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Problems with the nails on the hands and the feet account for around ten percent of all dermatological visits. What is interesting about this statistic is that few people actually know that a dermatologist is the person to see for any sort of finger or toenail problem.

All nails grow from the very deep “folds” in the skin at the tips of the fingers and the toes. If you were to pull off a nail (not recommended) you would see that deep fold. They are made from epidermal or skin cells from the outermost layer of the skin. As the cells shift from the dermis (the middle layer of skin), to the surface, they encounter the “nail root”. This triggers the cells to press together and to form into tiny plates that harden into nails.

This is process is known as keratinisation, and is also how hair is formed. There are also other “parts” to the nail including the bed of the nail, the largest area of the nail known as the nail plate, and the lunula, which is the top part (white crescent shaped tip).

Because nails are constantly growing (with fingernails growing around three times faster than toenails), they are open to all kinds of disorders and malfunctions. Nails are also capable of suffering trauma if struck or torn, and this too can lead to some issues.

Common problems with nails may include

  • Nail Dystrophy
  • Fungus
  • Psoriasis
  • Trauma
  • Malignancy
  • Ganglion

Treating Nail Conditions

Regardless of the reason behind a nail problem, it is imperative to visit a dermatologist at the first sign of trouble. Nail problems can be quite serious and are often a reflection of the body’s general health and well-being. For example, if you normally have pink and thick nails, then they suddenly discolor, grow thin and tear, it is an immediate reflection of an underlying health problem. Physicians can detect kidney and liver disease, heart trouble, and even anemia or diabetes because of the conditions of the patient’s nails.

Having said that, there are common conditions of the nail that are easy to manage that does not signal bigger health problems. Around 50% of all nail disorders tend to relate to fungal issues, often more common to the feet.

Anyone can be self-conscious if their feet and hands are marred by broken, malformed, discolored, and generally unhealthy nails. This is why it is important to get the situation taken care of by a dermatologist as soon as possible.

If you have any questions or concerns about nails or nail conditions contact your local doctor, who will arrange for you to see a dermatologist. Contact us today.

The post Nails appeared first on Dermatology Sydney.

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Historically, fluoride was used as a treatment for hyperthyroidism; however, it is not a treatment that is currently used. Fluoride is thought to be an antagonist of iodine, impacting upon the ability of body tissues, such as the thyroid gland, to utilise iodine. However, this is only important if iodine levels are low. Fluoride is commonly added to drinking water supplies as a public health intervention in industrialised countries. This is because fluoride is an important component of the defence against tooth decay, and carries significant benefits for oral health. But is there an association between fluoridated water supplies and increased rates of hypothyroidism?

Recently, an English observational study was published. This study compared the levels of fluoride in the water in different regions of London with the prevalence of diagnosed cases of hypothyroidism at GP practices in the same region.

The authors of the study claimed that there was an increase in the prevalence of hypothyroidism in areas with higher levels of fluoride in the water¹.

However, this study has been criticised in the media by experts for flaws in the study’s methodology². Firstly, the study employs a very simplistic design to investigate whether or not there is an association. The authors do not take into account the numerous other potential confounding factors, which may influence the results of the study. This type of study design makes it virtually impossible to prove a cause-and-effect relationship between fluoridated water supplies and hypothyroidism because there are so many other factors that can influence the rates of hypothyroidism, for example iodine intake, beyond just the levels of fluoride in the water.

Furthermore, the levels of fluoride in the water are at a very low level in the water supply. These levels are significantly below the amount of fluoride needed to have an inhibitory effect on the thyroid gland. Experts quoted in the article in The Conversation² are critical of how the authors of the paper exaggerate the potential effect of fluoride on the thyroid gland, and do not give sufficient recognition to the potential influence of iodine deficiency on the results.

Due to the flaws in the methodology of this study, the results of this study should be interpreted with a degree of scepticism. Further studies with a better design are required to determine if there is a cause and effect relationship between fluoride in the water and hypothyroidism.

References

  1. Peckham S, Lowery D, Spencer S. Are fluoride levels in drinking water associated with hypothyroidism prevalence in England? A large observational study of GP practice data and fluoride levels in drinking water. J Epidemiol Community Health, 2015. Published online 24 February 2015. http://jech.bmj.com
  2. Rattan R. Flawed study overstates link between fluoride and ill health: experts. The Conversation. http://theconversation.com

The post Is there an association between fluoridated water and increased rates of hypothyroidism appeared first on Thyroid Clinic Sydney.

