Healthy Life

Kehamilan Trimester 1

2012-01-16T20:59:00.000+07:00

~ Minggu : 1

Jaga Kondisi Tubuh Ibu

Tubuh Ibu akan banyak berubah dalam 3bulan pertama kehamilan. Janin berkembang di dalam rahim Ibu, perasaan mual,nyeri punggung, lelah, perubahan mood, keram kaki, sering berkemih, dan konstipasidapat terjadi di awal kehamilan. Ibu tidak usah khawatir karena semua kejadianini normal dialami dalam kehamilan. Seiring dengan bertambahnya waktu, semakinbesarnya kehamilan, maka keluhan ini perlahan-lahan akan menghilang. Makanlahasupan nutrisi yang bergizi karena trimester pertama adalah masa paling pentingdi dalam pertumbuhan organ janin (organogenesis). Setiap kehamilan berbeda, dankehamilan Ibu akan memiliki keunikan tersendiri.

Umur janin dihitung berdasarkan haripertama menstruasi terakhir. Hal ini dilakukan karena sulit untuk menentukansecara pasti kapan Ibu mengalami ovulasi (matang dan keluarnya sel telur dariindung telur), dan kapan sel sperma membuahi sel telur tersebut. Jadi karenaperhitungan kehamilan dimulai pada minggu terakhir ketika Ibu menstruasi,berarti umur dari janin yang dikandung Ibu adalah usia kehamilan dikurangi 2minggu.

Minggu pertama adalah minggu periodemenstruasi terakhir, meskipun pembuahan belum terjadi, Ibu sekarang sudah mulaimenghitung hari. Minggu ini rahim Ibu akan meluruh dan periode menstruasisedang terjadi. Perlahan-lahan hormon FSH (Follicle Stimulating Hormone)mulai diproduksi untuk membantu pematangan sel telur. Pembuahan (pertemuan selsperma dan sel telur) baru terjadi 12-14 hari lagi dimana setelah terjadipembuahan maka pada saat itu embrio baru tumbuh.

Saat ini merupakan momentum palingtepat untuk menghentikan segala kegiatan yang kurang baik apabila Ibu inginhamil. Hindari merokok, obat-obatan terlarang, dan alkohol. Tiga hal yangdisebutkan di atas dapat mempengaruhi perkembangan embrio dan menyebabkankecacatan. Sebaiknya hindari juga konsumsi obat-obatan termasuk yang dijualbebas. Namun untuk obat rutin yang diminum (obat untuk tekanan darah tinggi,obat diabetes) sebaiknya dikonsultasikan terlebih dahulu kepada dokter sebelummenghentikannya.

Menurut The Center for Disease Control (CDC), wanita yangberencana untuk hamil dianjurkan mengkonsumsi vitamin B dalam jumlah cukup danasam folat sebanyak 400 mikrogram/hari agar dapat mengurangi risiko gangguanperkembangan otak embrio. Sumber asam folat dapat berasal dari Hati,telur, brokoli, kacang, jeruk, padi-padian, buncis. Konsultasikan terlebihdahulu kepada dokter kandungan apabila Ibu akan mengkonsumsi suplemen asamfolat.

Tips : Posisi Berhubungan Seksual

Posisi misionaris (pria di atas) merupakan posisi yangdirekomendasikan apabila pasangan ingin memiliki anak. Dalam posisi tersebut,penetrasi (masuknya penis ke dalam vagina) dapat terjadi lebih dalam sehinggasemen yang mengandung sel sperma dapat lebih dekat ke serviks (leher rahim)maupun uterus (rahim). Posisikanlah pinggul Ibu lebih tinggi setelah selesaiberhubungan seksual agar memudahkan sel sperma berenang ke arah yang tepat.

~ Minggu : 2

Bersiap-siap Ovulasi

Keajaiban awal mula kehidupan diawali dengan bertemunya sel spermadan sel telur di saluran tuba. Hanya 1 sperma yang mampu memasuki sel telur danmembuahinya.

Apabila siklusmenstruasi Ibu adalah 28 hari, maka Ibu akan berada di masa subur pada akhirminggu ini. Hal ini dikarenakan ovulasi (keluarnya sel telur dari indung telur)terjadi pada pertengahan siklus menstruasi (12-14 hari). Jadi mingu ini adalahsaat paling tepat untuk terjadinya pembuahan. Minggu ke-2 adalahberakhirnya masa haid dan masuk ke masa proliferasi (lapisan endometrium rahimmengadakan proliferasi atau pertumbuhan rahim untuk mempersiapkan kehamilan).Hormon estrogen mulai meningkat dan menyebabkan lapisan endometrium tumbuh atauberproliferasi. Hormon FSH yang dihasilkan oleh tubuh akan berfungsi untukmembantu mengembangkan 1 atau beberapa folikel menjadi sel telur yang matang.Sel telur matang akan berjalan dari indung telur ke saluran tuba dan menungguuntuk dibuahi.

