Esophageal cancer

Introduction

Esophagus is the narrow muscular tube that runs from your mouth to stomach, forming passage to food you eat. It can be the site one of the lethal cancer of your body, called esophageal carcinoma or cancer of esophagus. It commonly begins to develop in the inner lining of your esophagus, but may involve other outer layers. It is malignant and have tendency to spread beyond esophagus to distant parts and organs of your body. Esophageal has very slow progress with minimal early symptoms. This one factor makes survival rate after treatment very low. By that time it is commonly diagnosed it has already spread to other parts of your body or to adjacent structure with serious and lethal effects.

Most common location of your esophageal cancer is lower third of the tube like structure.

The common factors which predict development of esophageal cancer are heavy alcohol and smoking. They act as chronic irritant in your cancerous esophagus.

Ÿ  Incidence of esophageal cancer ; The esophageal cancer has been encountered more commonly between age of 65 years-75 years. Men are effected more than women at ratio 4:1 worldwide. Being tenth most common cause of death due to cancer all over globe. It is very rarely seen in children.

Risk factors

Ÿ  Smoking of cigarettes, cigars and pipes are very strong provoking agents for your esophageal cancer. Among the leading risk factor smoking has been found to be greater risk in squamous cell carcinoma than in adenocarcinoma. The mechanism involves the release of carcinogens from tobacco smoke such as nitrosamines. These may initiate esophageal cancer growth in squamous cells layer of your esophagus. Duration of your smoking habit plays significant factor to increase your risk for esophageal malignancy.

Ÿ  Alcohol in excess has been risk factor for several cancers, likewise it plays its role in making you more susceptible for esophageal cancer. If you drink alcohol in larger volume even for short duration your risk for esophageal cancer increases greatly. The same will not be true if you drink alcohol in moderation for longer periods. Heavy drinking called binge together with cigarette smoking enhances your risk for squamous cells carcinoma of esophagus.

Ÿ  GERD syndrome is acquired condition in which acid from stomach reflexes back into esophagus causing chronic erosion at lower part of your esophagus. This constant irritation damages the squamous cells of esophagus converting them into cancer developing cells in long term. Adenocarcinoma is the type of esophageal cancer which grows due to this abnormality. Hyperacidity in lower esophagus thus can create risk for you esophageal cancer.

Ÿ   Barret’s esophagus is precancerous condition developing as result of acid reflux into esophagus from your stomach. During long standing exposure of the cells of lower esophagus to stomach content, changes into glandular columnar type. This cellular change or dysphasia  has great risk for esophagus cancer of adenocarcinoma type.

Ÿ  Obesity is risk for your developing esophageal cancer. This is attributed to gastro esophageal reflux. The heavier the weight you carry will put more intra-abdominal pressure on gastro-esophageal junction. This factor increases GERD symptoms and adeno-carcinoma risk.

Ÿ  Taking meals hot and drinking hot liquids like tea, coffee increases your esophageal cancer risk. Consumption of drinks with very high temperature has been shown as almost four fold increase in risk of esophageal cancer (study done in high risk areas of southern America, Argentine, Brazil, Uruguay and Paraguay).

Ÿ  Race of African origin is almost 3% more at risk of esophageal cancer than whites.

Ÿ  Age factor predisposes greatly on any chronic illness like cancer. Esophageal cancer will appear more commonly after your 45^th birth day. Risk becomes greater at 65 years and more.

Ÿ  Esophageal cancer is more common if you are living in developing country. This risk is based on nutritional deficiencies because of scarcity of fresh fruits and vegetable in your diet. There is more consumption of chewable tobacco, which is well known strong risk for esophageal cancer. Squamous cell carcinoma is more prevalent in dietary deficiency than adenocarcinoma variety.

Ÿ  Plummer Vinson syndrome, a triad of iron deficiency anemia, inflammation of tongue and dysphagia is linked with squamous cell cancer. It is an inherited condition( passed on from one generation to another).

Ÿ  Radiotherapy to your chest for some other cancer will put you in greater risk of esophageal cancer in later years of life. Risk of esophageal cancer in women who were treated for breast cancer by radiotherapy have shown two fold rise( study done in southeast of England). Similar studies done in north America have revealed that individual who underwent radiotherapy for Hodgkin’s lymphoma develop esophageal cancer in 15-20 years time.

Ÿ  Males are more at risk of developing esophageal cancer than women. It has occupational hazards, smoking and alcohol playing co-factors. Exposure to trichloethylene and soot dust(black dust particle fumes from coal, wood and oil burning) increases the risk in men.

Life style Support and Prevention

Life style and home remedies

Esophageal cancer carries grave prognostic outcome. you will be detailed about the seriousness of your esophageal carcinoma, the treatment and their side effects.You  should make yourself strong and understanding about prevailing condition on you. Your own composure and will to live and withstand all ill effects of your esophageal cancer can make your survival better and less distressing and depressing. This situation may create a change in your thought process how to cope. Making all positive changes that were missing or getting rid of negative and harmful habits will improve your health emotionally and physically, even with esophageal cancer.

