Warts Overview

Warts (verruca) are small, non-cancerous growths on the skin which are usually painless. They are caused by a virus called the human papilloma virus (HPV). Though largely harmless in nature, warts can be quite disfiguring at times and thereby a source of embarrassment. Certain types of warts can be itchy or even painful.
In some cases, warts may disappear spontaneously without any treatment but in most cases they require proper treatment. The response to treatment also varies significantly wherein some warts recover readily while others require prolonged treatment. The trouble with warts is that they spread easily on account of being contagious and hence must be treated promptly without any delay.
The issue with conventional treatment is that it does not target the root cause of warts and hence recurrence is common. However, with constitutional natural treatment, warts are treated effectively from the roots thereby preventing any further recurrence of the same. At Hakeem Hashmi's, we have treated a large number of cases of warts with good results in most cases. Go ahead and experience the benefits of natural ingredients at Hashmi Dawakhana.

What are Warts?
As described earlier, warts are small, non-cancerous growths on the skin that may vary in size, shape and color. Some warts present as small, flat and smooth lesions whereas some may appear as rough and hard growths on the skin. Warts are caused by a virus called human pappiloma virus (HPV). The human pappiloma virus causes the top layer of skin to grow rapidly, thereby giving rise to the formation of a wart.
Warts are generally skin colored though they can be darker or lighter than the skin color. The surface may be smooth or rough. The shapes may also vary significantly, some of the warts being flat, others being larger and fleshy and yet others being thin, long and cylindrical.
Although warts can occur on any part of the body, commonly affected areas include:
•    Hands
•    Feet (especially soles)
•    Genitals
•    Face and neck
Warts may occur one at a time or in clusters. They are usually painless though in case of affection of soles (plantar warts), pain may be an evident feature.
Children and young people are more prone to develop warts and being contagious in nature, they spread easily from one person to another. Warts also tend to spread easily from one part of the body to another in the same individual.
One of the common reasons why warts spread so easily is that people try to get rid of them by shaving them off or trying other means by which only part of the wart is removed. A half-removed wart of this kind is more prone to spread the virus to other parts of the body and to other people.
Warts often disappear by themselves within a few months or years but this may not be the case always. Some warts tend to be very stubborn and in spite of rigorous treatment, take long time to go.

Types of Warts
Several types of warts are seen in clinical practice and some of the common variants have been described here:
Common warts (verrucae vulgaris)
Common warts are typically grey to flesh colored, raised lesions varying in size from pinhead to about 10 mm in diameter. They are generally covered with rough, horn-like projections and are commonly seen on hands and feet, especially around the nails. As the names suggests, these are the most common variety of warts and can affect people belonging to all age groups.
Flat warts
As compared to common warts, these warts are small and only slightly raised above the skin. They can be flesh colored or whitish and appear smooth (unlike common warts that appear rough). Flat warts are generally the size of a pinhead and may appear in clusters. Common locations of flat warts are face and legs. When they occur on the face, they tend to spread rapidly especially with activities like shaving. Teenagers and adults are more prone to develop flat warts.
Filiform warts
Filiform warts, as the name suggests, are long, narrow and filamentous warts. These flesh colored growths tend to affect the face and neck more often. They generally appear in clusters and have a tendency to grow rapidly. Filiform warts also spread easily especially by sharing face towels or facial products. If accidentally rubbed or scratched, they may get irritated and may bleed.
Plantar warts
One of the painful varieties of warts, plantar warts occur on the soles of the feet. They are often called as mosaic warts due to their mosaic-like appearance. They tend to grow into the skin of the soles and hence are difficult to treat. Plantar warts often have a tiny dot at the centre which is due to clogged blood vessels. Having a plantar wart makes walking around painful since it is constantly subjected to pressure thus rendering it tender.
Genital warts / Condyloma
Warts that affect the genital region are called genital warts and they are amongst the most common sexually transmitted diseases. Typical locations in male patients include the penis and in case of women, the vulva, vagina and cervix may be affected. Occasionally the warts may even spread to the anal region or the pubic region in both the sexes.
Appearance-wise, genital warts are seen as flat raised lesions or cauliflower-like bumps that are generally flesh colored. They may be small in size making them difficult to spot at times; in other cases they may be larger and itchy. There may be tenderness or a burning sensation in the affected region. In case of genital warts on the cervix, the woman may experience bleeding after sexual intercourse.
Genital warts may occur singly or in clusters. They are highly contagious and they spread easily through sexual contact (vaginal or anal) or oro-genital contact (oral sex). Genital warts do not spread through bodily fluids and a direct physical contact is essential for transmission. After an initial exposure to the partner's genital warts, a person may develop the same weeks, months or even years later. They tend to be recurrent in nature and frequent outbreaks are seen in the affected person.