Akhir minggu ini,adalah waktu Ibu berovulasi. Apabila ibu berhubungan seksual tanpa pelindung,maka setelah pasangan Ibu ejakulasi, 200 - 300 juta sperma berenang di dalamvagina, jutaan sperma yang mampu mencapai rongga rahim dan tuba, hanya sekitar300 – 500 sel sperma yang mampu mencapai ampula tuba (dimana sel telur menantidibuahi), dan hanya 1 sel sperma yang mampu memenangkan persaingan dari jutaansel sperma lainnya pada akhir perjalanan.

Kesehatan Ibuyang baik merupakan salah satu faktor yang penting dalam kehamilan. Nutrisiadekuat, olahraga, dan istirahat yang cukup akan mempengaruhi kesehatan Ibu.Jika berat badan Ibu berada di dalam batas normal sebelum kehamilan, Ibumemerlukan asupan kalori sebesar 2200 kalori setiap harinya pada 13 minggupertama (trimester pertama). Selama trimester kedua dan ketiga, Ibu memerlukantambahan 300 kalori perhari. Kalori tambahan dapat memberikan energi yangdibutuhkan tubuh untuk Ibu maupun janin.

Tips:Hindari Kafein

Kafein sebaiknyadihindari pada wanita hamil. Kafein sendiri dapat masuk ke saluran pencernaanjanin yang masih belum sempurna. Beberapa penelitian membuktikan bahwa konsumsikafein berlebih pada wanita hamil dapat menyebabkan kecacatan janin, persalinanprematur,dan meningkatkan risiko untuk bayi lahir dengan berat badan rendah.

~ Minggu : 3

TandaAwal Kehamilan

Ibu masih belumtahu aku ada, aku masih terlalu kecil untuk dilihat tanpa mikroskop. Umurku 1minggu saat ini. Masih 37 minggu lagi!

Setelahejakulasi, sel sperma yang mencapai saluran kelamin wanita harus melalui masapenyesuaian terlebih dahulu selama 7 jam yang berlangsung di dalam vaginaMembutuhkan waktu sekitar 10 jam bagi sperma untuk mencapai saluran tuba namunhanya butuh 20 menit untuk sel sperma membuahi sel telur. Pembuahan berlangsungselama 12 - 24 jam, dimulai ketika sel sperma memasuki sel telur dan berakhirdengan terbentuknya zigot (sel yang berkembang).

Hasil utama daripembuahan adalah kombinasi kromosom (materi genetik) dari kedua orangtua,penentuan jenis kelamin, dan dimulainya pembelahan. Pronukleus sel sperma akanbergabung dengan pronukleus sel telur untuk mengkombinasikan materi genetik.Apabila sperma membawa kromosom Y, maka bayi Ibu laki-laki, sedangkan apabilasperma membawa kromosom X, maka bayi Ibu perempuan. Dalam beberapa jam setelahsel telur dibuahi, dimulailah pembelahan zigot.

Sel akan membelahmenjadi 2 sel, dan terus membelah, membelah, dan membelah lagi setiap 12jam. Dalam waktu 30 jam sel akan membelah menjadi 2, dalam waktu 3 harisel akan membelah menjadi 16 (morula). Dalam stadium morula, sel akan diarahkanperlahan-lahan berjalan dari saluran tuba menuju rahim. Di dalam rongga rahimsel akan berkembang menjadi ratusan sel dan dikelilingi oleh rongga berisicairan yang disebut dengan blastokista. Blastokista akan mencari tempat untuknidasi atau implantasi (melekat) ke dinding rahim (terkadang terjadi perdarahandi saat nidasi-salah satu tanda kehamilan). Dalam waktu 9 hari blastokista akanberimplantasi pada dinding depan atau dinding belakang rahim, dekat pada fundusrahim (bagian paling atas dari rahim).

Tubuh Ibu akan mengeluarkan proteinimunosupresan yang mencegah tubuh bereaksi karena melihat janin sebagai bendaasing. Jika implantasi atau perlekatan ini terjadi barulah dapat disebutkehamilan. Selamat Ibu! Saat ini Ibu sedang hamil 3 minggu! (meskipun janin Ibubaru berusia 1 minggu).