Ÿ  The most common factor which may have caused your esophageal cancer is acid reflex disease. The best way to ease the difficulty is to avoid food which may increase your stomach acidity. Eat food which are not spicy. Small frequent meals will also combat the discomfort of GERD with your cancer. Sleeping with your headend raised will greatly help prevent gastroesophageal reflux.

Ÿ  Swallowing difficulty is most predominant complaint. Eat food item which are cooked to texture suited for your extent of ease to swallow. Take liquids which will not only be easy to swallow but also nutritious. Fresh fruit juices and milk shakes can be your best choices.

Ÿ  Seek advise from diet expert about how to cope with lack of deficiency of important vitamins which may result because of your slow and difficult food intake. If your oncologist/healthcare provider recommends take vitamin supplements to gain strength.

Ÿ  With consultation from your doctor keep active before and during treatment. This will keep your blood circulation to optimum best.

Ÿ  The surgical correction may cause dumping syndrome. This is combination of symptoms of sweating, flushing and diarrhea after taking food. Eating balanced diet and keeping lean weight will help you combat such distresses on long term management.

Ÿ  Take ample rest and avoid undue fatigue. Although the intense chemo, radiotherapy or surgical remedies must have wear you out significantly, but studies have shown that adopting some degree of physical exercise according to your suit will have dual effects of physical as well as mental well being.

Ÿ  Quit smoking forthwith. This will help you in your treatment outcome much better. It will also enhance your longevity after esophageal cancer treatment.

Ÿ  Post treatment consultation with your oncologist/healthcare provider should be maintained. Follow up physical examination and investigation such as scanning or endoscopy will indicate progress of effects of treatment, whether surgical or otherwise.

Alternative medicine

The alternative and complementary medicine has still not been proved to assist in curing your cancer. It surly does help to comfort you from pain, stress and physical and emotional fatigue from your esophageal cancer. They may also counteract the side effects of your treatment. Some time and tested alternative remedies in your esophageal cancer are ;

Ÿ  Acupuncture technique comprises of piercing needles into specific pressure points in your skin. This relieves symptoms of nausea, vomiting and pain accompanying your esophageal cancer and its conventional therapies.

Ÿ  Massage will help your tense muscle and nerves to relax. It involves gentle kneading, rubbing and pressure massage of various parts of your body. It helps minimize anxiety, fatigue and other emotional distresses of your esophageal cancer.

Ÿ  Meditation is done with help of some expert guidance. Breathing exercises, practicing to imagine peaceful surroundings happy events and images will bring back your spiritual well being.

Ÿ  Yoga and tai chi involves stretching and deep breathing exercise. It will keep you active during your esophageal cancer treatment. It will also allay your stress and assist in good sleep.

Ÿ  Aroma therapy is based on the logic of soothing effects of scents on your mind. It uses scents from plant extract, which will make you feel relaxed, control your nausea and stress.

Coping and Support

Ÿ  Stay connected to your friends and close relatives besides your own family. Share and care role will lift your own spirit. During recovery this will help you feel wanted and involved in life. Seek help from them if you want.

Ÿ  Keep yourself abreast with your esophageal cancer status. Asking your doctor in detail about your esophageal cancer prognosis will give you sense of anticipation and readiness of things to come and how to deal with them. Read magazine on esophageal cancer. Search internet for latest information on your esophageal carcinoma.

Ÿ  Join group specific for cancer or individuals with esophageal cancer. Listen to their feelings and be open to express your own. It will generate new energy and vitality of your thought process. Some of those discussions may bring new revelation about coping and modality towards improvement in your daily life.

Ÿ  Acquire some leisure habit. Having some fun will help enjoy life and stay calm. Chose reading good material as hobby. It will keep you stay focused in present.

Ÿ  Volunteer work at charity or helping out other cancer patient will make you feel happier and useful to community even with your own esophageal cancer handicap.

Prevention

The latest approach in medical practice is based on preventive aspect of any disease or disability. Same is true for your esophageal cancer.

Ÿ  Quitting smoking will remove one risk factor which will reduce risk from all kinds of cancers, including esophageal cancer. It will also keep you protected from some other health hazards of smoking. Sometimes giving up smoking is not that easy. There are alternate or replacement substances available that will help  you get rid or smoking in a way that would be less demanding on you. Nicotine  gums, skin patches and spray have proven record in your efforts to give up smoking.

Ÿ  Binge drinking is risk for esophageal cancer. Drinking in moderation and making it a strong habit will minimize your risk for esophageal cancer.

Ÿ  Reduce weight if your carry weight greater for your height. A BMI below 25 of standard should be the aim. Avoid calories, exercise regularly daily for 15-20 minutes, five days a week can easily help you achieve your goal. This one factor will counter your GERD very effectively.

