Skin Tags

What are skin tags?
Skin tags or cutaneous tags are very common skin growths that look like soft, hanging skins that stick out. They are also kown as "skin tabs" or barnacles. Skin tags typically occur in the base of the neck, underarms, eyelids, groin folds, and under the breasts. They are usually painless, do not grow or change, and normally occur after midlife. These tags are actually harmless growths. Early skin tags may be as small as a flattened pinhead-sized bump. They could be small (2-5 mm in diameter), but may be as big as 5 cm in diameter. Some individuals may be more prone to tags (greater than 50-100 tags) either through increased weight, in part combined with heredity, or other unknown causes. They are more common in people who are overweight, diabetic or during pregnancy. They are thought to occur from skin rubbing against skin, so they commonly form in skin folds.

Who tends to get skin tags?
More than half if not all of the general population has been reported to have skin tags at some time in their lives. They are much more common in middle age, and they tend to increase in prevalence up to age 60. Children and toddlers may also develop skin tags, particularly in the underarm and neck areas. Since skin tags are thought to arise more readily in areas of skin friction or rubbing, tags are also more common in overweight people. Hormonal changes, especially pregnancy, may cause an increase in the formation of skin tags. Tags are essentially harmless and do not have to be treated unless they are bothersome. They are a benign condition and not directly associated with any other major medical conditions. It could be easily removed by your dermatologists or aesthetic physicians.

Will removing a skin tag cause more to grow?
There is no evidence that removing a skin tag will cause more tags to grow. There is no expectation of causing skin tags to "seed" or spread by removing them. In reality, some people are simply more prone to developing skin tags and may have new growths periodically. Some individuals require periodic removal of tags at annual or even quarterly intervals.

Are skin tags contagious?
No. There is not strong evidence to suggest that common skin tags are contagious. Most likely, people do not catch them from anyone and do not transmit them to anyone.

What problems do skin tags cause?
Except for the cosmetic appearance, skin tags generally cause no physical pain or discomfort. These tiny skin growths generally cause symptoms when they are repeatedly irritated as, for example, by the collar or in the groin. Cosmetic removal for unsightly appearance is perhaps the most common reason they are removed.

How are skin tags treated?
It is important to keep in mind that skin tags usually do not have to be treated. Deciding not to have treatment is always a reasonable option if the growths are not bothersome. If the tags are bothersome, multiple home and medical treatment options are available:

• Tie off tag at narrow base with a piece of dental floss or string.
• Freeze tag with liquid nitrogen.
• Burn tag using electric cautery or Hyfrecator.
• Remove tag with scissors, with or without anesthetic.
• CO2 lasers

Usually small tags may be removed easily without anesthesia, while larger growths may require some local anesthesia (injected lidocaine) prior to removal. Application of a topical anesthesia cream (Betacaine cream or LMX 5% cream) prior to the procedure may be desirable in areas where there are a large number of tags.

What are the brown spots on my face?

What are the brown spots on my face?
The brown spots are called melasma. Melasma is a relatively common disorder of hyperpigmentation (dark discoloration) that affects sun-exposed areas of the skin, most commonly the face.

Who gets melasma?

Melasma is a very common skin disorder. Though it can affect anyone, young women with brownish skin tones are at greatest risk.

What causes melasma?

The precise cause of melasma has not been determined. Multiple factors including pregnancy, birth control pills (oral contraceptives), genetics, sun-exposure, cosmetic use, thyroid dysfunction, and anti-epileptic medications have been identified. Sun exposure is a strong risk factor for melasma. This condition is particularly common in tropical climates.  Melasma is probably the most cosmetically disturbing pigmentary change associated with pregnancy, occurring up to 75 percent of pregnant women. Female hormones are the factors contributing to these pigmentary problems.
Melasma in men, shares the same clinical and histologic features, but not clear if it’s affected by female hormones.

What are the symptoms?
Melasma doesn't cause any other symptoms besides skin discoloration but may be of great cosmetic concern. A uniform brown color is usually seen over the cheeks, forehead, nose, or upper lip. It is most often symmetrical (matching on both sides of the face).

What are the simple tests to diagnose melasma?

Melasma can be easily diagnosed based upon the appearance of your skin. A closer examination using a Wood's lamp will be helpful to guide your treatment.

How can my brown spots be treated?

Treatment of melasma can be challenging because of the chronic and persistent nature of this condition.

Long-term topical cream use and strict sun protection is very important to control the disease. Chemical peeling are most often recommended for the treatment of melasma.

1. Topical cream
Creams used for whitening and pigmentation treatments usually contain hydroquinone, tretinoin, kojic acid, and azelaic acid. These are common bleaching agents which have been shown to improve the appearance of melasma.

