabrasion procedure is usually performed every 2 to 4 weeks for a total of six to eight treatments. To maintain results, it is often advisable to periodically repeat the treamtent after the original sessions are completed. As it is a cosmetic procedure. As with chemical peels, these treatments are an investment in time and finances. However, microdermabrasion offers the benefit of improving PIH and overall skin clarity, as well as uncovering soft, smooth and flawless skin that feels polished.
Other treatments
There are many home remedies for the treatment of dark marks. Some of these may result in serious harm to the skin. Others have not been scientifically proven to be effective in the treatment of PIH. It is very important to check with your doctor before using any treatment for PIH. If you take matters in your own hands, it may lead to more harm than you could ever imagine.
Cocoa butter is a commonly used home remedy for PIH, especially in the African-American community. The cocoa butter preparation is applied to the skin once or twice daily for weeks or months. It provides moisturization to the skin. However, there is no scientific data available that supports the efficacy of cocoa butter in the treatment of PIH.
Aloe vera is another home remedy used for healing wounds, burns and skin discolorations. The gel from the aloe vera plant or a commercially available cream or lotion is applied directly to the skin. However, there is no scientific evidence that aloe vera effectively treats PIH.
Topical corticosteroid (cortisone) creams, both over-the-counter and prescription varieties, are used for a variety of skin disorders. Unfortunately, some individuals with brown skin have used these creams for the treatment of PIH. The creams are inappropriately applied to the skin and in many instances are applied for a prolonged period of time. This leads to damaging side effects. The side effects include permanent thinning of the skin, permanent redness of the skin from overgrowth of blood vessels, the appearance of rashes on the skin and uncontrollable outbreaks of pimples. Topical cortisones should not be used for the treatment of PIH unless under the direct supervision of a dermatologist.
Chlorine bleach is a dangerous home remedy for the treatment of PIH and should never be used on the skin for any reason. As you would anticipate, there is no scientific data to support its efficacy in treating PIH.
Sunscreen is another effective and simple way to fight PIH. By regularly using a sunscreen containing an SPF of 15 or 30, even in winter, you can prevent the further darkening of areas of existing PIH. The best products to use are considered “broad spectrum” because they block both UVA and UVB rays. Patients concerned about oily skin should look for sunscreen sprays and gels in order to avoid further skin surface oil.

hair loss in females and treatment options

HAIR LOSS IN WOMEN

A hair grows from its follicle at an average rate of about 1/2 inch per month. Each hair grows for 2 to 6 years, then rests, and then falls out. A new hair soon begins growing in its place. At any time, about 85% of the hair is growing and 15% is resting.
Baldness occurs when hair falls out but new hair does not grow in its place. The cause of the failure to grow new hair in female pattern baldness is not well understood, but it is associated with genetic predisposition, aging, and levels of endocrine hormones (particularly androgens, the male sex hormones).
Changes in the levels of androgens can affect hair production. For example, after the hormonal changes of menopause, many women find that the hair on the head is thinned, while facial hair is coarser. Although new hair is not produced, follicles remain alive, suggesting the possibility of new hair growth.
Female pattern baldness is usually different from that of male pattern baldness. The hair thins all over the head, but the frontal hairline is maintained. There may be a moderate loss of hair on the crown, but this rarely progresses to total or near baldness as it may in men.
Hair loss can occur in women for reasons other than female pattern baldness, including the following:
Temporary shedding of hair (telogen effluvium)
Breaking of hair (from such things as styling treatments and twisting or pulling of hair)
Patchy areas of total hair loss (alopecia areata -- an immune disorder causing temporary hair loss)
Medications
Certain skin diseases
Hormonal abnormalities
Iron deficiency
Underactive thyroid
Vitamin deficiency
Symptoms
Thinning of hair over the entire head
Hair loss at the crown or hairline, mild to moderate
Exams and Tests
Female pattern baldness is usually diagnosed based on the appearance and pattern of hair loss and by ruling out other causes of hair loss.
A skin biopsy or other procedures may be used to diagnose medical disorders that cause loss of hair.
Analysis of the hair itself is not accurate for diagnosing nutritional or similar causes of hair loss, although it may reveal substances such as arsenic or lead.
Treatment
The hair loss of female pattern baldness is permanent. In most cases, it is mild to moderate. No treatment is required if the person is comfortable with her appearance.
The only drug or medication approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness is minoxidil, used on the scalp. For women, the 2% concentration is recommended. Minoxidil may help hair to grow in 20% to 25% of the female population, and in the majority it may slow or stop the loss of hair. Treatment is expensive, however, and hair loss starts again when minoxidil use is stopped.
Hair transplants consist of removal of tiny plugs of hair from areas where the hair is continuing to grow and placing them in areas that are balding. This can cause minor scarring in the donor areas and carries a modest risk for skin infection. The procedure usually requires multiple transplantation sessions and may be expensive. Results, however, are often excellent and permanent.
The use of hair implants made of artificial fibers was banned by the FDA because of the high rate of infection.
Stitching (suturing) hair pieces to the scalp is not recommended. It can result in scars, infections, and abscess of the scalp.
Hair weaving, hairpieces, or change of hairstyle may disguise hair loss and improve cosmetic appearance. This is often the least expensive and safest method of dealing with female pattern baldness.
Outlook (Prognosis)
Female pattern baldness is of cosmetic importance only and does not indicate a medical disorder, but it may affect self-esteem or cause anxiety. The hair loss is usually permanent.
Possible Complications
Complications are psychological stress and a loss of self-esteem due to change in appearance.
When to Contact a Medical Professional
Call your health care provider if hair loss occurs and persists, especially if there is itching, skin irritation, or other symptoms. There might be a treatable medical cause for the loss of hair.
Prevention
There is no known prevention for female pattern baldness.
Alternative Names
Alopecia in women; Baldness - female; Hair loss in women; Androgenic alopecia in women
References