Ibu:

Minggu ini Ibuakan sering merasa lelah dan payudara mulai terasa tegang dan sakit. Kedua haltersebut merupakan pertanda awal kehamilan. Ibu juga dapat mengalamiketidakseimbangan mood atau disebut ‘bad mood’ yang dikarenakanperubahan hormonal pada Ibu hamil. Selain itu, mual atau morning sicknessjuga dapat terjadi. Konsumsi nutrisi yang adekuat sangat dibutuhkan pada faseini, seperti asam folat, protein, kalsium, dan besi, sangat penting bagipertumbuhan embrio. Protein digunakan untuk membuat jaringan baru, kalsium(1200 mg/hari) berguna untuk pertumbuhan tulang dan gigi, dan zat besi (30 mg/hari)merupakan mineral dasar untuk meningkatkan volume darah embrio. Kalsium dapatbersumber dari produk susu, sedangkan zat besi banyak terdapat di daging merah,telur, dan sayuran hijau.

Tips: Tanda Positif Kehamilan

Tanda pertamayang menandakan kehamilan adalah telatnya periode menstruasi Ibu. Selain ituIbu juga dapat merasakan gejala lainnya seperti sering berkemih, pembesaran dannyeri pada payudara, mual, perasaan lelah, daerah areola (sekitar puting)menjadi semakin hitam, peningkatan temperatur tubuh, dan flek perdarahan tandaimplantasi (perlekatan embrio ke rahim). Tes kehamilan yang positif membantumendiagnosis kehamilan.

~ Minggu : 4

Awal PembentukanOrgan

Umurku2 minggu saat ini. Aku sudah melekat ke rahim ibuku sambil bekerja kerasmembuat tubuhku. Masih 36 minggu lagi!

Saat ini embrioberusia 2 minggu. Pada perkembangan minggu ke-4, blastokista sebagianterbenam di dalam stroma endometrium (rahim). Setelah blastokista aman melekatdi dalam rahim, salah satu bagiannya akan membentuk embrio dan bagian lain akanmembentuk kantung kuning telur (yolk sac) yang akan berfungsi untukmelindungi dan memberikan suplai makanan bagi embrio sampai plasenta terbentuk.

Saat ini plasentabaru dibentuk namun baru akan sempurna sekitar 8 minggu lagi. Akhir mingguke-4, sinsiotropoblas akan bertanggungjawab atas produksi Human ChorionicGonadotropin (HCG) yang akan terus meningkat sampai hari ke-60 kehamilan.Menjelang akhir minggu ini, telah diproduksi cukup banyak hormon hCG yang dapatmenjadi dasar untuk pengujian kehamilan. Hormon ini dapat ditemukan di airkencing wanita hamil dan menjadi kekhasan untuk menentukan wanita hamil atautidak.

Setelahperlekatan terjadi, hormon hCG akan mulai dilepaskan. hCG akan merangsangkorpus luteum (kantung tempat keluar sel telur) untuk memproduksi hormonprogesteron yang berguna untuk menjaga lapisan rahim sebagai sarana perlekatanembrio sampai plasenta mengambil alih-6 minggu dari sekarang.

Embrio akanbekerja keras minggu ini, membuat plasenta, tangkai penghubung (yang akanberkembang menjadi tali pusat), dan dasar dari tubuhnya. Kantung amnion yangberisi cairan amnion atau cairan ketuban yang mengelilingi embrio berguna untukmelindungi embrio. Sedangkan yolk sac akan memproduksi darah danmembantu memberikan nutrisi untuk embrio sampai plasenta mengambil alih.

Ibu:

Sama sepertiminggu sebelumnya, Ibu akan merasakan tanda-tanda kehamilan. Serviks (leherrahim) akan melunak dan berubah warna. Ibu dapat memeriksakan kehamilannyaminggu ini dengan melakukan tes kehamilan menggunakan stik. Jangan kecewaapabila hasilnya negatif, tidak semua alat tes kehamilan memiliki sensitifitasyang sama. Apabila hasilnya masih negatif maka Ibu dapat mencoba lagi 1 mingguke depan. Semakin lama menunggu untuk melakukan tes kehamilan, maka akansemakin besar kemungkinannya untuk positif.