Causes of Warts
Human Papilloma Virus (HPV) is the primary culprit in the development of warts. There are more than hundred types of the Human Papilloma Virus (HPV) and most of them cause warts to develop on the skin. Some of the types of HPV cause genital warts and these have been implicated in the causation of cervical cancer in women.
The Human Papilloma Virus spreads though direct contact and that is the reason why warts spread from person to person as well as from one body part to another in the same individual. The virus finds way into the body through skin that is moist, cracked or is peeling. A site of recent injury is another common entry-point for the virus. Once the virus enters the body, the incubation period begins (during which the virus remains dormant) and this varies from one to eight months. After this period, the outbreak of the wart is seen.
Virus that has been shed recently remains alive in a warm, moist environment such as cellars, locker rooms, etc. There are numerous ways in which the virus can spread and these include:
•    From one part of the body to another (in the same individual)
•    Direct contact with someone else's wart
•    Contact with towel or any other object used by someone who has a wart
•    Genital contact as in vaginal/anal/oral sex (for genital warts)
Genital warts are much more contagious as compared to other varieties of warts.

Natural Treatment
Natural practitioners have time and again demonstrated the success of natural ingredients in the treatment of warts for more than 200 years now. Whether it is getting rid of the existing warts, preventing the formation of new ones or healing the tendency to wart formation, natural treatment has an answer to all of these.
At Hashmi Dawakhana, we have been treating patients with warts for 35 years now, and have had good results in most cases. Natural treatment helps patients to get rid of warts safely and effectively without the use of any conventional methods. In any case, conventional methods like freezing (cryotherapy or liquid nitrogen therapy), cantharidin application, surgery, electrodesiccation, curettage, laser surgery, retinoid creams, etc. provide only temporary relief from warts and do not prevent new ones from cropping up.
Prognosis of natural treatment varies from case to case - some warts disappear readily with medication whereas others require long-term treatment and are slow to disappear. The important thing about natural treatment is that besides healing them, it prevents the warts from spreading to other parts of the body. Proper constitutional treatment removes the tendency for wart formation from the roots thereby giving lasting results.
Overall, the treatment of warts with natural ingredients gives good results in most cases and the best part are that the treatment is safe and without any side-effects. Natural treatment is strongly suggested for all cases of warts.

Self care for Warts
Warts can spread easily from one person to another as well from one location to another in the same individual. It is important to take good care so as to avoid the spreading of warts in the aforementioned manner.
At Hakeem Hashmi's, we have been treating patients with warts for last 35 years and have had good results in most cases. Based on our vast clinical experience and the expertise of qualified and skilled dermatologists belonging to our team, we have observed that the following tips go a long way in helping patients to deal with their warts:
•    Avoid picking at warts since they spread faster like this
•    Avoid shaving areas that have warts to keep the virus from spreading
•    In case of children, cover the warts with an adhesive bandage - this will keep them from picking the warts
•    Children must be encouraged to wash hands properly after they finish playing
•    Keep the affected area dry since warts tend to thrive better in moist environment
•    If you have accidentally touched someone else's warts (or even your own) , wash your hands properly after that
•    If you or your partner has genital warts, abstain from sexual activity since genital warts are highly contagious. Some physicians recommend using condoms but these do not provide complete protection from genital warts (since warts may be in areas not completely covered by the condom).
•    Don’t share personal care objects (such as towel, comb, nail clipper, etc.) with someone who has warts (or if you have warts, do not allow others to use your stuff). This helps to avoid the spreading of the virus.
Our qualified and experienced nutritionist recommends the following to deal with warts:
•    Include adequate amount of garlic, onions, eggs in your diet
•    To improve your immunity against development of warts, have amla, guava, citrus fruits (rich sources of Vitamin C)
•    Eat foods rich in vitamin B and calcium such as almonds, beans, whole grains (if no allergy is present), dark green leafy vegetables like spinach and kale, and sea vegetables
•    Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods and margarine.
•    Eliminate caffeine, alcohol, other stimulants, refined foods, sugar and tobacco

 

Vitiligo Treatment Overview

Vitiligo is a common condition in which the skin loses the pigment that determines its color. Also commonly known as Leucoderma (leuco = white and derma = skin), this condition is characterized by irregular pale or milky white patches on the skin.
Vitiligo is one of those conditions that have more of a social significance than medical. Although it affects people of all races, the symptoms are often more prominently seen in people with a darker complexion. This condition has been the cause of stress for millions of affected people worldwide as well as their near and dear ones.
At Hashmi Dawakhana, our experience of successfully treating more than 45,000 cases of skin enables us to ensure you of a safe and scientific solution for an effective Vitiligo treatment. So, go ahead and experience a lasting solution that comes to you without side effects.

What is Vitiligo?
Before we get to understand about the loss of color from the skin in Vitiligo, let us first see how the skin gets its normal color. A pigment called melanin imparts the skin (as well as hair) the native color. This pigment is produced in cells called 'melanocytes'. When the melanocytes die or are unable to function, it results in loss of melanin causing color-less, white patches on the skin.

