For the last several months, my younger brother, who is 25, has been dealing with pain, swelling, and discomfort near the tailbone area. At first, he thought it was just a small pimple or irritation from sitting for long hours at work, but the pain got worse over time. He started feeling a tender lump in the area, and sometimes it would leak fluid or even blood, which scared him.
We finally convinced him to see a doctor, and they diagnosed him with a pilonidal cyst. Before this, we had never even heard of the condition, but the doctor explained that a pilonidal cyst is a sac filled with hair, skin debris, and fluid that forms near the tailbone, usually due to ingrown hairs or prolonged pressure on the area.
The doctor said that pilonidal cysts are more common in people who sit for long periods, like office workers or truck drivers, and that they can become infected if not treated properly. In my brother’s case, the cyst became abscessed, and they had to drain it. He was prescribed antibiotics, but the doctor warned that the cyst might return if the underlying issue isn’t fixed.
Now we are trying to figure out the best way to prevent a pilonidal cyst from coming back. Some people say that laser hair removal can help reduce the risk by preventing ingrown hairs, while others suggest using antiseptic washes and warm compresses regularly.
One thing we are worried about is that some doctors recommend surgery to remove the cyst entirely, while others say that surgery can sometimes make the problem worse. If anyone has dealt with a pilonidal cyst, I’d love to know—does surgery completely cure it, or does it still come back? Are there any natural remedies or non-surgical treatments that have worked for others?
Would really appreciate any advice on managing and preventing pilonidal cysts in the long run.
Clinical Summary:
Your brother, 25 years old, has been diagnosed with a pilonidal cyst, which is a common condition characterized by the development of a cyst or abscess near the tailbone (coccyx) typically due to ingrown hairs and prolonged sitting. Symptoms include pain, swelling, tenderness, and possible drainage of fluid or blood. Treatment has involved drainage and antibiotic therapy, and you are seeking ways to prevent recurrence.
Etiology and Risk Factors:
Pilonidal cysts occur when hair penetrates the skin, leading to the formation of a cyst filled with hair, skin debris, and fluid. Risk factors for developing pilonidal cysts include:
- Prolonged sitting: Occupations that involve sitting for long hours can increase pressure in the sacrococcygeal area.
- Obesity: Increased body weight may contribute to the formation of cysts due to pressure.
- Hirsutism: Increased hair growth can increase the risk of ingrown hairs.
- Family history: Genetic predisposition can play a role.
Treatment Plan:
1. Surgical interventions:
- While drainage is often effective for acute abscesses, surgical options (like excision or marsupialization) may be considered, particularly for recurrent cysts. Surgical removal has been shown to have a longstanding cure rate of approximately 70-90% (Thompson et al., 2020). However, complications and recurrence can occur, particularly if not all cyst tissue is removed.
- Less invasive options, like phenol injection after drainage, might also be explored, which has been evidenced to reduce recurrence (Ger et al., 2021).
2. Non-surgical interventions for prevention:
- Laser hair removal: Evidence supports that laser hair removal can significantly reduce recurrence rates by minimizing ingrown hairs; studies indicated a reduction in recurrence when compared to traditional methods (Hirsch et al., 2019).
- Personal hygiene: Regular cleansing of the area with antiseptic washes and keeping the area dry and free from hair may help prevent new cyst formation.
- Warm compresses: These may help reduce irritation and promote drainage of any residual debris, but they are supportive rather than curative.
3. Lifestyle modifications:
- Encourage your brother to adjust his sitting habits by taking frequent breaks, using cushioned seating, and incorporating physical activity to reduce pressure on the coccygeal area.
- If overweight, weight loss can significantly impact the prevention of recurrence.
4. Follow-up and monitoring:
- Regular follow-ups with a healthcare provider to monitor the site and address any early symptoms of recurrence are essential.
Patient Communication:
It is important to convey to your brother that while pilonidal cysts can be troublesome, clear strategies can significantly reduce the risk of recurrence. Surgical removal presents a viable option with a good success rate but should be carefully considered based on his specific circumstances. Non-surgical interventions can also play a significant role in managing his condition long-term. Be sure he feels supported and involved in decision-making, and address any concerns he might have about potential outcomes.
It would be advisable to consult a specialist (e.g., a colorectal surgeon) who has experience with pilonidal disease to discuss the most appropriate management plan tailored to his case. This holistic approach will provide your brother with the best chances of preventing future issues.
