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Dermatographic Urticaria is a common form of physical urticaria where linear wheal occurs when skin is stroked with a firm object. The wheal may occur rapidly within 5-10 minutes and usually fades within 20-30 minutes. In some cases wheal may develop slowly and may last several hours to days, so called delayed dermographism. Dermatographic urticaria is also known as Dermographism, dermatographism or skin writing.
Although, more common in young adults; dermatographic urticaria can be seen at any age, with peak incidence in the twenties and thirties.
Dermatographic Urticaria Causes
The exact cause of dermatographic urticaria remains uncertain. Trauma to the skin causes the mast cells to release certain chemicals like histamine and few others. This process causes small blood vessels to leak, which allow fluid to accumulate in the skin resulting in wheal.
Dermographism may also be triggered by allergy to certain drugs (like penicillin), scabies, insect bites or a worm infestation. Congenital dermographism has been associated with systemic mastocytosis. Anxiety and stress may also be a triggering factor in some patients.
Signs and Symptoms of Dermatographism
When skin is stroked wheal develops immediately and usually lasts for 15-30 minutes before it fades out. In symptomatic individuals it is also associated with itching and may be more severe at night. as a result itch-scratch sequence may appear. These symptoms can be aggravated by physical pressure, exercise, heat, stress and emotions. In delayed type of dermographism wheal usually develops after 3-6 hours and generally last for 24 to 48 hours. Itching and whealing may affect whole body, but the scalp and genital area are often spared.
Dermatographic Urticaria Treatment
Although, dermographism can be very distressing condition, it is not a life threatening. Individuals with simple dermographism are usually asymptomatic and don’t require any treatment. In case of symptomatic dermographism, treatment is given until the problem resolves, which may take several months.
Identifying the cause and avoiding the triggering factors is the most important strategy in the management of this condition. In addition, avoidance of very hot bath and use of good moisturizers during winter is a must to avoid dry skin that may lead to scratching of the skin.
Oral antihistamines are the drugs of choice for most cases. There are several non-sedating one which can also be bought over the counter. For successive results treatment may be needed to continue for several months.
Light therapy like narrowband UVB phototherapy and PUVA (oral psoralen plus UVA) may also be beneficial for resistance cases. However, the beneficial effect may not last long and relapse within few months.
Cold urticaria is a skin disorder where affected patients develop urticarial rash after physical exposure to cold objects such as cold water, air, or foods. These symptoms can develop within minutes of exposure to cold stimulus.
There are two types of cold urticaria; acquired cold urticaria and familial cold urticaria. Familial type is a rare one. The symptoms of acquired type occur within minutes while those of familial type may take 24-48 hours.
What Triggers Cold Urticaria?
Cold urticaria can be triggered by many factors, few are listed below:
Swimming in cold water
Contact with cold surface
Ingestion of cold liquids and foods
Restriction of blood blow
Cold Urticarial Causes
As name suggest, cold urticarial is primarily caused by exposure to cold. However, why the cold stimulus causes such urticarial lesion is still unclear. It may also be due to secondary causes like blood disorders and infectious disease. Some condition that have been associated with secondary cold urticarial are:
- Viral hepatitis
- Infectious mononucleosis
- Chronic lymphocystic leukaemia
- Leukocytoclastic vasculitis
- Drugs like penicillin, oral anticoagulants and antifungal
Symptoms of Cold Urticaria
Symptoms of cold urticaria show up within 3-5 minutes after exposure to cold stimulus. Within minutes of exposure red itchy wheals develops that may be localized to the area of exposure or generalized to whole body. Some may also experience severe systemic and anaphylactic reactions, which is often due to swimming in cold water. Systemic symptoms may include:
- Swelling on the pharynx, uvula, tongue and lips
- Difficulty in breathing
- Nausea, vomiting, stomachache and cramps
- Rapid irregular heart rate, low blood pressure, shock, collapse
- Headache, disorientation and unconsciousness
How is Cold Urticaria diagnosed?
The diagnosis is based on clinical features and cold stimulus test like “ice cube test” or “hand immersion test”. When ice cube is applied for 1-5 minutes; red swollen wheal may develop within minutes, if a person has cold urticarial. Beside this, complete blood counts and other related test must also be performed in order to exclude any underlying systemic condition.