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Thyroid Conditions in Children

Whilst most people associate thyroid conditions with adults, children are also susceptible to thyroid issues. There are essentially two different types of thyroid problems found in children: congenital hypothyroidism and childhood onset hypothyroidism.

Congenital Hypothyroidism

This thyroid condition is present at birth, and is detected through the heel prick that all children undergo. Current statistics show that around one in 3,500 babies are born with hypothyroidism in the UK, and most of these cases are due to the thyroid gland failing to develop fully while in the womb. The cause of this condition is not fully understood, but treatment is necessary due to the dangers for the child.

Hypothyroidism is a condition that is marked by low levels of thyroid hormones in the body. One of these hormones, thyroxine, is an essential component in growth and development in children. During pregnancy, babies receive adequate amounts of this hormone through the mother’s production. However, after birth, babies who suffer from this condition are not able to produce enough thyroxine to properly support development.

Proper thyroxine levels are required throughout life, but they are much more important for an infant. This hormone is responsible for the healthy growth and development of every organ system in the body, which is why the heel prick test is so important. If congenital hypothyroidism is not treated within the first weeks after delivery, it can result in serious complications for the child, including brain damage. However, nearly every child that does receive proper treatment for this condition in a timely manner goes on to live a healthy life.

Neonatal screening for hypothyroidism

The neonatal heel prick or Guthrie test is a screening test done on newborns. It consists of making a pinprick puncture in one heel of the newborn and soaking the blood into pre-printed collection cards known as Guthrie cards. The blood samples can be used for a variety of metabolic test to detect genetic conditions, including congenital hypothyroidism.

If your baby is born with hypothyroidism, he or she will need to have thyroxine administered on a daily basis. The exact amount of the medication needed will change over time, depending on the results of frequent blood testing.

Childhood Onset Hypothyroidism

There is also hypothyroidism that occurs later in childhood. Childhood onset hypothyroidism is broken down into two forms; one is called Hashimoto’s thyroiditis, and the other is atrophic thyroiditis. Both forms are generally due the body’s immune response forming antibodies that destroy the function of the thyroid gland.

Hashimoto’s thyroiditis affects children by causing swelling and enlargement of the thyroid gland, which is often referred to as goiter. This form of hypothyroidism causes symptoms such as dry skin and hair, slow pulse, and changes in the facial features, much as they do in adults. However, these symptoms typically show up much later in the disease.

The second form, which is called atrophic thyroiditis, occurs without any signs of swelling, but results in the thyroid gland being completely destroyed. Children suffering from this form of acquired hypothyroidism show noticeable changes in their growth due to the lack of thyroxine in their bodies.

It is also possible for children to acquire Hashimoto’s thyroiditis, but end up with atrophic thyroiditis. No matter which form a child is suspected to have, diagnosing the thyroid problem requires blood testing to measure the amount of TSH and thyroxine.

Children who are diagnosed with hypothyroidism require treatment with oral thyroxine therapy. Once this treatment is started, most children experience excellent results. Children who have suffered growth issues due to decreased thyroxine levels are also able to quickly catch up with their growth, allowing them to return to normal. While children suffering from any form of childhood hypothyroidism will require oral thyroxine for the rest of their lives, they are still able to function normally with no adverse side effects.

Another thyroid related problem commonly seen in children is a thyroglossal cyst. Thyroglossal duct cyst often presents as a lump in the neck which may be painful. The thyroglossal duct is a structure which is important in the development of the thyroid gland in the embryo, and generally regresses in the majority of people. Thyroglossal duct cysts are most commonly diagnosed in patients before the age of 20; however, they can occur at any age.

Hypothyroidism in children can be very serious, so it is important that you speak to your child’s paediatrician or endocrinologist if you have any questions or concerns.

If you have questions about thyroid conditions in children contact your local doctor who will arrange for you to see a thyroid surgeon.

References

The post Thyroid Conditions in Children appeared first on Thyroid Clinic Sydney.

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Deciding to get Otoplasty for Your Child

“Kids can be so cruel.” This is a common sentiment we hear when discussing the ways children relate with each other. However, when a child is bullied it can have implications for a very long time, especially when children have a physical characteristic that makes them an easy target for bullies.

Children with large or misshapen ears are at an increased risk of being bullied while children, and therefore may run a risk of emotional issues later in life. This may be one of the reasons why ear surgery, known in the medical community as otoplasty, is one of the more common cosmetic surgeries performed on children.