I’ve been dealing with severe hair fall, and I’m trying to find the best shampoo for hair fall that actually works. I know hair loss can be caused by stress, diet, hormones, and genetics, but does using the right shampoo make a real difference?
From what I read, shampoos with biotin, caffeine, keratin, or natural oils are recommended for hair fall. But do they really help strengthen hair, or is hair loss mostly an internal issue? Should I be looking for sulfate-free shampoos, or are those just a marketing trend?
I also wonder if medicated shampoos like ketoconazole or minoxidil-based ones work better for hair loss caused by dandruff, scalp infections, or androgenetic alopecia. How do I know which type of hair fall shampoo is best for my condition?
For those who have struggled with hair fall, which shampoos actually helped reduce shedding? Did you have to combine it with supplements or treatments like PRP therapy?
Shampoos can help support hair health, but they usually aren't a cure for hair loss on their own. Ingredients like biotin, caffeine, keratin, and natural oils can nourish the scalp and hair, making hair stronger and potentially reducing breakage. However, hair loss is often influenced by internal factors like hormones, stress, diet, and genetics, which shampoos alone can’t address.
Sulfate-free shampoos are gentler on the scalp and hair, which can be beneficial if you're dealing with sensitivity, but they're not necessarily a solution for hair loss. Medicated shampoos containing ketoconazole or minoxidil can be more effective for treating hair loss related to dandruff, scalp infections, or androgenetic alopecia. Minoxidil, in particular, is a well-known treatment for androgenetic alopecia.
To determine the best shampoo for your situation, I recommend starting by identifying the underlying cause of your hair loss. You may want to consult a doctor or dermatologist to rule out any medical conditions or hormonal imbalances. Combining treatments like PRP therapy, supplements, or prescription medications may also be helpful depending on the root cause.
I recently experienced hives, but I don’t fully understand what they are or what causes them to appear suddenly. From what I read, hives are red, itchy welts that show up on the skin, but does that mean they are always caused by allergies, or can other factors trigger them? I also saw that hives can be triggered by stress—does that mean emotional anxiety can lead to a skin reaction, even without an allergen? Another thing I’m wondering about is whether food allergies are a major cause—do dairy, nuts, or seafood commonly trigger hives, or is it different for everyone? I also read that hives can appear due to temperature changes—does that mean exposure to heat, cold, or even sunlight can cause them? Another thing I’m curious about is how long hives last—do they go away on their own, or do antihistamines help speed up recovery? Also, if someone keeps getting hives frequently, should they see an allergist, or is it usually not a sign of a serious condition? I just want to understand what hives are, what causes them, and how to treat and prevent them effectively.
Hives, also known as urticaria, are indeed characterized by red, itchy welts on the skin, and they can arise from a variety of triggers, not solely allergens. Here’s a breakdown of your questions and concerns about hives:
Hives can be triggered by several factors, including:
1. Allergies: Foods like dairy, nuts, and seafood can trigger hives in individuals with specific allergies. However, the allergens vary from person to person, so someone might react to one food but not another.
2. Non-allergic triggers: Hives can also be induced by non-allergic factors such as:
- Physical stimuli: Temperature changes (heat, cold), pressure on the skin, sunlight exposure, or vigorous exercise.
- Stress: Emotional stress can indeed provoke hives even without direct exposure to allergens. This response varies among individuals.
3. Infections: Viral infections, bacterial infections, or certain illnesses can trigger hives.
4. Medications: Some medications may cause allergic reactions leading to hives, while others may induce hives through different mechanisms.
In terms of duration, hives can vary. Some may resolve within minutes to hours, while chronic hives (lasting more than six weeks) may persist for longer periods. Antihistamines are often effective in relieving itching and hastening the resolution of hives. The recommended dosages for common over-the-counter antihistamines like cetirizine or loratadine are typically one tablet per day, but you should always follow the instructions on the packaging or consult with a healthcare professional if you're unsure.
If you're experiencing frequent outbreaks of hives, it’s a good idea to speak with a healthcare provider for a complete evaluation. They may refer you to an allergist, especially if there are identifying factors such as specific foods or environmental triggers. While hives are often not indicative of a serious condition, chronic or recurrent cases warrant expert evaluation to identify and manage underlying causes.