Ÿ  Diet rich in fresh fruits and vegetables will go long way in helping weight management and acid reflux disease. Though seems difficult to you to have at least five daily servings of fruits and vegetables but its worth a price for preventing esophageal cancer.

Ÿ  Having constant complains of heartburn and stomach pain is risk for GERD. Get it treated in proper way by your family doctor/healthcare provider. This is one of major rsik for esophageal cancer and Barret’s esophagus.

Natural treatment

Black Cumin

Being used since the earliest of times, Black cumin seeds (Nigella Sativa) have shown to be a remarkable cure for many diseases. More than several studies have shown the specific benefit of black cumin seeds in countering Esophageal cancer. The oil of the black cumin seeds enhances the production of immune cells, anti-bodies and bone marrow. For cancer therapies it has been shown to suppress tumor growth by 50%. Increased immune response leads of better cancer targeting. Black cumin seeds can also effectively help reduce the aggressiveness of cancer cells that lean on angiogenesis.

Curcumin

The essential curcuminoid of the spice turmeric, curcumin has been known for ages for its use in treating a variety of illnesses. Its greatest benefit is its anti-carcinogenic effects. Its effectiveness in treating esophageal and other cancers lies in its property of causing apoptosis in cancerous cells without harming healthy cells. A study conduction in 2009 on the effects of curcumin states that, " curcumin modulates growth of tumor cells through regulation of multiple cell signaling pathways including cell proliferation pathway (cyclin D1), cell survival pathway (Bcl-2, Bcl-xL, cFLIP, XIAP, c-IAP1), caspase activation pathway (caspase-8, 3, 9), tumor suppressor pathway (p53, p21) death receptor pathway (DR4, DR5), mitochondrial pathways, and protein kinase pathway (JNK, Akt, and AMPK)"(Ravindran J., 2009).

Quercetin

Also known as Meletin and Sophretin, Quercetin is a flavaniod, found in most plants, where onions, apples and tea are some of its sources. Preliminary studies have shown the effectiveness of Quercetin against cancer and other diseases, due to its anti-inflammatory and anti-oxidant properties.  Quercetin can either be found in the skins of plants, or can be taken in supplement form. Supplements range in doses of 50-500mg, although appropriate dosage of Quercetin is unknown. Studies conducted in-vitro against the effectiveness of Quercetin has shown positive results. It has been shown to foster apoptosis (cell death) in cancerous cells. Knowledge of the benefits of Quercetin has been limited though, due to the lack of conclusive research.

Resveratrol

 Resveratrol, a natural phenol, is a chemical that is produced naturally by plants when they are attacked by pathogens like fungi and bacteria. The effectiveness of Resveratrol is a widely discussed topic in human and animal studies. Initial research has shown the anti-inflammatory and anti-cancer properties of this natural chemical. Sources for Resveratrol are the skins of red grapes and other fruits. Preliminary studies on rats treated with a carcinogen have shown that Resveratrol (1mg/kg orally) has reduced the size and number of esophageal tumors to a substantial degree (Hong T., 2002). It has also been shown to cause apoptosis in smooth muscle and platelets (Huang Y., 2002).

Although esophageal cancer has very poor prognosis. This is due to its early spread as well as slow progress and late diagnosis. Even then as long as healthcare is being given, you should keep your spirits high and take good care of yourself. A good nutrition will play a major role in maintaining your energy level high. With your doctors advise use supplements to boost any deficiency anticipated. They have proven efficacy to help you overcome the stress and side effects of your esophageal cancer and its treatment.

Another of my daughter's poetry

Shall I Write Another Verse

By Tazeen Razi

Shall I write another verse?

Shall I dare to say...

You look at me like a flower bent

O’er the water-bed,

Where lilies float and swans recline,

Where everything is blue

Like a sparkling drop from the heavens sent

Just for you.

Shall I speak like a poet speaks

To his beloved, divine?

Shall I dare to take that pretty hand,

Right into mine?

Of all the things that you say to me,

Of all the love that you give,

I have but one thing to give back to you

Your own eternal Bliss.

Cataract ,Life style factors, Support and Prevention.

Cloudy or milky appearance of your eye lens is termed cataract. It is one of the commonest eye defect and cause of blindness worldwide. You need a crystal clear lens which would send a sharp image to the back of lens called retina. With cataract in your eye/eyes your vision becomes hazy or diminished. Although quite common with aging, in most cases it does not require treatment. When it is causing visual disturbances it does have to be surgically taken care of and removed through one of the simple procedures available. With all pre-surgical condition ideal, cataract effected lens removal has high success rate with restoration of your normal vision.

You may be effected by cataract in one or both lenses of your eyes. And your eyes may be effected by opacity of your lens at different time. It is slowly developing abnormality which is usually not associated with any pain or eye redness. Aging is constant cause of your cataract but there are several other factor playing their role in causing clouding(cataract) of your lens.