Hydroquinone
- blocks formation of pigments by inhibition of enzyme tyrosinase.
- apply twice daily for up to 3-4 months with subsequent tapering
- normally 2-4% is used, but higher concentration yield better results
- complications: allergies, contact dermatitis, hypopigmentation of surrounding skin
- efficacy can be improved by combining with glycolic acid or tretinoin.

Azelaic acid
- Inhibits tyrosinase just like hydroquinone
- Used twice daily
- Adverse reactions: redness, scaling, itchiness, and burning

Tretinoin (Retin-A)
-  Tretinoin is a derivative of vitamin A. Tretinoin increase the turnover of cells. It is used for acne skin, where new cells replace the cells of existing pimples, and the rapid turnover of cells prevents new pimples from forming. By a similar mechanism, tretinoin reducewrinkles, areas of darkened skin (hyperpigmentation), and rough areas of skin, all of which occur in sun-damaged skin. Improvement in the skin usually are seen within the first 3 to 4 weeks of treatment. Brown spots begin to fade after 6 to 8 weeks. Wrinkles decrease or disappear after three to six months. Following application to the skin, a minimal amount of drug is absorbed into the body.

                          

Combination of topical creams are widely used these days.

2. Chemical peels
Chemical peels in indicated for patients with moderate to severe melasma, especially those who did not respond to bleaching agents (topical creams).
Chemical peeling uses fruit acids that is applied on the surface of the skin, to create smooth, rejuvenated skin by way of organized repair process and exfoliation.

Few types of chemical peels exists:

Mild peeling
Mild peelers includes Alpha hydroxy acids (AHAs) and Beta hydroxy acids (BHAs)
Alpha hydroxy acids (AHAs) are usually fruit acids: citric acids, glycolic acid, lactic acid, malic acid and tartaric acid.
Beta hydroxy acids (BHAs) such as salicylic acid are normally better for oily and acne-prone skin type.

Intermediate to deep peeling
Trichloroacetic acid (TCA) is used as an intermediate to deep peeling agent in concentrations ranging from 20-50%. Depth of penetration is increased as concentration increases, with 50% TCA penetrating into the reticular dermis. Concentrations higher than 35% are not recommended because of the high risk of scarring.
Trichloroacetic acid peels smooth out fine surface wrinkles, remove superficial blemishes, correct skin pigment problems and normally require repeat treatment to maintain results. After peeling, use of sunblock for several months is a must.

3. Lasers
A wide variey of light -emitting devices are useful for the treatment of melasma. Q-switched lasers (QS) are currently the gold standard for treating pigmentation/melasma.
QS lasers deliver exceptionally high energy laser pulses with pulse durations in nanoseconds, creating acoustic shock waves within melanosomes, thus removes melanin.
Ablative and nonablative lasers work similarly like chemical peeling, inducing skin resurfacing and skin cells turnover.
Light therapy such as Intense Pulse Light is currently no longer a good modality for pigmentation treatments.

4. Sun protection
Regardless of the method chosen, therapy must be combined with use of broad spectrum sunscreens, preferably more than SPF35.
Clothing and hats should be also used.

Prevention

Daily sunscreen use not only helps prevent melasma but is crucial in the prevention of skin cancer and wrinkles.

Top 10 anti-aging food

What are anti-aging food?
These are food containing antioxidant properties that will help your body fight off the damage caused by aging and environmental toxins.

What are anti-oxidants?
Antioxidants are substances that protect your cells against the effects of free radicals. Free radicals are molecules produced when your body breaks down food, or by environmental exposures like tobacco smoke and radiation. Free radicals can damage cells, and may play a role in heart disease, cancer and other diseases.
Antioxidant substances include beta-carotene, lutein, lycopene, selenium, vitamin A, C & E.

1. Tomato

    Tomato is major source of lycopene, an antioxidant compound that gives its color. The bright red carotene and carotenoid pigment may lower the risk of heart disease, macular degenerative disease, and lipid oxidation, the damage to normal fat molecules that can cause inflammation and disease. It is also said to lower LDL (the bad cholesterols), enhance the body's immunity, and protect enzymes, DNA, and cellular fats. Because preliminary research has shown an inverse correlation between consumption of tomatoes and cancer risk, lycopene has been considered a potential agent for prevention of some types of cancers, such as cancers of the prostate, lungs, stomach, bladder, cervix, and skin. Tomato also contains vitamin C, and other anti-oxidants.

2. Walnuts & Almonds

Walnuts and almonds contain fibres, magnesium, vitamin E, selenium and omega 3. A typical serving size of 1 oz of these nuts will provide you with around 160-180 high-quality calories with between 4 and 6 g of protein and a sizable amount of good-fats (mostly mono-unsaturated fats). In addition almonds are a superb source of the anti-oxidant Vitamin E, while walnuts pack on heart-healthy omega-3 fatty acids and anti-oxidants like melatonin and ellagic acid.