nutritional protection from uv rays

The Importance of Sunglasses
For some, sunglasses are an extension of their personality, for others a fashion accessory and for many just a practical instrument to keep the sun out of their eyes. However you view your sunglasses, protecting our eyes with sunglasses is part of general eye care which has become a necessity in this day and age.
When buying a pair of sunglasses, it is important to buy a pair that gives 100% ultra-violet (UV) protection or has a reading of UV400. UV400 means that the sunglasses blocks out all rays that have a wavelength up to 400 nanometers, which includes all UVA and UVB rays.
The Different UV Rays
Experts differentiate between four types of harmful rays:
UVA rays: These are low energy, almost visible rays and can pass through the eye and reach the eye’s lens and retina. UVA rays are also linked to cause cataracts and macular degeneration.
UVB rays: A slightly higher energy ray, mostly blocked by the earth’s ozone, but some UVB rays still reaches earth. UVB rays are responsible for the darkening of the skin when we are exposed to sunlight.
UVC rays: Very high energy rays and is blocked by the earth’s ozone layer, however, with the damage to the ozone layer, it could potentially allow some UVC rays to reach earth. These rays can cause serious damage to our skins and eyes.
High-energy visible rays (HEV): Often also referred to as ‘blue light’. These rays are visible light and can penetrate deep into the eye and cause damage.
Apart from blocking 100% of the UV rays and absorbing the HEV rays, it is also important for sunglasses to wrap around your eyes in order to avoid any stray light to enter around the sides of the glasses. This is especially important when you are in areas where there is much reflection, like snow covered areas and beaches or swimming pools. Wearing a wide brimmed hat can also increase UV protection of the eyes.
People are often mistaken when they think that UV rays are not present when it is overcast. Although UV exposure in overcast weather is minimized, it is still as harmful. The colour of your sunglass lenses does not matter when it comes to UV protection.
Contrary to popular belief, the most UV damage to your eyes occurs before the age of 20 years. This is due to the fact that children spend much more time outdoors than adults and their eyes are more sensitive and not as capable to filter light. It is therefore imperative that children start to wear sunglasses at an early age, especially when on sandy beaches and snow covered areas, as reflection of UV rays is just as harmful as direct exposure.
The Importance of Diet and Nutrition
Assist your children in forming healthy eye care habits by encouraging them to wear For healthy eyes, antioxidants are vital. Vitamins A, C and E are the three most important ingredients in your diet for eye health.
Vitamin A – This vitamin is important for healthy cells in the retina and is essential to eye care. A vitamin A deficiency is the leading cause of night blindness and it plays an important role in preventing cataracts and Age Related Macular Degeneration (AMD).
Best sources for Vitamin A: Liver, beef, chicken, egg yolk, milk products, yellow and orange fruit and vegetables such as carrots, mangoes and sweet potatoes
Vitamin C – This truly is the wonder vitamin. Not only does it help with keeping your immune system strong, it also does wonders for your eyes. As with vitamin A, it assists in delaying the onset of Age Related Macular Degeneration (AMD) and cataracts. More importantly, it assists in the prevention of glaucoma and pressure relief for glaucoma sufferers.
Best sources for Vitamin C: Citrus fruit, sweet peppers, broccoli, strawberries
Vitamin E – Apart from being good to prevent heart diseases, vitamin E also aids in the prevention of cataract formation and growth.
Best sources for Vitamin E: Raw nuts, sunflower seeds and oil, wheat germ oil