Ÿ  Incidence of cataract ranges from 55% to 60% over the age of sixty years. Both male and female are effected by cataract equally. In US, and UK almost 50% population is effected by cataract in their old age. In very rare instances baby may be born with cataract or they may develop this anomaly as younger child.

Ÿ  Symptoms of cataract are attributed to failure of  light or image to pass through the opaque lens. Initially the opacity may be smaller ,but when not taken care it becomes wider in dimensions. This may cause you following symptoms;

-           blurred vision

-           diminished vision at night

-           colors appear faded

-           double vision in one eye

-           difficulty in seeing in glare or sun light

-           heightened nearsightedness

Life style factors, Support and Prevention

It is a well known fact that aging will bring you closer to developing cataract. If you want to minimize your risk, the foremost lifestyle modification that keeps your lens in healthier state will be dietary changes. It  has been studied that individuals who eat more of animal protein have greater risk of cataract. Reducing meat and adding more fresh vegetables and fruits in your platter will keep your vision in good standards longer (researchers at University of Oxford 2011, report published in American Journal of Clinical Nutrition). Other home remedies that will help you improve your vision and relieve some of your cataract complication till you go for definitive surgery are mentioned here;

Ÿ  Wearing sun glasses during outdoor work will help your vision greatly. It will help avoid UVA and UVB, reduce the bright sun ray effect and glare. These are not well tolerated by your cataract effected eye/eyes.

Ÿ  Wearing a hat has same effect of protection from strong sunlight and fluorescent light. Sun rays are most intense between 10am to 3am, so you should be well aware of this fact to minimize further damage to your lens. Use non-fluorescent bulbs or special bulbs to illuminate your indoor lighting of home.

Ÿ  Wear magnifying glasses for reading purpose. This may help you busy in your office task till you have surgical correction done.

Ÿ  Communicate with your doctor/healthcare provider regularly. Keep him up dated with any changes in your visual complaints. When deem necessary make visit and have eye sight and any worsening of your cataract checked.

Ÿ  Reduce salt and saturated fats in your diet. Butter, lard and coconut oil should be avoided to minimize your cataract risk as they contain high concentration of saturated fats.

Ÿ  Eat more of fish and chicken breast to get healthy proteins, which is essential for your general health and integrity of your lens.

Prevention

The precise cause of your cataract is not known. But minimizing risk factors is the best prevention, to keep your eye sight normal and unaffected by cataract. Your cataract is incurable and neither can it be reversed with any medicine. You can adopt certain measure to prevent its occurrence in some cases or delay its progress.

Ÿ  Quit smoking with help from your healthcare personnel. He may prescribe nicotine replacement treatment methods. This includes nicotine patches, gums, inhalers. They release slow nicotine which is much lower in concentration. This will allow gradual withdrawal from your smoking without causing any symptoms.

Ÿ     Alcohol should be avoided if you want to prevent cataract in aging. You can also minimize risk by drinking in moderation.

Ÿ  Diabetes should be controlled with diet and medication, as your cataract risk runs parallel with poor diabetic state. You should be communicative and compliant with your doctor. He will guide you how to manage your diabetes and avoid related complication, specially effecting your eyes.

Ÿ  Supplement which have vitamins beneficial for your eye’s health, particularly of lens can be added. That may include beta carotene, vitamin C and E. These anti-oxidants keep glutathione levels high, which help in protection against effects of oxidants on your lens.

Ÿ  Regular eye check stands on top of all preventive measures. Your opthalmologist will maintain your eye health status. He will keep you up date about all the details about your lens and deeper structures of your eye after each visit you make. His advise should be followed. That alone in an excellent and most effective way to prevent cataract development.

Ÿ  If there is family history of cataract genetic counseling is advised .

6.0     Natural Treatment

Beta Carotene

An inactive form of vitamin A, beta carotene can be found in foods with orange, yellow, green and red pigments such as carrots, sweet potatoes, squash, bell peppers and spinach (Office of Dietary Supplements: Vitamin A and Carotenoids). Also known as pro-vitamin A, beta carotene is known to reduce the risk of age related cataract by one-fourth (Arch Ophthalmol. 2003 Mar;121(3):372-8). It is known to protect the cornea and is a cure for every eye-related illness you may be effected. Being a potent anti-oxidant, b carotene protects smokers from developing cataract (Age related eye study ,America, 2003). Other carotenoids like , xanthophylls, inhibit development of aging in your eye and protect lens from cataract. It is present in abundance in green leafy vegetables, broccoli and eggs.