Sekarang adalahsaat yang tepat untuk mengkonsumsi asam folat 400 mikrogram/hari. Asam folatsangat penting untuk dikonsumsi di awal kehamilan karena mengurangi risiko kelainansaraf tulang punggung pada janin. Sumber dari asam folat dapat ditemukan dihati, gandum, sayuran, buah, dan ragi. Jangan biarkan diri Ibu lepas kendalihanya karena Ibu hamil, Ibu mungkin makan untuk berdua tetapi Ibu tidak harusmakan dua kali lebih banyak. Makan berlebihan tidak akan menambah kesehatanjanin namun hanya akan menambah berat badan Ibu, dan hal tersebut tidak baik.Apabila Ibu lapar, sebaiknya Ibu mengkonsumsi makanan sehat seperti snackringan, jus segar, roti gandum, susu atau produk susu, dan sumber proteinseperti daging dan unggas. Sereal, buah, dan sayuran sebaiknya dikonsumsisecara seimbang. Hindari kalori kosong (banyak gula dan lemak).

Saat ini adalahsaat yang emosional bagi seorang Ibu yang sedang hamil. Perubahan mood dankeluhan mual sangat mengganggu. Disinilah peran ayah atau pasangan untuk selalumendampingi sang istri. Perhatikan istri anda, dampingi selalu, tanyakankeluhannya, dan cobalah mengerti kondisinya. Calon orangtua dapat membaca bukukehamilan bersama-sama untuk mengetahui mengenai apa yang terjadi di kehamilansetiap minggunya.

Tips: Jaga Kesehatan JaninAnda

Hindari aspirin,merokok, dan minum alkohol ketika sedang hamil. Aspirin dapat menyebabkanperdarahan dan perubahan di dalam fungsi pembekuan darah. Merokok mengganggupenyerapan dari vitamin B dan C serta asam folat, menyebabkan bayi lahirdengan berat badan rendah, peningkatan risiko keguguran, dan kematian bayisegera setelah melahirkan. Perokok pasif juga memiliki efek yang sama denganyang aktif. Saat sedang hamil, mintalah agar orang sekitar untuk tidak merokokdi dekat Anda. Minum-minuman keras dapat menyebabkan Fetal Alcohol Syndrome.

~ Minggu : 5

Permulaan MasaEmbriogenik

Umurku 3 minggusekarang. Aku terdiri dari 3 lapisan yang akan membentuk tubuhku. Masih 35minggu lagi!

Minggu ke-5adalah permulaan periode embrionik (dari minggu 5 – 10 kehamilan), suatuperiode yang sangat penting di dalam perkembangan organ janin. Embrio Ibu saatini berusia 3 minggu. Peristiwa yang paling khas dalam minggu kelima adalahgastrulasi, yaitu proses yang membentuk ketiga lapisan germinal pada embrio.Tiga lapisan yang berkembang yaitu endoderm, mesoderm, dan, ektoderm,masing-masing akan membentuk organ. Lapisan endoderm atau lapisanterdalam akan membentuk saluran pencernaan, usus, hati, dan paru. Lapisantengah atau mesoderm akan membentuk jantung, alat kelamin, otot, tulang,dan ginjal. Lapisan terluar, yaitu ektoderm akan membentuk rambut,kulit, mata, dan sistim saraf.

Pada akhir mingguke-5 embrio akan membentuk dasar kerangka sumbu badan, otak, serta jantungprimitif. Embrio akan berukuran 0,36 mm – 1 mm dan memiliki berat kurang dari 1gram. Minggu ini adalah suatu tahapan yang sangat peka terhadapgangguan-gangguan teratogenik (kecacatan janin).

Pada akhirminggu, embrio yang sebelumnya hanya berbentuk kumpulan sel, saat ini berbentuktabung dengan bagian atas dan bagian bawah yang melebar. Terbentuk alur sarafyang memanjang dari atas ke bawah. Lipatan saraf kranial sudah membagi dirimenjadi bagian-bagian dari otak. Pembuatan jantung primitif akan dimulai padatengah minggu ke-5, jantung akan terbagi menjadi 4 ruang. Dengan menggunakanUSG atau echocardiografi fetal, pergerakan jantung embrio dapat terlihat.

Ibu:

Pada minggu iniIbu tidak akan mendapatkan menstruasi, salah satu pertanda untuk kehamilan.Apabila Ibu melakukan tes kehamilan, maka akan sangat besar kemungkinannyauntuk positif. Tes ini mendeteksi adanya hCG, hormon yang meningkat pada saatkehamilan. Produksi hormon yang masih meningkat dapat menimbulkan keluhanseperti minggu-minggu sebelumnya.