Treatment for Cold Urticaria
Treatment includes strict avoidance of cold environment. Those with cold urticaria should always avoid cold foods, ice-creams, cold beverages and most importantly should strictly avoid swimming alone in cold water. Severe form of cold urticaria can be very fatal. Although antihistamines may be enough for mild rashes and itching, systemic reaction needs immediate medical attention and hospital admission. There are some reports of successful treatment with systemic corticosteroids, dapsone, oral antibiotics, ciclosporin, leukotriene antagonists and synthetic hormone danazol.
Another option is desensitization therapy with slowly and gradually exposing the skin to cold condition.
Mask of pregnancy, also known as melasma or chloasma is a common presentation during pregnancy. Almost 75% of the women who becomes pregnant have muddy brown pigmentation on their face. Melasma usually appear on cheeks, nose and forehead or any other parts that are exposed to sunlight. Although the pigmentation will fade after pregnancy, it may not disappear completely.
What causes mask of pregnancy ? (Melasma)
The precise cause of melasma is still unknown; however there are several possible contributing factors. The two most contributing factor being excessive sunlight exposure and genetic predisposition. Clinical studies have shown that several other factors also plays important role in triggering melasma. These factors include pregnancy, birth control pills, hormonal replacement therapy, emotional stress and photosensitizing medications that make skin prone to pigmentation after exposure to sunlight.
When melasma occurs during pregnancy, people use the term chloasma “mask of pregnancy”. During pregnancy there is increase in the level of progesterone, which is the major contributing factor. During pregnancy there is increase in the level of other hormones like estrogen and melanocyte-stimulating hormone (MSH), but experts think that progesterone is the major contributing factor in pregnancy related melasma.
How to Prevent Mask of Pregnancy? (Melasma Treatment)
The most important step in treatment and prevention of melasma is to avoid the contributing factor that is triggering your melasma. These include; avoidance of excessive sun exposure and regular use of broad-spectrum (UVA+UVB) sunscreen. The most common treatment of melasma is the use of topical hydroquinone. There are several other alternative skin lightening agents like azelaic acid, Kojic acid and tretinoin. Chemical peels, laser therapy and intense pulse light (IPL) are the other alternatives. All these treatment options may gradually fade your melasma, but will recur if you are exposed to excessive sunlight. So always apply broad-spectrum sunscreen of at-least SPF30 throughout the year.
If single therapy is not working, you can use combination therapy with hydroquinone, tretinoin with or without mild corticosteroids. Always remember; none of this treatment will completely eradicate your melasma. People with genetic tendency to occur melasma or the people who are frequently exposed to excessive sunlight should always apply sunscreen throughout their life to avoid melasma. Be sure to apply sunscreen 20 minutes before you go out to the sun.
Aging of the skin is an ongoing process which usually begins at early thirties. It is usually associated with increased wrinkling, laxity and sagging of the skin. There are two factors that contribute to aging of the skin; intrinsic aging and extrinsic aging. Intrinsic skin aging is largely genetically determined and can’t be controlled. While extrinsic aging may relate to environmental factors and can be controlled, such as exposure to sunlight, smoking, stress, inadequate nutrition and improper hygiene.
It is estimated that more than 80% of facial aging is due to sun exposure. Other factors like smoking, stress and other lifestyle account for 20% of facial aging. So, avoiding these factors may help delay your aging process or avoid premature skin aging. Here, we’ll discuss some of these factors that contribute to premature skin aging and few tips that can help maintain your skin appearance.
1. Excessive Sun Exposure: The sun is the main culprit for around 80% of the premature skin aging. Excessive sun exposure may result in loss of elasticity, increase dryness and roughness, deep wrinkling and irregular pigmentations. Ultraviolet radiation from the sun breaks down collagen and elastic fibre network, thus loosing the tensile and elastic properties of the skin resulting in wrinkle formation. Although application of broad spectrum sunscreen won’t reverse existing damage to your skin, it will sure help prevent further damage and wrinkling and also protect against skin cancer. Always apply sunscreen to protect from the harmful radiation of the sun. For normal skin you can use sunscreen with SPF15 and for more sensitive skin sunscreen with SPF30 can be used as necessary.