Vitiligo is a chronic disorder and tends to run a variable and often unpredictable course. It affects up to 2% of the population globally and the incidence is almost double this (3 to 4%) in India and Mexico. People of different races, religions, ethnic groups, socio-economic groups and with different dietary habits are affected by this condition.
Vitiligo affects males and females equally and it is commonly seen in children as well. The incidence is higher in children whose both parents are affected by Vitiligo. By and large, people who develop it are between 10 to 30 years of age and most of those who develop this, do so before 40 years of age.
The goal of most treatment options available today is largely to stop or slow down the progression of pigment loss and to attempt the re-pigmentation in affected areas.

Vitiligo Causes
The underlying mechanism which causes Vitiligo is loss of melanin. This occurs due to destruction of existing melanocytes and defective formation of new melanocytes. However, the precise reason for white spot on skin that is loss of melanin and what causes the destruction of these pigment-forming cells is not completely understood.
A combination of auto-immune, genetic and environmental factors has been seen as Vitiligo causes, in most cases. Recent studies have demonstrated that Vitiligo may also be caused by stress which affects the immune system, leading the body to react and mistakenly destroy the melanocytes by releasing antibodies against them.
Heredity has been strongly proposed as one of the Vitiligo cause, since many cases with Vitiligo do report incidence of this condition (or other auto-immune disorders) in their family. Research has also shown the NALP1 gene to be the trigger in predisposing people to Vitiligo.
Additionally, Vitiligo is said to be associated with (and affecting people with) certain auto-immune and inflammatory diseases such as:
•    Hypothyroidism - Under -functioning of thyroid gland
•    Hyperthyroidism - Over -functioning of thyroid gland
•    Diabetes mellitus
•    Addison's disease
•    Alopecia areata
•    Psoriasis
•    Pernicious anemia
Possible things that can trigger Vitiligo in an individual who is genetically prone include:
•    Skin trauma
•    Sun burn
•    Emotional stress
•    Skin rash
•    Exposure to de-pigmenting chemicals - the disease can later spread beyond areas of contact via immune-mediated mechanism. Phenolic/catecholic derivatives are the prime chemicals causing this.
All said and done, the exact reason why Vitiligo affects some people and not others, and that too with such unpredictability, still remains unexplored!

Vitiligo Symptoms
As one of the key Vitiligo symptom, a sudden onset is seen in most cases where the patient notices a single, few or many milky white patches of irregular shapes and sizes on the skin. Small areas of de-pigmentation gradually start spreading to involve larger areas of the body. The patches appear more prominent in dark-skinned people and can be quite disfiguring at times.
As far as the progress and reasons for white spot on skin are concerned, it is highly unpredictable. Some cases experience an extremely fast advancement with quick involvement of large areas of the body whereas in some cases there may be few small patches that don't change much with time. The active phase of development of new patches can be followed by a phase where there are no new patches.
The affected areas retain the normal sensitivity to touch and pain; however sun-sensitivity is seen to be increased in many cases. Other Vitiligo symptom may be that the hair over the affected parts, such as skin, scalp, beard, eyebrows, eyelashes, etc. may also lose colour.
Over a period of time, some of the Vitiligo patches may re-pigment by themselves.
The patches of Vitiligo can affect any part of the body though sun-exposed regions, body folds (e.g. groins, armpits), areas around body orifices or sites of previous injury are commonly affected. Following are some of the common patterns of body affection seen in Vitiligo patients:
•    Focal: The patches are limited to particular areas of the body
•    Segmental: The distribution of the patches is usually asymmetrical affecting one side of body
•    Symmetrical: Bilaterally symmetrical patches over the body
•    Generalized: Widespread patches spread all over the body
•    Over Bony Prominences: The skin near the joints is affected by the patches
•    Lip-tip Vitiligo: Vitiligo that is limited to the lips, tips of the fingers and toes, fingertips
•    Genital Vitiligo: The private parts of the body are affected

Diagnosis
The look of Vitiligo is typical enough to diagnose it on the first look. In addition, your medical and family history will enable your physician to make sure of his diagnosis. However, certain tests may be conducted to confirm the condition as well as to ascertain the cause if possible:
•    Biopsy of the affected area can confirm the diagnosis of Vitiligo
•    Blood tests may be done:
o    To check the thyroid functions
o    To look for the presence of anti-nuclear antibodies (that would point towards auto-immune cause)
o    To rule out pernicious anemia
•    Examination of the spots under Wood's lamp can be used to diagnose and evaluate Vitiligo especially when the changes are not appreciated with the naked eye.
At Hashmi Dawakhana, we scientifically evaluate each case of Vitiligo with Wood's lamp and effectively use it for the following:
•    To accurately diagnose Vitiligo
•    To rule out fungal infections
•    To measure extent of the disease
•    To detect early changes that are not visible to naked eyes
•    To monitor response to treatment