Hindari polutanseperti merkuri (ikan yang terkontaminasi), pestisida (DDT, heptaklor,klordane), timbal (bensin, pengawet kayu, bahan bangunan cat), dan polychlorinatedbiphenyl atau PCB (campuran senyawa kimia, terdapat di ikan yangterkontaminasi). Hentikan konsumsi obat isotretinoin. Isotretinoin adalahturunan dari vitamin A yang banyak dipakai untuk mengobati jerawat. Konsumsiisotretinoin dapat menyebabkan kecacatan seperti sumbing palatum, gangguanjantung, dll. Obat ini juga dapat menyebabkan keguguran. Jaga tubuh Ibu daribahan-bahan yang dapat menyebabkan gangguan perkembangan pada janin.

Ibu hamilmembutuhkan 300 kalori ekstra setiap harinya. Pastikan Ibu memakan makanan yangbergizi untuk perkembangan embrio. Beberapa makanan yang mengandung parasitseperti listeriosis dan toksoplasma dengan efek dapat mengakibatkan kecacatanpada embrio sebaiknya dihindari. Beberapa jenis makanan yang sebaiknya tidakIbu konsumsi adalah:

	•	Hati dan produk hati. Mengandung vitamin A dosis tinggi yang bersifat teratogenik (menyebabkan cacat pada janin)
	•	Makanan mentah atau setengah matang karena risiko toksoplasma (seafood, daging)
	•	Ikan yang mengandung metilmerkuri dalam kadar tinggi seperti hiu, marlin, yang dapat mengganggu sistim saraf janin
	•	Kafein yang terkandung dalam kopi, teh, coklat, kola dibatasi 200 mg per hari. Efek yang dapat terjadi diantaranya adalah insomnia (sulit tidur), refluks, dan frekuensi berkemih yang meningkat
	•	Vitamin A dalam dosis > 20.000 – 50.000 IU/hari dapat menyebabkan kelainan bawaan
	•	Susu atau produk susu yang tidak dipasteurisasi
	•	Telur mentah atau makanan yang mengandung telur mentah
	•	Keju lunak seperti brie, camembert, feta, roquefort

Toksoplasmosisjuga dapat melekat pada kotoran kucing. Sebaiknya Ibu meminta orang lain untukmembersihkan kotoran kucing selama Ibu sedang hamil. Pastikan Ibu memasakmatang semua makanan, mencuci sayur dan buah sampai bersih, menghindari kotorankucing, dan memakai sarung tangan apabila akan bekerja dengan tanah.

Tips: Mengurangi Mual dan Muntah di Kehamilan

•	Bila muntah adalah masalah di pagi hari, makan makanan kering seperti sereal, roti, atau biskuit sebelum bangun dari tempat tidur, atau coba makan makanan ringan tinggi protein seperti keju sebelum pergi tidur (protein membutuhkan waktu lama untuk dicerna)
•	Makan makanan ringan setiap 2-3 jam lebih baik dari 3 kali makan besar. Makan secara perlahan dan kunyah makanan secara sempurna
•	Tetap duduk tegak selama 10-20 menit setelah makan untuk menghindari refluks lambung dan heartburn
•	Makan makanan yang mengandung banyak cairan. Hindari jumlah besar konsumsi cairan dalam satu waktu. Coba minuman yang dingin, jus buah seperti apel atau anggur
•	Hindari makanan pedas, gorengan, atau berminyak. Hindari kopi karena dapat merangsang asam lambung
•	Hindari bau yang menyengat dan menyebabkan mual
•	Jahe cukup efektif untuk mengurangi mual. Cobalah untuk memakan permen jahe, minum air jahe, atau jahe dalam bentuk kapsul
•	Hubungi dokter untuk konsumsi vitamin B6 atau terapi obat lainnya
•	Hubungi dokter bila muntah terjadi terus-menerus sehingga makanan atau minuman tidak dapat masuk. Hal ini dapat menyebabkan dehidrasi (kekurangan cairan) dan harus diterapi sesegera mungkin

~ Minggu : 6

Kunjungan PrenatalPertama

Aku memilikipanjang sekitar 1,25 mm - 3 mm. Otak, jantung dan pembuluh darah, sistim saraf,dan organ lain mulai berkembang. Aku berusia 4 minggu dan masih harus menunggu34 minggu lagi!