For self-management, try to:
- Keep track of potential triggers to help identify patterns.
- Consider using antihistamines at the onset of new hives.
- Avoid known allergens and minimize stress when possible.
If you experience severe symptoms such as difficulty breathing, swelling of the face or throat, or feel faint, seek immediate medical attention as these may indicate a more serious allergic reaction.
Always consult a healthcare professional for personalized advice, particularly if hives persist or worsen.
I was prescribed hydrocortisone cream for a rash, but I’m not sure how often I should apply it. How does hydrocortisone work, and what types of skin conditions is it best for?
I’ve heard that long-term use of hydrocortisone can thin the skin. How can I prevent side effects while using it? Also, is it safe to apply hydrocortisone on the face, or should it only be used on certain areas?
If the rash doesn’t improve with hydrocortisone, does that mean I need a stronger medication? I need advice on how to use this treatment effectively and safely.
Hydrocortisone cream is a topical corticosteroid that helps to reduce inflammation, itching, and redness associated with various skin conditions. It works by suppressing the local immune response and reducing the production of inflammatory substances.
It is commonly prescribed for conditions such as eczema, contact dermatitis, insect bites, and psoriasis. The specific frequency of application often depends on the condition being treated and the strength of the formulation. Typically, hydrocortisone cream can be applied 1 to 3 times daily, but you should follow your healthcare provider's recommendations closely or check the instructions provided with the medication.
Regarding long-term use, you're correct that prolonged application of hydrocortisone, especially in high-potency formulations, can lead to skin thinning (atrophy), striae (stretch marks), or other side effects. To minimize these risks, here are some suggestions:
1. Use the cream sparingly and only on affected areas.
2. Avoid occlusion (covering the area with a bandage or tight clothing) unless instructed otherwise by your healthcare provider.
3. Limit the duration of use, especially on thin-skinned areas, such as the face, and discuss with your doctor if you should take breaks from treatment.
4. If you are using it on your face, do so cautiously and for the shortest duration possible, as the skin there is thinner and more sensitive.
If you do not see improvement in your rash after using hydrocortisone for a couple of weeks, or if the condition worsens, it does not necessarily mean you need a stronger medication, but you should consult your healthcare provider. They may consider reevaluating your condition, exploring other treatment options, or conducting further investigations.
Always monitor your skin for any adverse reactions such as increased redness, burning, or irritation, and report these to your doctor. If you're unsure about any aspect of your treatment or have concerns about your rash, make an appointment to discuss them directly with your healthcare provider, who can provide tailored advice based on your individual needs and circumstances.
I’ve been struggling with melasma for a while now, and it’s been frustrating because nothing seems to work long-term. It started as a few light patches on my cheeks, but over time, they’ve darkened and spread across my forehead and upper lip. The pigmentation is more noticeable when I spend time in the sun, even though I always wear sunscreen. I’ve tried different over-the-counter melasma treatment creams, but they either don’t work or cause irritation. I was prescribed hydroquinone in the past, but I stopped using it because I heard it can cause side effects if used for too long. Are there any safer alternatives that are just as effective?
I also read that hormonal changes can trigger melasma, and I wonder if my birth control pills are making it worse. Could switching to a different contraceptive help, or would that not make a difference? I’ve also been considering in-office treatments like chemical peels or laser therapy, but I’ve heard mixed reviews on whether they actually work for melasma. Do allopathic doctors recommend laser treatments for melasma, or is it better to stick with topical treatments? I just want to find a solution that will lighten these dark patches without making my skin more sensitive. Also, are there any specific lifestyle changes or diet modifications that can help prevent melasma from getting worse?
Managing melasma can indeed be challenging, especially when conventional therapies fail to produce lasting results or cause irritation. Given your history and current concerns, here are several targeted recommendations based on your situation.
1. Topical Treatments: Since you've previously used hydroquinone and experienced irritation with over-the-counter options, consider non-hydroquinone topical agents. Effective evidence-based alternatives include:
- Tretinoin: A prescription retinoid that can promote skin cell turnover and enhance the efficacy of other treatments. It might initially cause irritation, so starting with a lower concentration and gradually increasing is advisable.
- Azelaic Acid: This has antimicrobial and anti-inflammatory properties and can improve pigmentation. It’s generally well-tolerated and may cause fewer side effects than other treatments.