Psychological Impact
Vitiligo can be socially devastating for afflicted individuals and it has a significant psychological impact on patients. It can cause feelings of being shunned by the society or being singled out due to the disfigurement that is often seen in this condition. In certain countries like India, these patients often face discrimination especially at the time of marriage. Sometimes Vitiligo can even be a ground for divorce if the patient develops it after marriage.
Vitiligo patients often feel awkwardness in public places and for some it is even hard to move around without developing feelings of embarrassment. Long term sufferers are more prone to fall prey to depression, anxiety and feelings of low self esteem. Many are constantly on the watch as to how the opposite person will react to their looks. Thus, it has significant negative effects on the self-image of a person, his quality of life and self esteem.
For some people, Vitiligo might even be a limitation in pursuing the career of their choice or marrying the person they like. Such people must be encouraged to come out of their shells and to lead a healthy life that does not give too much significance to looks. They must be explained the significance of pursuing whatever they want in life with full confidence because suffering from Vitiligo does not change the kind of personality they have. Regular counseling may be required for those few who do not improve in spite of all these steps.

Natural Treatment
Recent studies conducted in University of Toronto and published in the BioMed Central journal of Dermatology have clearly demonstrated evidence of benefits of orally taken Ginkgo biloba in the treatment of Vitiligo. This is a known natural drug and besides some others drugs, it has been successfully used in the treatment of Vitiligo.
In another clinical study conducted by the AKP Homoeopathic Clinical Center, 259 Vitiligo patients had improved out of 629 patients included in the study and 42 Leucoderma patients had benefited out of 97 patients. Thus research has also demonstrated the effectivity of natural ingredients in a difficult condition such as Vitiligo.
At Hakeem Hashmi's, we have the expertise of treating more than 45,000 skin cases successfully over last 35 years and we can ensure you of a safe and scientific solution for your Vitiligo. The treatment is primarily aimed at stopping or slowing down the further destruction of melanocytes and stimulating the re-pigmentation in the existing patches. Our team of expert Hakeems, dermatologists and nutritionists work in unison to ensure the best for every case we treat.
The scope of natural treatment extends beyond the physical symptoms and the approach is more holistic in nature. It also addresses the underlying stress and depression that is often seen in many cases. Thus, the treatment at Hashmi Hashmi’s goes a step further and works towards re-integrating the patient into normal life.
Prognosis with natural treatment depends on certain criteria such as the location, duration, extent of spread and the disease activity. It also depends on the general health of the patients and the presence of other systemic illnesses such as thyroid disorders, auto-immune diseases, etc. Vitiligo over bony prominences, around lips, on tips of fingers and toes and generalized extensive Vitiligo show slow improvement. Even after starting the treatment, patient may notice occurrence of some new spots; however, this is because it takes some time to control the disease activity and balance the immune system.
The medicines prescribed at Hashmi Dawakhana are known to be safe without any adverse effects and the patients are not advised any particular dietary restriction which is otherwise a common case with most of the alternative treatments available in the market.
Additionally, at Hakeem Hashmi's , we follow certain international medical protocols set by our dermatologists to monitor the improvement of the Vitiligo patients:
•    Appearance of the Trichome sign (pale pink color development in the patches)
•    Re-pigmentation around the follicles
•    Concavity of the borders of the affected patch
Apart from all this, our qualified and experienced nutritionists formulate a personalized diet chart to give the Vitiligo patients valuable dietary help. Thus treatment at Hashmi Dawakhana is truly holistic in every sense of the word and is different from the superficial nature of conventional treatments for Vitiligo.
Brief overview of Conventional treatment options for Vitiligo:
The conventional methods aim at treating Vitiligo by altering its appearance without addressing the underlying cause. The treatment varies from the patches being hidden by cosmetic camouflage solutions to application of cortico-steroidal creams to phototherapy. Camouflage solutions also include tattooingof the affected patch. However, it is often difficult to match the exact color and the patches also tend to spread in spite of the tattooing.
Phototherapy is another option available but this carries a risk of causing sun burn as well as skin cancer. Lastly, surgical procedures are also opted for by many patients and include grafting of the skin on the affected patches but again these cannot be performed in extensive and generalized Vitiligo and carry the risk of scarring apart from its cost value.

Self Care Tips
Based on our expertise and experience of treating thousands of cases over the last 35 years, we at Hashmi Dawakhana have seen patients being helped with certain changes in their diet and lifestyle. These have been clinically verified by us repeatedly and have a scientific backing as well. Here are some points that Vitiligo patients can put to good use:
•    Exposing the affected areas to early morning sunlight just after sunrise is known to stimulate pigment forming cells. However, patients must avoid strong sunlight especially between 10 am to 4 pm. If necessary to move out during such hours, patients must opt for a sunscreen with SPF (Sun Protection Factor) of more than 30.
•    Regular use of sun screen also guards against sunburn and long term damage
•    Use mild soap for bathing and avoid rubbing skin vigorously after a bath (friction can trigger new patches)
•    Wear clothing that adequately covers the skin (e.g. full sleeved shirt) - this protects the skin from any kind of external trauma
•    Avoid direct contact with deodorants, perfumes - spray on clothes rather than directly on skin
•    Avoid mental stress - take effective steps to identify and tackle with stress, if it exists
•    Diet rich in copper is suggested for Vitiligo patients since scientific studies have shown low serum copper levels in patients suffering from Vitiligo. Green leafy vegetables and sesame are good sources of copper.
•    Supplementation with vitamin B12, folic acid and pantothenic acid has been seen to have beneficial effects in Vitiligo patients (it has been credited with the formation of new melanin). Patients should include adequate lentils, eggs and yogurt in their daily diet for the same.