3. Fish

Fish is a great source for omega3 and good quality proteins. Omega 3 fatty acids that are abundant in fish oils are extremely powerful anti-oxidants that can stop the decay of cells and retard the process of aging at the cellular level. Fish oils have the remarkable property of slowing down inflammation, and it is also extremely good for skin. It prevents wrinkles, dark spots, dryness, acne, psoriasis and eczema. It restores the firmness and elasticity of skin, a property that makes fish oil very adorable among anti-aging proponents.

4. Brocolli, Cauliflower or Cabbage

A study published in the British Journal of Cancer, showed that compound called indole-3-carinol (I3C), found in broccoli, cauliflower and cabbage, can increase the levels of BRCA1 and BRCA2 proteins that repair damaged DNA. These anti-cancer nutrients should not be missed in a healthy anti-aging diet.


5. High-fiber, all-bran, or oatmeal cereals

Fiber is a calorie-free nutrient that is necessary for maintaining regular bowel movements, controlling cholesterol and blood glucose levels, and helping with weight loss or maintenance. It has been shown to help reduce the risk of colon cancer. Most adults consume about half of the recommended amount of fiber, which is 38 grams for males 19 to 50 years of age and 25 grams for women of the same age. It is important to get the recommended amount of fiber daily to help prevent age-related diseases, such as heart disease, diabetes, and atherosclerosis, and to help maintain skin health. Include one serving of oatmeal, all-bran, or another high-fiber cereal per day is also vital in your anti-aging diet.

6. Blueberries, blackberries & cherries

Blueberries, blackberries & cherries contain proanthocyanidins, which has strong anti-oxidant properties. They have high oxygen radical absorbance capacity, which has been linked to numerous health benefits such as weight management, cell health, and cardiovascular health. These free radical scavengers may help protect against the effects of internal and environmental stresses such as cigarette smoking and pollution, as well as supporting normal body metabolic processes. The effects may include depressing blood fat, emolliating blood vessels, lowering blood pressure, preventing blood vessel scleroses, dropping blood viscidity and preventing thrombus formation. Additionally, studies have shown that they may prevent cardiovascular diseases by counteracting the negative effects of high cholesterol on the heart and blood vessels.


7. Turmeric/Curcumin

Curcumin is the principal curcuminoid of the popular Indian spice turmeric, which is a member of the ginger family. Curcumin has antitumor, antioxidant, antiarthritic, antiamyloid, anti-ischemic, and anti-inflammatory properties. Anti-inflammatory properties may be due to inhibition of eicosanoid biosynthesis. In addition it may be effective in treating malaria, prevention of cervical cancer, and may interfere with the replication of the HIV. Curcumin acts as a free radical scavenger and antioxidant, inhibiting lipid peroxidation and oxidative DNA damage. Curcuminoids induce glutathione S-transferase and are potent inhibitors of cytochrome P450.


8. Lecithin
Lecithin is naturally found in the foods that we eat, especially rich foods, such as egg yolk, soybeans, grains, wheat germ, fish, legumes, yeast, peanuts, etc. The compound can also be found as supplement sold to the public. Lecithin capsules, powder, or granules are sold in many food and drug stores, often marketed as weight loss promoting supplements for dieters and weight loss enthusiasts. It promotes cardiovascular health, improve liver and cell function, facilitate fat transport and fat metabolism, good for reproduction and child development, treatment for gallstones, improvement in memory, learning and reaction time, promote healthy hair and skin etc.

9. Artichoke hearts

Artichoke hearts detoxes the liver and kidneys, and it contain high fibers. Cynarin, found in the pulp of the leaves, causes an increased bile flow. This diuretic vegetable is of nutritional value because of its exhibiting an aid to digestion, strengthening of the liver function and gall bladder function, and raising of the HDL/LDLHMG-CoA reductase and having a hypolipidemic influence, lowering blood cholesterol. Artichoke contains the bioactive agents apigenin and luteolin. Artichoke leaf extract has proved helpful for patients with functional dyspepsia and may ameliorate symptoms of IBS.


10. Wine

The red wine antiaging benefits have been recognized for quite some time. When consumed in moderation, 1 glass of wine per day, the antioxidants and flavonoids present in the wine provide antiaging benefits to the body. Red wine containes Resveratrol, not only protects the heart, but also makes one's skin glow. There are also good studies that show people who drink red wine on a regular basis have fewer actinic keratoses, significantly lower risk of Alzheimer's disease, cancer, diabetes, and all of the things that go along with aging. People assume that drinking would decrease brainpower as you get old, but the most amazing thing is that regular wine drinkers have an 80% lower risk of developing Alzheimer's disease.