- Kojic Acid and Vitamin C (Ascorbic Acid): Often used in combination formulations, these agents can also help brighten skin.
2. Hormonal Considerations: Hormonal fluctuations, especially related to birth control, can indeed exacerbate melasma. Discuss with your healthcare provider about your birth control options. Switching to contraceptives that have lower estrogen or considering non-hormonal options may be beneficial. Monitoring any changes after a switch will be crucial.
3. In-Office Treatments: You are correct that in-office treatments can be effective for melasma, especially when combined with topical agents. Options to consider include:
- Chemical Peels: Superficial peels with glycolic acid could be beneficial, but it's essential for a qualified dermatologist to tailor the treatment to your skin type and melasma severity.
- Laser Therapy: Treatments like fractional lasers and intense pulsed light (IPL) can yield positive results for melasma in several patients. However, they carry a risk of post-inflammatory pigmentation, especially for individuals with darker skin tones. A consultation with a dermatologist who specializes in melasma is advised to discuss the risks and expected outcomes.
4. Lifestyle Modifications: To help manage and prevent melasma flare-ups, consider these adjustments:
- Use a broad-spectrum sunscreen daily with an SPF of at least 30, reapplying it every 2 hours, especially after swimming or sweating.
- Wear sun-protective clothing and seek shade during peak sun hours.
- Incorporate antioxidants in your diet (fruits and vegetables rich in vitamins C and E) which may support skin health. There is some evidence suggesting that a diet low in processed sugars and rich in omega-3 fatty acids can also benefit skin integrity.
5. Follow-Up: Given the complexity of melasma treatment, establishing a follow-up plan with a dermatologist who understands your concerns is vital. They can help monitor treatment response and make adjustments as necessary.
In summary, effective management of melasma often requires a multifaceted approach that includes the right combinations of topical treatments, possible hormonal evaluation, and professional aesthetic interventions. It’s essential to tailor your management plan with a qualified dermatologist who can provide individualized advice based on your skin type and treatment history.
I recently heard the term acanthosis, but I don’t fully understand what it means or why it happens. From what I read, it’s a skin condition that causes dark, thick patches, but does that mean it’s a disease on its own, or is it always a symptom of something else? I also saw that acanthosis nigricans is linked to insulin resistance—does that mean it’s a warning sign for diabetes? Another thing I’m wondering about is whether acanthosis is only caused by high blood sugar, or if obesity and hormonal issues can also trigger it. I also read that it can appear in places like the neck, armpits, and groin—does that mean friction plays a role in making it worse? Another thing I’m curious about is whether acanthosis can be reversed—if someone loses weight or improves their insulin levels, do the dark patches go away, or are they permanent? Also, are there any creams or treatments that help lighten the affected areas, or is managing the underlying cause the only way to treat it? I just want to understand what acanthosis means, why it happens, and how to treat it.
Acanthosis, particularly acanthosis nigricans, is a skin condition characterized by dark, velvety patches that appear predominantly in areas such as the neck, armpits, groin, and sometimes on the elbows and knees. It is indeed considered more of a symptom rather than a standalone disease. Acanthosis nigricans is often associated with underlying conditions, predominantly insulin resistance, which is a key factor in the development of type 2 diabetes.
Insulin resistance occurs when the body's cells do not respond well to insulin, leading to elevated blood sugar levels over time. This condition can signal that someone may be at a higher risk of developing diabetes, especially if accompanied by other risk factors such as obesity. While high blood sugar is a significant contributor, obesity, hormonal imbalances (such as polycystic ovary syndrome), and certain medications can also play a role in triggering this skin change.
Friction can indeed exacerbate the appearance of acanthosis nigricans, as the condition often develops in skin folds and areas subject to friction, but it is not a primary cause. The primary driver remains the underlying metabolic condition.
Regarding reversibility, the good news is that these dark patches can often improve or even resolve with effective management of the underlying cause. For instance, weight loss and improved insulin sensitivity can lead to a noticeable reduction in the pigmentation. Even modest weight loss of 5-10% can have a significant impact on insulin levels and the skin changes.
In terms of treatment options, while managing the underlying cause is crucial, there are also topical treatments that might help lighten the affected areas. These could include over-the-counter creams containing ingredients such as alpha hydroxy acids, retinoids, or prescription-strength products like tretinoin. However, a healthcare professional should evaluate the condition and provide specific recommendations tailored to individual needs.