Facts and Myths
Myth: Vitiligo is contagious.
Fact: It is not contagious and cannot be passed on through contact. Click here to read about what causes Vitiligo.
Myth: Vitiligo increases after consuming milk and other white foods.
Fact: It is an auto immune disease which has no direct relation to food.
Myth: Will my child also get it?
Fact: Researches claim that it does not get carried to the progeny, however strong hereditary tendencies cannot be denied.
Myth: Does the disease stop spreading as the treatment starts?
Fact: It can't be guaranteed as it takes time to build the immune system and by the time the immune system is built, few new spots might appear which recover as the treatment proceeds.
Myth: No new spots come after the stoppage of the treatment.
Fact: Generally speaking no new spots occur but there are certain cases of extreme stress or compromised immunity wherein the spots may recur, however these can be taken care of and controlled by the treatment.

Urticaria

An Overview
Urticaria (also known as hives) is a rash that is primarily a manifestation of an allergic reaction on the skin. One of commonest reasons for Urticaria is exposure to allergens. Peculiarly seen as clusters of raised, red wheals of varying sizes on the skin, this condition lasts for some time and then disappears without any trace. The condition is not life-threatening; however Angioedema is a severe variant and this condition may endanger life if not attended to promptly.
In a study involving natural treatment of 60 Japanese patients with chronic skin diseases (including Urticaria), the holistic approach used in natural ingredients was concluded as a useful strategy. Natural treatment can indeed be effectively used to treat Urticaria which otherwise tends to be a very elusive disease, especially in chronic cases. At Hashmi Dawakhana, we have the proficiency and experience in treating this disease successfully for more than 35 years now. Go ahead and experience an Urticaria-free life!

What is Urticaria?
Urticaria (hives) is basically an allergic skin rash that 15% of the world population will have experienced at some point in their lives. In most cases, the hives go away within a few weeks or less; however sometimes they may turn into a chronic problem. And a whopping 80% of the chronic cases are idiopathic, which means that no cause can be found.

The typical description of Urticaria is an itchy skin eruption that is characterized by 'wheals'. The wheals usually have with well-defined red margins and pale interiors. As discussed earlier, Urticaria is a manifestation of an allergic reaction and the eruptions tend to come and go intermittently. The wheals can last for several hours or even the whole day before fading off. When the wheals disappear, they do so without any trace.
Urticaria rashes can occur anywhere on the body such as the trunk, arms, legs, face, etc. They have a tendency to change locations - disappearing from one place and reappearing in another often in a matter of hours. A severe variant of Urticaria, called Angioedema is marked by swelling that occurs beneath the skin (at a deeper level) and this can be life-threatening.
The cases may be acute in nature (lasting less than 6 weeks) or may run a chronic course (for more than 6 weeks). In either case, treatment must be sought early on, so as to treat it effectively in the early stages itself.

Causes
The primary mechanism that leads to development of an urticarial rash is the release of histamine (a chemical) by the human immune system into the blood. In response to histamine, blood plasma leaks out of small blood vessels in the skin resulting in swelling.
A large number of things can trigger the onset of Urticaria and some of them have been discussed here:
•    Allergens: A number of food allergens, environmental allergens, etc. can trigger Urticaria; however reactions may vary in different individuals
o    Foods: Some of the common culprits are fish, crabs, oysters, shell fish, prawns, milk, cheese, eggs, nuts, chocolates, citrus fruits, spices, yeast, food additives and preservatives like tartazine, berries, wheat, tomatoes, pineapple, strawberries, alcohol, etc.
o    Environmental: Pollen, dander, fungi, house-dust are few of the common reasons
•    Drugs: A number of drugs can trigger an Urticaria rash and these include morphine, codeine, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen), certain antibiotics, vaccinations, contraceptive pills, etc.
•    Stings of insects such as bee stings commonly cause acute urticarial rashes
•    Infections: Parasitic worm infestations such as round worms, tapeworms, etc; bacterial infections, etc can also cause Urticaria
•    Cold Urticaria is one variant that results from exposure to extremely cold climates 
•    Solar Urticaria - results from exposure to sun
•    Pressure on the skin such as that caused by tight clothes may lead to pressure Urticaria
•    Physical exertion, exercise, hot shower, perspiration may trigger Cholinergic Urticaria
•    Direct physical stimulation of the skin by vibrations, firmly stroking or scratching the skin, etc.
•    Abnormal functioning of the immune system (auto-immunity) - has been considered to be a trigger for chronic Urticaria. Other auto-immune systemic illness such as thyroid disorders, systemic lupus erythematosus, etc. may be linked to Urticaria
•    Idiopathic - In about 80% of chronic Urticaria cases, the cause is unknown