Curcumin

One of nature’s finest miracle ingredients, curcumin reduces the oxidation of the eye and protects from its damaging effect. It is an antioxidant that safeguards the eye from the onset of cataract (Curr Eye Res. 2010 Feb;35(2):122-9). This substance, which is also known as curcuma longa, is an ingredient of turmeric and is famed to be anti-cataractogenic (Invest Ophthalmol Vis Sci. 2005 Jun;46(6):2092-9). Curcumin is also famed to delay diabetes-induced cataract (Investigative Ophthalmology and Visual Science Journal, Dr. Palla Suryanarayana et al.,  2005). The mechanism by which curcumin influences its anti-oxidant effect, is by removing free radicals from your body. These free radical are there to cause damage to your lens and cause cataract. 

Grape seed extract

Obtained from red grapes, the intake of grape seed extract (GSE) reduces the risk of cataracts (J Agric Food Chem. 2002 Aug 14;50(17):4983-8). Being an antioxidant, grape seed extract suppresses the formation of cataracts (J Cataract Refract Surg. 2006 Jun;32(6):1041-5). Grape seed extract is rich in flavonoids that have anti-oxidant properties greater than Vitamin C. It has been shown to improve circulation in eyes micro-vessels which appear to be narrowed by certain diseases. This delays the progress of cataract in your eyes. Grape seed extract is also beneficial in computer screen related eye stress. It eases such stress and improves contrast perception in 60 days of treatment with supplement containing 300mg.

Selenium

Selenium, which helps increase the absorption of antioxidants, is necessary to fight cataract off along with the aforementioned natural ingredients. Glutathione peroxide is an antioxidant enzyme that prevents the eye from cataracts. Selenium is found in nuts, seeds, seafood, meat, poultry, onions, mushrooms and grains. It has been studied that selenium in higher than normal concentration is harmful to lens. Similarly , a low selenium level can effect integrity of your lens (2006 study. So it is clear from these facts that even smaller amount of selenium , by acting as anti-oxidant, can prevent cell damage by free radical and removing them from your body. This specially effective in chronic conditions like cataract.

Vitamin E

Vitamin E as an anti-oxidant has been studied and shown to prevent and slow down the development of cataract and other eye defects. In one study lens clarity was detected to be better with high vitamin intake group compared to non-vitamin E group. In another group study long term Vitamin E supplement has shown to slow the progression of age related cataract formation. The foods that have good concentration of vitamin E are nuts and sun flower seeds.

There are few other natural ingredients that have positive effect on preventing your cataract. One of them is omega-3 fatty acid (American Journal of Epidemiology). Easily available source, all these natural ingredients benefit so many human ailment when taken in proper way and dosage. If ever you choose to supplement these vitamins and natural elements, you should always consult your health care provider for dosage, need and frequency/ day.

Folliculitis and Chronic illnesses

Folliculitis may affect any person at any age or sex. Its an inflammatory condition of hair follicle. It is well distributed to parts of skin which have hair. The common sites are  scalp, face (including bearded area), armpits, chest and back, thighs and buttocks. It can occur in absence of any underlying illness with unhygienic living. But it has some known association with few underlying chronic debilitating diseases. What ever the underlying reason the lesion has typical red pimple, itchy, with a white head effecting one or more than one part of body. It does not effect palm of hand, sole, or mucous membranes.

Some chronic illnesses associated with follicultis are:

1) Diabetes and folliculitis: These individuals have weaker immune system as well as higher average blood sugar concentration, which provides favorable conditions for all kinds of yeast, fungi, and bacteria to infect. They show delayed healing of skin wounds.

2)  HIV and folliculitis: Whether asymptomatic HIV positive person or person suffering from AIDS has weakened ability to fight against micro-organism because of suppression of  immune system. Folliculitis with appearance of red pimples may be the first sign in HIV positive individuals. It almost always effects homosexual males and very rarely in HIV positive females.

Human immune deficiency virus related follicultis is commonly known as eosinophillic folliculitis.

Eosinophilic folliculitis: This type of folliculitis is almost always encountered in HIV positive or AIDS patients, for unknown reason. But it may occur in pediatric population and those receiving organ transplants. Skin eruption seen is erythematous, papules on the facial area including forehead, behind the ears, and neck. The other common sites are trunk, head and proximal extremities. It has itchiness. Eosinophilic folliculitis may be the first sign of immunosuppression in children or adults.

The eosinophilic folliculitis is commonly non-infectious and there is only infiltration of eosinophils inside hair follicles of effected area of skin. The classic presentation is pustular folliculitis.

Treatment of eosinophilic folliculitis is mainly based on topical application of steroids. Its anti-inflammatory and anti-pruritic effects makes folliculitis get better. Using any formulation of antihistamine is also quite beneficial in relieving irritating itch.

Highly active anti-retroviral therapy has changed the treatment response of most of skin condition in HIV patients, that includes eosinophilic folliculitis. It dramatically results in regression of folliculitis and speeds healing.