I recommend scheduling an appointment with a healthcare provider to discuss your concerns, as they can offer a personalized assessment based on your medical history and potential risk factors. They may suggest tests to evaluate your insulin levels and provide guidance on weight management or other lifestyle changes that could help. Understanding the broader context of your health will be key to effectively addressing acanthosis nigricans.
I’ve been dealing with persistent skin issues for a while, and I’m wondering if I should see a dermatologist, but I don’t fully understand what they specialize in. I know they treat skin conditions, but do they only handle serious cases, or can they also help with mild problems like acne and dryness? I have sensitive skin that reacts to certain products, and I occasionally get rashes that don’t seem to go away with over-the-counter creams—would a dermatologist be the right person to see for this? Also, do they only focus on medical skin conditions, or do they also provide cosmetic treatments, like chemical peels or anti-aging procedures? I’ve been considering getting a mole checked out, but I don’t know if I should wait for it to change or just get it examined now. What are the warning signs that a skin issue needs professional attention rather than just home remedies? Also, do dermatologists handle hair and nail conditions, or are those separate specialists? I just want to understand when it’s necessary to see a dermatologist and what kinds of treatments they can offer for different skin concerns.
It sounds like you're dealing with various skin-related issues, and it’s great that you are seeking information about when to consult a dermatologist. Dermatologists are medical doctors who specialize in diagnosing and treating a wide range of skin, hair, and nail conditions, so they can help with both mild and severe issues.
1. Conditions Treated: Dermatologists address everyday concerns like acne and dryness, as well as chronic conditions such as eczema, psoriasis, and persistent rashes. If your rashes aren’t improving with over-the-counter creams, it would be advisable to consult a dermatologist for a thorough evaluation and tailored treatment plan.
2. Cosmetic Procedures: In addition to medical treatments, many dermatologists are also trained in cosmetic procedures. These include chemical peels, laser treatments, and anti-aging procedures, so if you're considering any cosmetic enhancement, they can provide appropriate options.
3. Mole Examination: If you have a mole you are concerned about, it’s best not to wait for any changes before getting it checked. Dermatologists recommend examining moles if you notice any of the following warning signs: asymmetry, irregular borders, multiple colors, a diameter larger than a pencil eraser, or any changes in size, shape, or color (commonly referred to as the ABCDE rule). Early evaluation is key to addressing potential issues effectively.
4. When to Seek Help: If you experience any of these situations, it's advisable to seek professional attention rather than just relying on home remedies:
- A rash that doesn’t improve or worsens over a few days
- Persistent skin irritation that disrupts daily activities
- New growths or changes in existing moles
- Severe acne that leads to scarring
- Skin infections or excessively dry skin
5. Hair and Nail Conditions: Dermatologists also treat hair disorders (like hair loss or scalp issues) and nail conditions (like fungal infections). They are equipped to handle these areas and can provide appropriate treatment or referrals as necessary.
Given your symptoms of sensitive skin and rashes that don't resolve with over-the-counter treatments, I recommend scheduling an appointment with a dermatologist. They can perform a comprehensive assessment, help identify the causes of your skin issues, and discuss potential treatment solutions, whether they are medical or cosmetic.
I’ve been hearing a lot about retinol lately and how it’s supposed to be amazing for reducing wrinkles and fine lines. I’m considering adding a retinol cream to my skincare routine, but I’ve also heard it can irritate your skin.
How do you use retinol safely without causing redness or peeling? Does it really work for anti-aging, or is it overhyped?
Retinol, a form of vitamin A, is one of the most well-researched and effective ingredients for anti-aging. It can help reduce fine lines, wrinkles, and even improve skin texture by increasing cell turnover and stimulating collagen production. So, yes, it definitely works, but the key is using it correctly to avoid irritation.
To start, use a lower concentration (like 0.25% or 0.5%) and apply it only 2-3 times a week at first to allow your skin to adjust. You can gradually increase the frequency as your skin gets used to it. To minimize irritation, apply it to clean, dry skin, and make sure to follow up with a gentle moisturizer. Avoid using it on the same nights as other strong actives, like exfoliating acids.
If you experience redness or peeling, scale back and focus on moisturizing. The irritation should subside as your skin builds tolerance. And, don’t forget sunscreen in the morning, as retinol can make your skin more sensitive to the sun.