Symptoms
A red, raised, itchy rash that comes suddenly, lasts for some time and then disappears without any trace is the typical history any patient of Urticaria will provide. The rashes may come and go with no apparent trigger at times. They can occur anywhere on the body and have the following features:
•    Irregular shaped, red, raised rashes - small or large in size
•    The rashes may have a central clearing
•    Intensely itchy - may lead to disturbance at work, sleeplessness, irritability, restlessness, impatience, etc.
•    Burning or stinging pain in the areas of affection
•    May be surrounded by a red flare
•    Lasting from few hours to the whole day
•    The frequency of the rashes is also not fixed - some people experience it once in a while whereas others may get rashes several times daily
Some of the variants of Urticaria that differ in presentation are discussed here:
•    Cholinergic: triggered by physical exertion or a hot bath or shower, this is marked by hundreds of small itchy bumps. These occur quickly and disappear in the same manner. Cholinergic Urticaria is seen more often in young people.
•    Dermographism:  This literally means 'skin writing'. The hives in this case are produced by direct physical stimulation of the skin such as stroking with a blunt object.
•    Angioedema: This is a severe variant also known as 'Giant Urticaria'. Large areas of affection are seen and swelling occurs around the eyes, lips, hands, feet, genitalia and inside the throat. When the wind-pipe in involved due to swelling in the throat, it can obstruct breathing and this is a medical emergency (Anaphylactic shock)
Symptoms to watch out for (report to your physician immediately if you experience any of these)
•    Difficulty in breathing
•    Dizziness
•    Tightness in chest, wheezing
•    Swelling of the lips, tongue, face

Diagnosis
Your medical history and a thorough examination by your physician are usually sufficient to diagnose Urticaria and no tests are usually required for this. However, to detect the cause of your Urticaria, your physician may ask you to get certain tests done such as:
•    Allergy tests: To check if the Urticaria is related to specific allergic triggers
•    Blood tests: Tests to rule out thyroid disease, other auto-immune diseases, etc.
You can help your physician in effective diagnosis and treatment by keeping a diary to track activities, drugs, foods, etc. that trigger your Urticaria.

Natural Treatment
In a study conducted on 60 Japanese patients with chronic skin diseases (including Urticaria as well as psoriasis vulgaris, eczema, atopic dermatitis, severe acne), the holistic approach used in natural ingredients was found to be a useful strategy.
A total of 88.3% of patients reported over 50% improvement in this study. The results were based on patient-reported and clinically observed effects of the individualized natural treatment. It was concluded that individualized natural treatment can provoke a good response in patients with chronic skin disease.
Apart from this study, a number of cases that have seen excellent relief with natural ingredients also provide clear evidence that natural treatment works effectively in allergic diseases like Urticaria.
At Hashmi Dawakhana we have treated thousand of cases of Urticaria and provided relief to a large number of suffering patients. We have helped many of them to get rid of their dependence on anti-histamines and steroids which provide only temporary relief.
The treatment for Urticaria may vary from cases to case - some requiring short-term whereas others requiring long term treatment. The duration of treatment depends on various factors such as the severity, duration and extent of the illness, nature of treatment taken for the same and general health of the patient. Some forms are obstinate and need more patience on part of the patient. Over a period of time, we can taper and even stop the conventional medications being taken by the patient.
Natural ingredients also help to deal effectively with the psychological aspects of this illness such as depression, irritability, aggressiveness, etc. Overall, patients report significant change in their physical and mental health with continued treatment. And not to mention that the treatment is without any side-effects whatsoever! Natural treatment is definitely suggested in all cases and forms of Urticaria.

Self Care Tips
Our experience and expertise of treating a large number of cases has helped us devise effective tips that can be very fruitful to our patients of Urticaria. Some of these are discussed here:
•    For relief from the burning and itching, apply cool compresses or wet cloths over the affected areas
•    Stay in cool (not very cold) environment as far as possible
•    Wear cotton garments and preferable loose-fitting ones
•    Avoid known triggers such as foods or food additives, alcohol, medications, temperature extremes, stress, etc. that can trigger an attack
•    Keep a diary of your activities to help your doctor identify triggers
•    Avoid foods that contain high levels of histamine naturally such as eggplant and spinach. Food additives such as azo dyes, preservatives, etc. also mediate the release of histamine.
Report to your physician immediately if you experience any of these symptoms which may be signs of an impending Angioedema:
•    Difficulty in breathing
•    Dizziness
•    Tightness in chest, wheezing
•    Swelling of the lips, tongue, face