There are micro-organisms causing follicultis in HIV positive and AIDS patients. They  attack quite frequently in all immunocompromised individuals. They most commonly belong to class yeast, pityrosporum is the one responsible. It effects upper arms, chest, shoulder, back and occasionally face. Other common infestation is caused by mites of Demodex variety. Demodex effects facial area near nose, cheeks, eyelashes and eyebrows.

Treatment of  Demodex follicultis in HIV cases is to first identifying the mite. It is done by scrapping obtained from lesion at eyebrows treating it with hydrogen peroxide and examining under microscope.

A combination of crotamiton 10% and benzyl benzoate for two weeks on the affected area of the skin works wonders. It is not to be applied on eyes affected with demodex, as intense irritation can occurs. For eyebrow and eyelash infestation by demodex in HIV, combination of tobramycin and dexamthasone three times  daily for two to three weeks suffices.

Pityrosporum folliculitis in HIV patients is managed by adopting good personal hygiene, which is basic of treating any skin infection. Another ideal treatment is the application of local lotions and creams. Salicylic acid solution used after showers keeps the skin dry.

Ketoconazole shampoo 3-5 times weekly or as cream applied twice daily till the lesion is healed and organism eradicated. Econazole  cream can be used as second choice.

Selenium sulfide lotion is very effective applied daily for two weeks can eradicate pityrosporum yeast.

Oral anti-fungal itroconazole or fluconazole 100-200 mg once or twice daily for two weeks controls fungus effected folliculitis in HIV  patients.

The basics of personal hygiene always must be mainstay of management.

Folliculitis in women: Genuine Cosmetic Issue

Unhygienic habits in daily life are among the commonest causes of many skin conditions. Folliculitis, for one, can easily develop due to same reason.  Using old blades for shaving, not showering regularly are some of factors for folliculitis to allow microbes invasion and flare up. Although  folliculitis does not have any predilection to sex or age but women can become more prone. This is because there are factors apart from common ones,  which predispose to folliculitis in women. In  women cosmetic procedure can become an added risk.

There are common factors like hot weather, using common swimming pool which is being used by some infected individual, hot tubs, sharing towels at ladies gyms, even sharing common cosmetic items can make women more prone to get folliculitis.

The distribution of hair follicles is generally same in men and women. But other than hidden body areas normally a woman does not have visible hair on exposed parts, particularly face, neck, legs and chest region. If this occurs, it gives the picture of female hirsutism. this condition is hormone dependent. Either there is excess of or increased sensitivity to normal amount of androgens. That causes undue thickness and faster growth rate of hair, specially at the facial area.

For a female the situation is quite embarrassing. The method adopted generally to get rid of unusual and prominent hairs are plucking, shaving and waxing. These procedures can cause damage to hair follicles pretty easily. Once that happens, it can give rise to folliculitis in women. The procedure has to be repeated quite often and that becomes an added risk for spread and complication of folliculitis in women.

Rash of folliculitis in women is same as in other groups. So are the general protocols of treatment. Immaculate hygiene with regular baths using anti-septic soap is a good idea. Cleaning the effected area of skin with benzyl peroxide and drying it with a warm damp cloth cleans the debris too.

Shaving and other methods adopted to get rid of unwanted hairs should be meticulously cared for. When the folliculitis has set in, leg shaving should be stopped until measures to clear the infection have been done. Meanwhile unwanted hair of  folliculitis in women can be removed by electrolysis and laser techniques. Both involve using tools to remove individual hairs.

Causative bacteria is commonly staphylococcus aureus. When  isolated from cultures of infected skin lesion, proper anti-biotics are given. The choice can be made from cephalexin, flucloxacillin and dicloxacillin in a dose range of 250-500mg three times daily for 10 days. Women regularly using common hot tubs have greater chance of getting pseudomonas infection. Benzoly peroxide wash is required in mild infection which clears folliculitis in women. The parts effected parts  of body in hot tub folliculitis in women are belwo the trunk. In more exuberant cases of ciprofloxacin 500 mg twice daily for 5-10 days may be needed.

Other than the aforementioned conventional and non-conventional methods, specific drugs have to be used in folliculitis in women who have hormonal imbalance. They include use of anti-androgenic medicine as well as oral contraceptives. The effects are though slow but ultimate results are quite rewarding for thickness as well dark unwanted hairs disappear. This itself minimizes chances of folliculitis in women.

Folliculitis of scalp

The inflammation of hair follicles in its simplest form appears as a small bump on part of the skin which has hair follicles. Treatment is also based on simple management, with remedies which can be readily made available at home. As the condition of folliculitis has no predilection for age, sex or region, it is one of most common skin ailments. It can appear in any part of the body except the palms of hands, soles of feet and the mucous membrane.

Anatomical location may be widespread at one particular instance as the autogenous extension of folliculitis is very common when personal hygiene is not maintained to good  standards. But even in that case, the morphology of causative or infective organism may differ widely in different locations. The common areas observed to be effected by folliculitis are the facial area with predilection for shaving region, underarms or armpits, scalp, thighs, buttocks and legs, in that order of frequency.