Minggu ini embrioakan memiliki bentuk seperti kecebong, dengan kepala yang lebih besar dariorgan lain dan memiliki buntut. Tabung saraf yang akan membentuk saraf tulangbelakang dan otak memanjang dari atas sampai bawah embrio. Penonjolan padapusat embrio (tengah) akan membentuk jantung. Pembentukan otak, jantung danpembuluh darah, sistim saraf, dan organ lain mulai berkembang. Lidah mulai terbentukpada embrio berusia 4 minggu dalam bentuk 2 tonjolan lidah lateral dan 1tonjolan lidah medial. Saluran usus primitif dan pembentukan tunas hati akanterbentuk pada embrio berukuran 3 mm ini. Kantung amnion dan plasenta jugasedang dibentuk.

Embrio Ibumemiliki panjang sekitar 1,25 mm - 3 mm. Minggu ini adalah minggu perkembanganbesar-besaran dari organ tubuh embrio. Sudah terbentuk lempeng telinga, lempengmata, lengkung faring, dan rigi lengan. Tonjol-tonjol wajah berupa tonjolmaksila (rahang atas) dan tonjol mandibula (rahang bawah) sudah terbentuk.

Sel mesoderm akanberkembang menjadi sel-sel darah dan kemudian membentuk pembuluh-pembuluh darahkecil. Dengan berlanjutnya pembentukan tunas pembuluh darah, pembuluh darahekstraembrional akan membentuk hubungan dengan pembuluh darah di dalam embriosehingga menghubungkan embrio dan plasenta (ari-ari).Selaput perikardium(meliputi jantung) mulai terbentuk. Tunas paru mulai tampak sebagai suatutonjolan di dekat dinding depan usus. Bagian-bagian dari ginjal yaitu tubulusnefron dan glomerulusnya berkembang pesat minggu ini.

Ibu:

Ibu mungkin akanmulai merasa moody (sedih di satu waktu dan bahagia di waktuberikutnya), hal tersebut wajar terjadi dan disebabkan oleh hormonal yangberfluktuasi. Perdarahan berupa bercak merupakan hal normal yang terjadi diawal kehamilan, namun berhati-hatilah karena bercak atau flek perdarahantersebut dapat berupa tanda awal dari keguguran atau kehamilan ektopik(kehamilan di luar rahim). Hubungi dokter kebidanan Ibu apabila bercakperdarahan tersebut berlanjut.

Apabila Ibu mulaisering merasa kelelahan, maka latihan fisik sedang atau olahraga disarankanuntuk meningkatkan energi. Cobalah untuk berjalan atau mengikuti kelas yoga.Sering berkemih atau sering bolak-balik ke kamar mandi merupakan tanda umumkehamilan. Hal ini terjadi karena hormon β-hCG akan meningkatkan aliran darahke daerah panggul-bagus untuk peningkatan kepuasan seksual selama kehamilan.Selama kehamilan, efisiensi dari ginjal semakin membaik sehingga membantu tubuhIbu untuk menyingkirkan produk sisa metabolisme lebih cepat. Selain itu, rahimyang membesar akan mulai menekan kandung kemih, menyisakan tempat yang lebihkecil untuk menampung air seni dan mengakibatkan peningkatan frekuensiberkemih.

Pada minggu ke-6calon pasangan orangtua dapat berkonsultasi dan memulai kunjungan prenatalpertama ke dokter. Mungkin akan terdapat banyak pertanyaan mengenaiperkembangan janin, terutama bila ini adalah kehamilan pertama. Pada sebagianbesar Ibu hamil, Ibu akan diminta untuk kembali setiap 4 minggu selama 7 bulanpertama, kemudian setiap 2 minggu pada bulan ke-8, lalu setiap minggu padabulan ke-9. Apabila terdapat masalah, kemungkinan Ibu akan dijadwalkan lebihsering lagi berkunjung. Pemeriksaan USG dapat dilakukan minggu ini untukmendeteksi gerakan janin dan anggota tubuh janin. Kelainan seperti blightedovum atau mola hidatidosa dapat diketahui dengan pemeriksaan USG.

Tips:Hubungi Petugas Kesehatan Anda

Terkadangdidapatkan beberapa tanda-tanda yang mengancam nyawa janin dan berbahaya bagiIbu, tanda-tanda tersebut diantaranya adalah:

•	Perdarahan atau bercak dari vagina
•	Nyeri perut tiba-tiba dan berkelanjutan
•	Rembesan cairan dari vagina
•	Muntah terus menerus (Hiperemesis Gravidarum)
•	Nyeri berkemih
•	Sakit kepala hebat dan terus menerus
•	Gangguan penglihatan pada mata
•	Pembengkakan pada tangan dan kaki

~Minggu : 7

PerubahanTubuh Ibu Hamil

Saya berusia 5minggu dan berukuran 2-5 mm. Jantungku sudah dialiri darah dan kaki-tangankumulai memanjang. Tinggal 33 minggu lagi!