Tonsillitis Overview

One of the commonest complaints amongst children and affecting as many as one out of every 10 people worldwide, tonsillitis is surely one condition that demands a lot of attention from medical experts. Commonly known as sore throat, tonsillitis is basically an inflammation of the tonsils which are protective glands (lymph glands) situated in the throat.
Tonsils play a vital role in protecting the body against harmful bacteria and viruses. However, when the immunity reduces, the tonsils themselves fall prey to these infective organisms thereby resulting in swelling (inflammation) of the tonsils. On account of tonsillitis, patient experiences pain in the throat, difficulty in swallowing, fever, etc.
Surgical removal of tonsils was once a very common method of treating tonsillitis; however, it has now been proved that surgical treatment is not the only option for chronic and recurrent tonsillitis. Research studies have now clearly shown that natural treatment is very effective in treating cases of tonsillitis safely and gently and without any side effects. The immunomodulatory, analgesic and anti-inflammatory properties of natural medicines have now been accepted as playing an important role in treating tonsillitis. At Hashmi Dawakhana, we have been treating cases of tonsillitis for 35 years now and have had good results in most cases. The treatment has helped many patients to avoid get operated upon. Go ahead and experience the goodness of natural ingredients at Hakeem Hashmi's.

What is Tonsillitis?
Inflammation or infection of the tonsils is medically termed as tonsillitis. Tonsils are protective (lymph) glands that are situated on both sides in the throat. The tonsils constitute an important part of the body's immune system and are vital defense organs. They protect the body from bacteria and viruses by fighting these as soon as they enter the body (via the oral/nasal cavity). The tonsils along with adenoids are said to form the 'first line of defense' against infective organisms.
In the normal state, tonsils are pink in color (similar to their surroundings tissues) and about the same size. When the tonsils get inflamed, they become red, swollen and may develop pus pockets that start exuding a discharge. In cases with recurrent infections, the tonsils may become so swollen over a period of time so as to almost touch each other.
There are three types of tonsillitis:
•    Acute tonsillitis- An episode of tonsillitis that has been of recent origin is termed as acute tonsillitis. Acute tonsillitis can last for anywhere between four to ten days. It is commonly caused by virus or bacteria.
•    Sub-acute tonsillitis - This type of tonsillitis is commonly caused by the bacterium Actinomyces and lasts for more than 2 weeks.
•    Chronic, recurrent tonsillitis - Chronic tonsillitis is mostly caused by bacteria and lasts long periods. There may be enlargement of tonsils in cases of chronic infection. In case of recurrent tonsillitis, the patient tends to get episodes of tonsillitis repeatedly and remains symptom-free in between these episodes. It has been seen that recurrent episodes of tonsillitis can lead to scarring of the tonsils and renders them less capable of fighting against infections.
Tonsillitis can affect people of all ages though it tends to be very common amongst children especially those between the ages of 5 to 10 years. No particular gender predilection is seen in cases of tonsillitis.

Causes of Tonsillitis
In a vast majority of cases, tonsillitis is cause by a viral infection (i.e. due to a virus). Certain bacteria can also cause tonsillitis and Streptococcal bacteria have been found to be the culprit in some cases. These are the same bacteria that cause streptococcal throat infection. Tonsillitis can rarely be caused by fungus or parasites also.
A number of food substances can lead to tonsillitis in susceptible individuals and common triggers include foods with artificial colors and preservatives, peanuts, cold foods, cold drinks, ice creams, sour foods, etc. The possible mechanism may be triggering of an abnormal immune response on exposure to any of these substances which acts as an allergen.
Episodes of tonsillitis can also be triggered by environmental changes though the exact mechanism has not been clearly understood. Changes of weather, extremely cold climate, damp weather, exposure to a lot of pollution, etc. can all trigger an episode of tonsillitis.
Tonsillitis can easily spread from one person to another via droplet infection. When a person with tonsillitis coughs or sneezes, the infection is dispersed in the air in the form of minute droplets which when inhaled by a healthy individual can lead to infection. These droplets can also settle on certain objects (e.g. handkerchief, telephone receiver, door handles, etc.) and when these objects come in contact with the nose, mouth or eyes of a healthy individual, the infection can get transmitted.
Crowded places such as shopping malls, theatres, classrooms, etc. form a fertile ground for the infections to thrive and spread further to more and more people.
Thus there are multiple factors that work together in conjunction to cause tonsillitis in any given case.