Scalp folliculitis is very common for being most hairy part of body. It is more prone to all kinds of skin infection since it sweats more and being oily it can provide breeding ground for micro-organism who grow on such favorable surroundings. Follicles also get exposed after deep combing allowing invasion of bacteria inside and triggering folliculitis. Like folliculitis in any other location on  skin, scalp inflammation too starts as redness of surrounding skin with appearance of small bump. Two different causes provoke scalp folliculitis. Infectious  folliculitis and non-infectious folliculitis.

The difference in etiology will determine the protocol of treatment. Infectious variant, as name suggests is caused by either one or more of microbes present on skin of scalp or get into from unclean surroundings. It can be effected by bacteria, fungi, parasites or viruses. Non-infectious type is seen in oily scalp.

The  most common and annoying part of  scalp folliculitis is severe itching which can further aggravate an already existing inflammation by damaging more hair.

Treatment of non-infectious scalp folliculitis is based on keeping scalp area as much dry as possible and not letting it get greasy.  Luke warm or cold showers are advisable  instead of hot, as taking showers with hot water will enhance the oily secretion from sebum secreting glands. Salicylic acid or zinc containing shampoos can solve the problem of oily scalp. It is preferable to use these preparation till the scalp folliculitis subsides completely. Local steroidal creams will minimize the annoying symptom of itching.

Infectious scalp folliculitis is commonly caused by staphylococcus aureus, which needs regular wash out with anti-septic soap or lotion,  anti-pruritic steroidal creams, and warm swabs on effected area to clear debris of dead skin in  and around the effected skin.

The choice of anti-biotics to be given orally are either,  cephalexin  or Dicloxacillin or flucloxacillin, dose ranges from 250mg -500mg four times daily for 10 days.

In case of superadded fungal infection, local anti-fungal shampoo baths may suffice. Ketoconazole or econazole are very effective in this regard.

Last but not the least important is alopecia areata, which may occur if complication sets in. Oral or  local injectable steroids can result in re-growth of  lost hair.

Benign paroxysmal positional vertigo.(BPPV).

Introduction

The definition of vertigo is quite simple. It is a feeling as if you are spinning, though in reality you are stationary. Benign paroxysmal positional vertigo is one of the commonest variant of vertigo, which is featured by attacks of severe spinning when you move your head. It can occur ,in lying ,sitting or standing position, or at times when you are looking up the roof. 

It is in precise terms, paroxysmal Positional Vertigo, as it occurs in sudden episodic attack form, from mild to severe intensity. BPPV is mainly concern and caused by disturbances in balancing system of body, control by vestibular apparatus(labyrinth) located inside the middle ear. It just happens to effect you suddenly ,without any reason. It may last for few weeks and then you go in remission.

 Life style factors, Support and Prevention

Life style and home remedies

As the condition of vertigo you are experiencing is diagnosed to be benign paroxysmal positional vertigo, you must take all precaution to maintain a healthy and safe routine life.

The worst case scenario in your BPPV is getting injured while the attack of vertigo comes suddenly. While at home follow these instruction :

Ÿ  During attack sit or lay still as long as the vertigos last.

Ÿ  Always have some family member around when you know you are not completely out of danger of another episode of vertigo. Keep your head raised to some extent, and avoid fall by seeking help to move . Using supporting stick can be a good preventive measure while you need washroom facility.

Ÿ  While in bed drink lot of fluids to avoid dehydration.

Ÿ  Do not drive when you have an attack or operate any machinery or work at heights. All these situation may endanger your life if you get a paroxysm of dizziness/vertigo. Take leave of absence from work of such nature until your doctor advises you to do so, taking all necessary test and examination in consideration for your fitness. 

Ÿ  Keep a good compliance with your doctor’s advise with regards to use of your medication as long as needed.

Ÿ  Avoid sleeping on side of troubled ear.

Ÿ  It is advisable to use two or more pillows when you sleep.

Ÿ    While you wake up in morning try to make slow moments at first, instead of sudden twist or turns of head. That can provoke an attack of vertigo.

Home exercises

These simple to perform exercises are aimed at dislodging the otoliths and reposition them at utricle, which is the main cause of your vertigo. Couple of useful self-to-do exercises are explained for your guidens:

Ÿ  Brandt-Daroff exercise can be done by sitting at your bedside, head turn on one side 45°, quickly lay down on bed opposite to turned side with your nose up.Keep yourself in this position for 30 odd seconds. Sit up and do the same, now beginning on other side. Repeat procedure at least 5 times.

Ÿ  Romberg exercise is carried out while you stand with your feet closed together, and arms by the sides. Hold this position for 30 seconds. Twice daily repeat of same exercise will help build up your balance strength.