Pada minggu ke-7,bentuk luar dari embrio berkembang dengan pesat. Mata yang berukuran sebesartitik saat ini akan membentuk lensa mata. Lempeng telinga juga akan membentukgelembung telinga yang berkembang membentuk bangunan-bangunan yang berfungsiuntuk pendengaran dan keseimbangan. Pembentukan lapisan untuk kavum timpaniserta tuba eustachius (bagian dari telinga) sudah mulai berkembang. Minggu initangkai kantung kuning telur dan tangkai penghubung bersatu membentuk talipusat.

Rongga jantungyang hampir sempurna sudah mulai dialiri oleh darah. Sekat jantung mulaidibentuk mulai minggu ke-6 sampai minggu ke-8. Apabila terjadi gangguan padapembentukan sekat jantung saat ini, maka bayi dapat lahir dengan kelainanjantung bawaan.

Permulaan darisistim pencernaan dan sistim pernapasan mulai terbentuk. Tunas paru akanmembentuk trakea dan tunas bronkialis. Tunas bronkialis akan membentuk saluranbronkus di kanan dan kiri. Otak, otot, dan tulang juga sudah memiliki bentukawal. Plakoda hidung membentuk lubang hidung dan membentuk tonjol hidung. Tunasuntuk anggota badan depan dan belakang (tangan dan kaki) sudah mulai berbentukdayung dan semakin memanjang. Panjang embrio dari puncak kepala sampai bokongberukuran 2-5 mm, pengukuran ini lebih sering dipakai daripada pengukuran darikepala ke tumit karena kaki embrio seringkali terlipat yang mengakibatkansulitnya pengukuran.

Ibu:

Apabila Ibu mulaimerasa mual atau mengalami morning sickness, disarankan Ibu mengurangimakan makanan berlemak, banyak minum cairan, frekuensi makan ditingkatkan namundalam porsi yang lebih kecil (6x/hari), istirahat teratur, dan jangan lupauntuk mengkonsumsi vitamin prenatal. Bila gejala mual dan muntah Ibu semakinmeningkat, kehilangan berat badan, atau dehidrasi (kekurangan cairan), makakemungkinan Ibu mengalami hiperemesis gravidarum. Segera berkonsultasi dengandokter kebidanan Ibu.

Kehamilan akanmenyebabkan perubahan pada serviks (leher rahim). Mukus atau lendir yangterbentuk di pintu masuk dari kanalis servikal mulai terbentuk dan berfungsiuntuk melindungi rahim. Payudara Ibu akan membesar dan terasa tidak nyaman, halini terjadi karena peningkatan dari hormon estrogen dan progesteron. Putingakan terasa lebih sensitif dan lebih nyeri dari biasanya. Areola-daerah gelapdi sekitar puting- akan menjadi semakin gelap, semakin besar dan akan terusmembesar dalam beberapa bulan ke depan. Selain itu Ibu juga dapat melihatadanya bintil-bintil (seperti saat kita merinding) di sekitar areola. Bintilini dinamakan tuberkel Montgomery, yaitu kelenjar keringat yang berfungsisebagai pelumas bagi areola.

Produk sususangat penting di masa kehamilan karena banyak mengandung kalsium yang bergunauntuk pertumbuhan gigi dan tulang embrio. Mulailah mengkonsumsi susu atauprosuk susu. Bila Ibu ingin tetap menjaga kalori yang masuk, maka susu rendahlemak menjadi pilihan, kandungan kalsium tidak akan terpengaruh pada produksusu rendah lemak. Vitamin prenatal juga sebaiknya dikonsumsi oleh Ibu hamil.Vitamin prenatal mengandung kalsium, tembaga, asam folat, yodium, zinc, danvitamin A, B, C, D, E. Vitamin ini akan lebih baik dikonsumsi ketikasedang makan atau di malam hari.

Selama kehamilan,tidak ada larangan untuk berhubungan seksual dengan pasangan selama tidakditemukan masalah dengan kehamilan. Namun bila istri sedang tidak tertarikuntuk berhubungan intim, jangan jadikan ini sebuah masalah. Hasrat seksual ibuhamil umumnya akan kembali normal, bahkan meningkat ketika keluhan kehamilanberkurang yaitu sekitar trimester kedua. Dengarkan keluhannya dan selaluperhatikan dia.