Symptoms of Tonsillitis
The symptoms of tonsillitis vary from case to case and may be gradual or sudden in onset. In most cases of tonsillitis, a varying combination of the following symptoms is seen:
•    Soreness of throat
•    Difficulty in swallowing or painful swallowing of food and drinks
•    Pain / discomfort while swallowing saliva
•    Fever with or without chills
•    Red and swollen tonsils
•    White spots (specks or patches) on the tonsils
•    Enlarged lymph nodes in the neck region
•    Change of voice
•    Bad breath, foul breath
•    Pain in the ears (due to common nerve supply of the back of the throat and ears)
•    Headache
•    Malaise, tiredness
•    Difficulty in taking feeds in babies - this may be the sole indicator in some cases of tonsillitis in infants
In certain cases of tonsillitis, the following symptoms may also be seen:
•    Runny nose
•    Cough
•    Hoarseness
•    Nausea and vomiting
•    Skin rash
If left untreated, tonsillitis can lead to the development of any of the following:
•    Chronic tonsillitis: When infection of the tonsils persists, it leads to formation of small pockets in the tonsils where bacteria thrive for extended periods and lead to chronic tonsillitis. This may further lead to formation of small calcified pieces called tonsilloliths that remain lodged on the tonsils. Tonsilloliths emit a foul smelling, rotten egg like odor (halitosis) which gives rise to bad breath. Patient frequently experiences a foreign body sensation in the back of the throat due to tonsilloliths.
•    Peritonsillar Abscess: Collection of pus behind the tonsils is called peritonsillar abscess. Patients who develop peritonsillar abscess experience severe pain in the throat and difficulty in opening mouth. This condition can spread to cause life-threatening complications if not attended to promptly.
•    Enlargement of tonsils (Hypertrophic tonsils): Enlarged tonsils can obstruct breathing leading to snoring and disturbed sleep pattern. Obstructed breathing due to enlarged tonsils can be seen in patients as frequent waking at night, restless sleep, excessive sleepiness during daytime, irritability, etc.

Diagnosis of Tonsillitis
Diagnosis of tonsillitis can easily be made by the treating physician based on the history given by the patient and the findings on examination. Examination of the throat in tonsillitis reveals:
•    Redness and swelling of the tonsils
•    Pus pockets on the tonsils
•    Discharge from the tonsils
•    In case of peritonsillar abscess, there may be a shift of the involved tonsil towards the center of the throat. The uvula may be shifted towards the opposite side (away from the affected tonsil).
The treating physician may order certain tests that will confirm the diagnosis of tonsillitis. These tests include:
•    Throat swab: This is used to get a sample of the secretion from the back of the throat. The sample is then checked in a laboratory for the presence of bacteria.
•    Blood tests: This primarily includes a complete blood count (CBC) which is done to confirm the presence of infection.

Natural Treatment
Natural treatment of tonsillitis is time-tested and has proven to be useful in most cases. In one of the research studies conducted on 107 patients of acute tonsillitis, all the cases were treated with natural remedies (Phytolacca americana, Guajacum officinale, Capsicum annuum) and no antibiotics were used. In as less as two and a half days after starting treatment, a significant reduction in the symptoms of acute tonsillitis was seen in the patients. No serious side effects were reported at all in any of the cases. The treatment had been prescribed after taking into account objective as well as subjective symptoms of the patients. This study thus concluded that acute tonsillitis can be successfully treated with natural ingredients. It also clinically proved the immune-modulatory, analgesic, and anti-inflammatory properties of natural remedies.
At Hashmi Dawakhana, we have been treating cases of tonsillitis (acute, chronic, recurrent) for 35 years now and have had good response in most cases. Thousands of cases that have been treated at Hakeem Hashmi's have reported freedom from the recurrent attacks of tonsillitis and have been saved from surgery for the same.
Natural treatment targets the root cause of the ailment and reduces the tendency of the patient to fall prey to frequent attacks of tonsillitis. It improves the immunity of the patient and thus provides long term benefits rather than simply controlling the acute infection as happens with conventional medicines. Thus patients of tonsillitis who opt for timely and regular natural treatment have a reduced need for antibiotics or may even be able to avoid the same completely.
Regular treatment with natural medicines ensures that the patient gets lesser attacks of tonsillitis and even when they do occur, they are not as severe and are easily controlled with proper medication. The good part about Natural treatment is that it is without any side effects and thus is completely safe and non-toxic. For effective and safe solution to acute, chronic or recurrent tonsillitis, natural treatment is indeed the best.

Self care tips for Tonsillitis
Tonsillitis can usually be tackled well with natural medicines; however some self-help tips can help patients to cope better with their discomfort. Based on our experience of treating a large number of patients with natural treatment at Hashmi Dawakhana, we have found that following certain clinical tips make a lot of difference to tonsillitis patients and helps them deal better with the pain and suffering of tonsillitis.
Here are few of the important clinical tips that can be used in cases of acute, chronic and recurrent tonsillitis:
•    Gargle with warm water (one cup) to which 1 teaspoon of salt has been added - repeat this twice in a day or more frequently if required
•    Drink plenty of fluids. Patient may not feel like drinking fluids on account of the throat pain but should still consume lot of water to keep the throat moist and to prevent dehydration
•    A humidifier should be used in the room where the patient is resting or working
•    Avoid spicy foods, smoking, acidic drinks
•    Suck on throat lozenges as they soothe the pain
•    Avoid eating food and limit the intake to soups, milkshakes, etc. if the throat is very bad and the patient cannot eat at all
•    Make a drink by mixing honey and lemon juice in warm water - sip it often to soothe the throat and reduce mucus production
•    Care for others too - keep your mouth covered while coughing or sneezing and wash your hands regularly to keep them clean