Prevention  

Ÿ  If you are frequent motor bike rider, baseball player, use helmet to avoid head injuries and be safe from BPPV, as vertigo due to head injury is very common at younger age group.

Ÿ  At home installing support bars at toilet and bathtub will make you more safe from getting a fall if you have balancing problem due to BPPV.

Ÿ  Try your best to be more active, taking all necessary precautions. This will make your brain more adopted to quick recovery. As it has to learn to ignore false stimuli from your inner ear, the root cause of your HPPV.

Ÿ  Take regular yearly flu shots, as BPPV, may result from post viral complication due viral neuronitis.

Coping and Support

Your  benign paroxysmal positional vertigo is spontaneously receding condition. All you have to manage is, while you let it subside, follow measure to help avoid injuries and complicate, otherwise a benign condition. Take your medication on time as advise. They will minimize symptoms. Take all the support you can get from your doctor and family member during this recovery phase. Understanding the fact that your BPPV, is not life long disorder and will disappear in due time will make you much stronger in gaining confidence.

There is always a positive outcome of joining groups or individuals with BPPV and discussing ways and means to cope the situation in collective way. Sharing difficulties and finding some small details to compensate will help you and your family. As your symptoms start receding, it is advisable to join your job place and become more active and show productivity.

Natural Treatment For Positional Vertigo

CoQ10

One of the best natural supplements that helps treat positional vertigo is coenzyme Q10, also known as CoQ10 ("Prescription for Nutritional Healing"; Phyllis A. Balch, CNC; 2010). This substance is found in body tissues but is accepted to decrease with age. It is an influential anti-oxidant and diminishes brain neuron damage. It helps in restoration of effective circulation to your central nervous tissues. It is one type of energy synthesizer, by acting as coenzyme in ATP production. It is effective anti-aging substance, thereby preventing degeneration of labyrinth apparatus. This have been implicated in age related BPPV. It can be obtained from foods like fish, meat and soybean  and canola oil.

Ginger

Ginger is a very safe alternative for relaxing your vertigo. It can be taken every few hours as per need (National Library of Medicine: Vertigo-reducing Effect of Ginger Root). This root can be consumed in the form of powder and ginger tea. Ginger-ale is also known to do the trick. For years, ginger has been used as an anti-nausea and without a doubt, it is effective on patients with benign paroxysmal positional vertigo too (Dr. Sharol Tilgner, author of Herbal Medicine From the Heart of the Earth). It also cures motion-sickness (Grontved A et al 1986; Grontved A et al 1988).

Ginkgo biloba

Yinhsing and silver apricot - known to us as ginko biloba - is essentially a living fossil since it’s been around for longer than 200 million years. This Chinese medicine treats vertigo and its many symptoms including dizziness, cerebral insufficiency and cognitive impairment. It contains antioxidant flavonoids, terpenes and polyphenols. Ginkgo biloba hold anti-inflammatory properties too and its terpenes are acknowledged to increase circulation and oxygen flow to the brain and ears (MayoClinic.com; Ginkgo (Ginkgo Biloba L.); Natural Standard Patient Monograph; Staff; July 2011). It also helps overcome the feeling of nausea (American Hearing Research Foundation: Benign Paroxysmal Positional Vertigo BPPV). Ginkgo biloba also lessens dizziness by 65 % (Cesarani A et al 1998).

Vitamin C

You  can get ample vitamin C from citrus fruit, green pepper, broccoli, dark green leafy vegetables. Yet another natural remedy for vertigo, it fights free radicals. Vitamin C, being an anti-oxidant allays the harmful effects of free radicals on DNA, tissues and cell membranes. This vitamin if taken regularly has shown to provide complete remedy from your vertigo in BPPV. One of most important effect vitamin C has that it reduces the risk of peripheral vascular disease that plays significant role in degeneration of nerves and other tissues of body. The susceptibility of labyrinth degeneration is easily overcome if you take this vitamin if you are in older age group.

Vitamin B6

Among the types of positional vertigo happens to be drug-induced vertigo. For that, luckily we have vitamin B6 which helps alleviate it (Claussen CF et al 1988). It alleviates symptoms of nausea vomiting, associated with BPPV. Found in good concentration in beans, banana, walnuts, spinach , peanut butter and avocados. This vitamin has very essential role in building your immune as well as nerve system. It exerts its indirect effect to curb vertigos, by improving your hemoglobin status and anemia , which can aggravate your existing BPPV. If you have been diagnosed suffering from viral neuritis causing BPPV, using B6 supplements will help in restoring the effected nerve strength and functions.

While you have a choice of using all the natural ingredients  as supplements, it should always be after you have discussed the cons and pros associated with them. Some of the ingredients may interact with conventional drugs you  are taking. The role of all the existing and discovered natural elements is undeniable and proved successful in alleviating symptoms in several debilitating illnesses. Your benign paroxysmal positional vertigo is one of them.