A Simple Guide to Dandruff

A Simple Guide to Dandruff
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What is Dandruff?
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Dandruff is an acute to chronic inflammatory scaly disease of the hairy areas of the scalp endowed with sebaceous glands.

As a result scales that are shedded from the the dead skin cells of the scalp are called dandruff or pityriasis capitis.

What are the Causes of Dandruff?
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The cause of Dandruff is not completely known but are related to three possible factors:

1.Excessive sebaceous or oil gland secretions from the skin

2.the fungus Malassezia furfur has been known to be a possible cause of dandruff.
It metabolises the oils present in sebum to a lipid byproduct oleic acid .This oleic acid can cause an inflmmation in the epithelium of the scaly resulting in the shedding of dry scales.

3. allergic reaction to chemicals in hair oils, cream or gel

Certain oily foods may trigger the production of dandruff

Stress has been known to trigger off dandruff


What are the symptoms of Dandruff?
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Onset is usually gradual.

Symptoms:
1.Flaking of scales from the scalp.

2.Itchiness of the scalp

3.Redness of the skin on scalp, forehead and eyebrows

Signs:
1.Dry, rounded, greyish macular or papular lesions on the scalp.

2.The surface consists of dry scales which can be rubbed off

3.Sometimes the lesions can become crusted

4.Some lesions may become purulent with yellow exudate.

What is the Treatment of Dandruff?
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1.Dandruff shampoo such as Sebutone, Genisol, Selsun will help to remove flakes and reduce the lesions.

2.fungus infection should be treated with antifungal orally with ketoconazole
and topical antifungal lotion and shampoo such as salicylate acid lotion, nizoral or ketoconazole shampoo.

3.For more severe cases with bacterial infection a combination of hydrocortisone and tetracycline ointment can be used to remove infected crusts.

4.General hair hygiene -
shampoo hair daily

Avoid too strong hair cream or gels


What is the prognosis of Dandruff?
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Generally good with treatment.

However recurrences are not uncommon.

General hair hygiene is important.

A Simple Guide to Paronychia

A Simple Guide to Paronychia
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What are Paronychia?
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Paronychia is acute or chronic infection of the tissue surrounding the nails of fingers or feet.

What are the Causes of Paronychia?
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There are two main causes of Acute Paronychia:
1.Bacteria-pseudomonas, Proteus,staphylococus

2.Fungal- candida

Chronic Paronychia:
1.Fungal- candida

2.Bacterial-pseudomonas

Micro-organisms usually enter through injured or damaged tissues from a ingrowing nail or sharp nail.

Tissues around the base of the cuticles becomes infected and inflammed, usually on one side of the nail.

Pus may form and oozes from the infected tissues.

What are the Symptoms of Paronychia?
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1.Acute paronychia:
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1.swollen

2.painful

3.red nail fold

4.may dicharge pus

2.Chronic paronychia
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1.recurrent

2.painful

3.swollen tissues at base of nail

4.pus may be present

5.nail plate may rigid, distorted or invaded by micro-organism

What are the investigations for Paronychia?
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Swab for culture and sensitvity to antibiotics

Exclude Diabetes

What is the Treatment of Paronychia?
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Acute Paronychia:
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1.Systemic antibiotics

2.Incision and drainage of pus

3.Surgical excision of part of the cuticle causing tissue damage(Ingrowing toenails) and the removal of infected lateral nail folds

Chronic Paronychia:
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1.Keep hands dry and use protective gloves

2.Apply anti fungal lotions and creams such as clotrimazole, nystatin

3.Systemic anti fungals such as griseofulvin or ketoconazole

4.Treat secondary bacterial infections with antibiotics

What are the Prevention measures in Paronychia?
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1.Avoid pressure on the lateral folds of the nails

2.Footwear should not be too tight

3.Avoid biting of nails

4.Avoid constant contact with water and soaking in water

5.Cutting of nails should not be too deep

6.Good personal hygience

A Simple Guide to Athlete's Foot

A Simple Guide to Athlete's Foot
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What is Athlete's Foot
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Athlete's Foot is a common disease caused by superficial fungi infection affecting the webs and toes of the foot

What is the cause of Athlete's Foot?
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A group of fungi called dermatophytes thrive in the warm, moist environment of webs and toes of the feet caused by trapped sweats and the closed environment of the shoes.
They grow on the keratin a protein found in hair, nails and skin.

Fungal infection is mildly contagious and can spread by direct contact with the infected skin cells found on socks and other clothing.

What are the Symptoms of Athlete's Foot?
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Symptoms are:
1.Unpleasant foot odour.

2.Small itchy blisters on the soles of the feet.

3.Itchy, scaly, red rash usually in the webs of the toes.

4.cracked, blistered skin of the toes and nails

5.Dry scaly skin on the soles.

What are the complications of Athlete's foot?
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Secondary bacterial infections with cellulitis, lymphangitis and lymphadenitis may occur especially in diabetic patients.

What is the Treatment of Athlete's Foot?
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1.Antifungal powder, creams and oral medicines

2.basic good foot hygiene
It is important to prevent the fungal infection from spreading.
Avoid scratching of the infected area as this will cause the fungi to spread to other areas.

Dry the feet thoroughly after bathing and before sleep.

Socks or stockings should be changed daily.

Anti fungal powder may be placed in socks before wearing.

Clean and air shoes.

Even after treatment and clearing of the fungal infection, recurrence of the infection may take place because of the presence of spores of the fungus under the skin.

The spores are very resistant to treatment and only when they germinate to the mycelia stage, the fungus can be eliminated through the anti fungal creams, ointment, powder or oral medication.

The antifungal creams must be applied each time there is wetness or trapped sweat so as to get rid of the germinated spores.

Once the spores are completely removed from the skin, then you can be sure that the fungal infection will be unlikely to recur.

Treatment may take up to 6-8 weeks before the fungal infection disappear.