Retinol is definitely worth trying for anti-aging, but it's important to be patient with your skin while it adjusts. If you continue to have trouble with irritation, a dermatologist might be able to recommend other formulations or alternatives.
For the past year or so, I’ve been struggling with persistent acne on my face. I’ve tried several over-the-counter treatments, but nothing really worked, so I finally decided to go to a dermatologist. After checking out my skin, the doctor prescribed adapalene and benzoyl peroxide gel. I’ve read a little about both ingredients, but I still have a lot of questions about how this treatment works and what to expect.
I’m 25, and I’ve had acne for as long as I can remember, mostly along my jawline and cheeks. The acne has been getting worse in the past few months, so I was relieved when the dermatologist prescribed adapalene and benzoyl peroxide gel. I know adapalene is a retinoid that helps with cell turnover, and benzoyl peroxide is supposed to kill acne-causing bacteria. But I’m wondering, how exactly do these two ingredients work together to treat acne? Will I see results quickly, or does it take time for them to start clearing up my skin?
I’ve been using the gel for about a week now, and I’ve noticed some dryness and redness around the areas I applied it. Is this normal, or should I be worried? I’ve also read that adapalene and benzoyl peroxide gel can cause peeling, and I’ve been experiencing some of that. Should I continue using the gel even though my skin seems to be reacting this way, or should I scale back?
One thing I’m unsure about is how often I should use the adapalene and benzoyl peroxide gel. I’ve been applying it once a day before bed, but I’ve heard some people use it twice daily. Would using it twice a day make it more effective, or is it better to stick with once a day? Also, I’ve heard that adapalene and benzoyl peroxide gel can make your skin more sensitive to the sun. Should I be avoiding the sun completely, or can I still go outside if I wear sunscreen?
Lastly, I’m curious about how long I’ll need to keep using adapalene and benzoyl peroxide gel before I see significant improvement. If I start seeing some improvement, but not total clearance, should I continue using it as directed, or will I eventually need to switch to something else?
It's great to hear you've sought advice from a dermatologist, as acne treatment can often benefit from professional guidance. Let's address your questions regarding adapalene and benzoyl peroxide gel, which are effective ingredients in acne management.
Adapalene is a topical retinoid that promotes cell turnover, helping to prevent clogged pores, while benzoyl peroxide acts as an antibacterial agent that kills the bacteria responsible for acne and has anti-inflammatory properties. When used together, these ingredients can complement each other by addressing multiple factors of acne formation, including excess oil production, clogged pores, and bacterial growth. This synergistic effect can enhance the overall efficacy of the treatment.
It's common to experience some dryness, redness, and peeling when starting a new acne treatment, particularly with retinoids like adapalene. These effects are generally part of the adjustment period as your skin acclimates to the medication. However, if the irritation becomes severe or painful, it would be advisable to consult your dermatologist for further guidance. You can continue using the gel as directed, but consider applying a gentle, hydrating moisturizer after the gel to help alleviate some of the dryness. Starting with every other night application for adapalene may also help your skin adjust before resuming nightly use.
Regarding the frequency of application, using adapalene and benzoyl peroxide gel once a day is typically effective for most individuals, and increasing to twice a day can sometimes lead to increased irritation without necessarily enhancing results. Stick to the prescribed once-daily application unless your dermatologist recommends a different regimen.
Since these treatments can increase your skin's sensitivity to the sun, it’s crucial to apply a broad-spectrum sunscreen daily with an SPF of 30 or higher, even on cloudy days. Avoid prolonged sun exposure, especially during peak hours, to prevent sunburn and further irritation.
In terms of how long you might need to use these treatments, patience is essential. Many patients begin to notice improvement in four to six weeks of consistent use, although complete clearance may take several months. If you observe some improvement but still have persistent acne after a couple of months, it's worth discussing with your dermatologist. They may adjust your treatment plan or recommend additional therapies.
Overall, continue with your current regimen while monitoring your skin's reactions closely, and maintain regular follow-ups with your dermatologist to evaluate your progress. This way, you can make informed decisions about your treatment moving forward.
round patches like ringworm appears on various body parts..but that is not wring worm ..it's not ichy..spreading day by day ..what is the reason for this and what is treatment...I can share photos if you want to see
Hello
Kindly send the image once.