2. Smoking: Epidemiological studies suggest that heavy smoking causes premature skin aging. Several toxic components in tobacco are absorbed during smoking that causes the destruction of connective tissue. Smoking also increase collagenase enzyme which result in degradation of collagen. Smoking is sure a curse to your skin. Smoking further constricts your blood vessels, thus, decreasing blood supply to the skin, as a result, depriving skin of the oxygen it needs. So it is obvious that smoking leads to accelerated skin aging. Here are some more effects of cigarette smoking on your skin.
3. Too Much Alcohol: As alcoholic beverages will dehydrate your body, over indulgence may lead to drier and older looking skin. So, if you are looking for beautiful skin while maintaining your overall health, avoid or at-least limit your alcohol intake.
4. Too Little Sleep: Lack of sleep is another factor that can lead to dull complexion and dark circles and puffiness under your eyes. Take enough sleep everyday, most experts suggest 8 hours sleep each night. If you are having difficulty in sleeping, avoid caffeine in the evening.
5. Too Much Stress: Stress is another factor that can accelerate normal aging process. Try to avoid stress as much as possible. Learn some relaxation technique, or do something you feel happy. Get yourself a face or body massage. It will help you relax and improve your blood circulation and delivery of oxygen and nutrients while eliminating the toxin out of your body. If you follow these tips you can prevent premature skin aging.
Does it seem like the more you try to hide your acne, the more acne you have to hide? If that is the case, then part of the problem may be the makeup you are using. We’ll try some makeups tips to prevent acne breakout.
If you are a woman who is prone to acne breakouts, you probably use makeup to conceal those breakouts. There is nothing wrong with using makeup to conceal unsightly pimples unless the makeup you are using is actually making the acne breakout worse.
There is no need to stop using makeup to conceal your acne, you just need to start choosing the right types of cosmetics; ones that won’t cause more breakouts.
Here are some tips to help you choose cosmetics that will not aggravate your acne, along with some tips for proper makeup usage that will help prevent additional makeup-related acne breakouts.
1. Use water-based, hypo allergenic makeup and moisturizers. These properties won’t guarantee that the products will not promote acne but these products are less likely to do so.
2. Avoid oil-based cosmetic products. Using heavy oil-based makeup is, most likely, the cause of most makeup-related acne breakouts. Beware of products that claim to be oil-free but actually contain synthetics that can provoke an acne breakout.
A simple test to show oil content is to place a dab of the cosmetic on a piece of quality cotton fibre stationary and leave it for twenty four hours then check for a high migration of oil, in the form of large oil rings.
3. Avoid products that contain ingredients such as lanolins, coal tar and coal tar derivatives like D & C red dyes (look for products that use Carmine for red coloring). Isopropyl Myristate is one of the worst acne-provoking ingredients, it is used in makeup to help it apply smoothly.
Also check cosmetic labels for acetylated lanolin, cetyl alcohol, decyl oleate, isocetyl stearate, isopropyl isothermal, isopropyl palmitate, isostearyl neopentonate, laureth 4, myristyl myristate, octyl palmitate, octyl sterate, PPG myristyl propionate, putty stearate and stearic acid; avoid these products if at all possible.
4. Makeup that is labeled non-comedogenic or non-acnegenic is formulated to not clog oil-producing pores, thus they help prevent acne breakouts. But that doesn’t mean using cosmetics with these labels won’t worsen your acne. If the makeup you are using is labeled non-comedogenic or non-acnegenic and it still seems that you experiencing makeup-related acne, try a different brand as there may be an ingredient that you are sensitive to.
5. Use powdered rather than liquid makeup as the liquids are more likely to contain oil that will exacerbate any acne breakouts you may be experiencing. Lightly apply as little powder as possible to get the effect you seek.
6. Only use the minimum amount of makeup necessary. Go as light as possible to help avoid the pore blockage than can cause an acne breakout. Try new techniques that will allow you to use less makeup thus preventing additional acne.
7. Clean your makeup applicators often or simply purchase new ones. Using a dirty applicator can cause acne-producing dirt and bacteria to be applied directly to your skin.
8. Try different brands. What works for others may not work for you. Trial and error can be an effective way to find the right cosmetics for you; cosmetics that don’t exasperate your acne.
9. Remove makeup completely as soon as possible. Wash thoroughly each night and be sure to completely rinse away all soap residue.
10. Whenever possible, do not wear any makeup. Give your skin a break and let it breath.
Hopefully these tips were informative and helpful. Remember, makeup-related acne prevention is really all about finding what works for you and your skin.