Apart from these three very important vitamins, you eyes will also benefit from the following:
Selenium and Zinc that assist in antioxidant absorption. Nuts, yeast, seafood and wheat are good sources of Selenium and Zinc
Lutein and Zeaxanthin, found in leafy green vegetables or yellow and orange fruits and vegetables have been proven to reduce cataracts.
Fatty acids found in oily fish and bioflavonoid found in berries.
By following a balanced diet, your body should be able to absorb all of these vitamins and mineral. However, with busy and stressful lives, we sometimes neglect our diets and require supplements to fill the gaps in our diets. Make sure that you choose your supplements carefully and preferably with the advice from your health care professional.

Summer Skin Care: Get your vitamin D in moderation!
What's the largest organ of your body? Your skin, of course. The skin is more than a shell that covers our bones, tissues, and organs. It serves as a barrier against infection and injury, regulates our internal temperature, produces vitamin D, removes waste products from our body, shields us against the sun's radiation, and provides us with a sense of touch.
Our skin has 3 main layers, the epidermis, dermis, and subcutaneous fat tissue that protects our inner tissues from the harshness of the outside world (Fig. 1). The epidermis is the translucent (allows light to partially pass through it), thin, outside layer. The epidermis has 4 or 5 microscopic thin layers that do not contain blood vessels; it gets its oxygen and nutrients from the deeper layers of the skin. Underneath the epidermis lies the dermis, a thick layer composed of connective tissues containing nerves, lymphatic tissue, blood vessels, hair follicles, sweat glands, and sebaceous glands. Beneath the dermis is a layer of subcutaneous fat. The subcutaneous fat lies on our muscles and bones and attaches the skin structure using connective tissues.
Care for our skin should be one of our top priorities, but sadly it is often neglected. Many of us neglect our skin through unprotected sun exposure, putting us at risk for skin damage, immune system suppression, and even cancer.
Sun safety We all need sun exposure; it's our primary source of vitamin D, which helps us absorb calcium for stronger, healthier bones. However, it doesn't take much time in the sun for most people to get all the vitamin D they need. After that, the risk of over-exposure can begin. Most children get between 50% and 80% of their lifetime sun exposure before age 18, so it's important for parents to teach their children how to safely enjoy fun in the sun.
Sunlight consists of 3 types of ultraviolet (UV) rays: UVA, UVB, and UVC (Fig. 2). UVA rays are most common and cause skin aging and wrinkling. Tanning beds usually use UVA and are not safer than the sun. UVB rays cause sunburns, cataracts, immune system damage, and contribute to skin cancer. UVC rays are the most dangerous; but fortunately, they are absorbed by our ozone layer; and therefore, can't harm us.
UV rays react with the pigment melanin in most people's skin. This pigment is your first defense against the sun. It absorbs dangerous UV rays before they do serious harm. The lighter your natural skin color, the less melanin you have to absorb UV rays. A sunburn develops when the amount of UV exposure is greater than what can be protected against by the skin's melanin. Both light- and dark-skinned individuals need protection against burning.
You should talk to your doctor or pharmacist about any medications you are taking that may increase your skin's sensitivity to UV rays. Many medications, prescribed and over-the-counter, increase sun sensitivity. Extra precautions are necessary in these situations.
Once burned If you are sunburned, stay in the shade until the burn is healed. Take a cool bath to alleviate pain. Try pure aloe vera gel on the burn and take acetaminophen or ibuprofen for pain control. Apply topical moisturizer cream to rehydrate the skin and help reduce swelling.