Children Respond Best to Otoplasty

Another compelling reason to consider otoplasty for your child is that children tend to heal and recover faster than adults. Therefore, not only can you stop the bullying, but you can set your child up for a better recovery period than if they decide to get the surgery later in life. Surgeons report that the best ages to get otoplasty are between 5 to 10 years old. Since your child will still experience growth during these years. In turn, this growth will help to blend the surgery in with the child’s budding physical characteristics.

Additional Benefits of Otoplasty

Many cosmetic surgeries are very invasive, yet otoplasty is not one of them. During the procedure children are typically put under general anaesthesia by an anaesthetist, and then the surgeon will begin their work. This will include a small incision on the back of the ear that will expose the cartilage. Your surgeon will then expertly sculpt the cartilage in order to give the child the desired aesthetic effect.

Additionally, if the ears are protruding, a couple of stitches can be used inside the ear in order to draw the ear back toward the head and allow it to grow in a more natural position. Once all of this is completed, the surgeon stitches up the small incision and bandages the child so they can recover peacefully.

Otoplasty is a safe and quick procedure that is most effective on children. Not only will the child experience less bullying, but also they will have a better recovery and be able to enjoy their beautiful ears for the rest of their life.

If you have questions about otoplasty surgery make an appointment to see our ear nose and throat specialist.

For more information click here.

The post Otoplasty Surgery appeared first on ENT Clinic Sydney.

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Clients may decide to have rhinoplasty for any number of reasons

Perhaps they have always hated the size or shape of their nose. Maybe they suffer from snoring or sleep apnea due to a deviated septum or blocked nasal passages. Sometimes they may have suffered a traumatic injury that has left the nose scarred and misshapen.

You have no doubt read articles on all kinds of reasons for plastic surgery, including rhinoplasty. The simple fact is, whether your reasons are cosmetic, functional, or both – so long as you are seeking rhinoplasty for yourself and not to satisfy anyone else – you are perfectly justified in seeking this procedure. It is safe and patients who pay attention to their doctors’ consultations and advice will be very satisfied with the outcome.

While you may have a good idea of what you want your new nose to look like, or how you want it to function, you may not have a clear picture in your mind of how this can happen. In this article, we will discuss the basic steps your rhinoplasty surgeon will take during your procedure and what you can expect during recovery.

What happens during the procedure

Depending on the type of surgery and whether or not you are having any other procedures done at the same time – such as jaw contouring or a brow lift – your rhinoplasty will most likely take between 1 and 3 hours. You, of course, will not be awake during this process, as you will be given an IV of anesthesia, fluids, and medication as you are taken into the operating room. Your heart rate, blood pressure etc will then be closely monitored by your anesthetist.

While you are under anesthetic, your surgeon will either perform an open or closed rhinoplasty. In an open rhinoplasty, your surgeon will make a small Z-shaped incision under your nose, between your nostrils. During this type of procedure, the skin is folded up while your surgeon reshapes and restructures the bone, cartilage, and tissue underneath. Afterward, you may be left with a very discrete scar in between your nostrils.

During a closed rhinoplasty, all of the incisions will be made inside the nostrils. In this procedure visible scarring can be avoided. Some surgeons will often prefer this method of the procedure as it enables them to see how the nose will look after the surgery is complete. However, closed rhinoplasty does make repositioning of the skin over the nose more difficult and if often not recommended for more complex surgeries.

Both of these techniques have advantages and disadvantages, depending on the desired results for the procedure. Talk to your surgeon about which will be better for you.

What to expect after surgery

Rhinoplasty often includes breaking and reshaping the bones in your nose. When you take this into consideration, it is understandable that the recovery process is similar to recovering from a broken nose. After your procedure, your surgeon will cast and tape your nose to hold it in place. You may need to refrain from some physical activities during your recovery to avoid strain on the healing tissue, bone, and cartilage. Be sure to ask your doctor what you can and can’t do following surgery, this will ensure the best possible recovery.

After your procedure, you will have a number of follow-up visits to ensure that the nose and wounds are healing properly and that the results will be satisfactory.

If you have questions about a rhinoplasty procedure contact your local doctor, who will arrange for you to see a rhinoplasty specialist.

The post What to Expect From a Rhinoplasty Procedure appeared first on Rhinoplasty Clinic Sydney.

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