Tips:Pemeriksaan Roentgen X-Ray

Sangat pentinguntuk berkonsultasi dengan dokter terlebih dahulu sebelum melakukan pemeriksaanradiologi di abdomen (perut) dan bagian bawah panggul. X-ray dapat berbahayauntuk janin. Ibu hamil dapat melakukan pemeriksaan radiologi untuk gigi atauekstemitas (lengan dan kaki) karena x-ray ini tidak secara langsung terpajandengan level radiasi berbahaya pada janin. Namun sinar x-ray secara langsungdapat berbahaya bagi janin.

~Minggu : 8

PerkembanganPesat Otak dan Jantung Embrio

Umurku 6 minggudan panjangku sekitar 11-13 mm. Otakku berkembang pesat dan wajahku sudahsemakin jelas terlihat. Tinggal 32 minggu lagi!

Perkembanganterbanyak minggu ini adalah perkembangan otak dan kepala embrio. Pada mingguke-8, otak embrio berkembang dengan kecepatan yang luar biasa. Wajah dariembrio juga semakin jelas terlihat, matanya terbuka, mulut dan lidahnyaberkembang, dan embrio sudah mulai membentuk ginjal. Saat ini adalah periodekritis perkembangan lengan hampir berakhir, tonjolan lengan dan kaki mulaimembentuk bagian tangan, bahu, dan jari-jari. Tonjolan lengan sudah berada di posisiproporsional akhir dan perkembangan rigi jari-jari tangan dan kaki sudahterbentuk. Tali pusat-bagian yang menghubungkan antara embrio dengan plasenta-sudah terbentuk. Tali pusat akan menjamin transportasi nutrisi dan oksigenuntuk embrio Ibu.

Pada minggu ke-8,jantung janin sudah lengkap terbentuk 4 rongga, sekat untuk membatasi ruangbilik dan serambi, serta katup diatara ruang-ruangnya. Tonjolan paru sudahdiliputi oleh pleura (selaput paru) dan cabang dari saluran bronkus.Saluran-saluran dari ginjal juga semakin banyak dan semakin berkembang.Membrana kloakalis pada janin sudah terbagi menjadi membarana urogenitalis(membentuk saluran kencing dan alat kelamin) serta membrana analis (membentukanus atau dubur). Tonjol genitalia akan berkembang menjadi tonjol skrotum(kantong kemaluan) pada bayi laki-laki dan akan berkembang menjadi labia mayorapada bayi wanita. Embrio Ibu saat ini memiliki panjang 2 kali lipatnya yaitu11-13 mm.

Akhir mingguke-8, embrio Ibu berusia 6 minggu dan berukuran 22-24 mm, kepala masih lebihbesar dibandingkan dengan tulang belakang. Tonjolan jari tangan dan kaki sudahada, saluran dari tenggorokan ke paru-paru sudah terbentuk. Bibir atas sudahsempurna dan bentuk telinga bagian luar mulai membentuk elevasi pada kedua sisikepala. Bagian ‘buntut’ embrio akan perlahan menghilang. Pertumbuhan embriomemiliki kecepatan 1 mm/hari, namun tidak harus di dalam penambahan panjangbadan, dapat juga di pertumbuhan organ lain seperti di lengan dan kaki.

Periode kritisperkembangan jantung sudah hampir berakhir. Bilik jantung sudah lengkap danakan menyempurnakan bentuknya. Perkembangan hati disini akan menyebabkanpenonjolan dari perut embrio. Sistim saluran pencernaan berkembang diumbilikus, usus halus berkembang dan akan bermigrasi ke dalam perut ketikaruang di perut embrio sudah cukup besar. Punggung embrio semakin memanjangsekarang, rangka embrio masih terdiri atas kartilage (tulang rawan) dimana seltulang pertama akan menggantikan kartilage pada hari ke 47 kehamilan. Osifikasi(proses penulangan) primer mulai terjadi di pusat dari tulang panjang, EmbrioIbu sudah mulai terlihat seperti bayi kecil sekarang.

Ibu:

Jangan kagetapabila ukuran bra Ibu bertambah 1-2 ukuran lebih besar, terutama bila iniadalah embrio pertama. Payudara Ibu akan terus membesar sebagai persiapan untukmenyusui. Sedangkan rahim Ibu sekarang berukuran sebesar jeruk. Jangan berdietselama kehamilan. Ibu harus meningkatkan berat badan sekarang karena akanberbahaya bagi janin bila Ibu mengurangi berat badan.

Vitamin prenatalsebaiknya tetap Ibu konsumsi. Meskipun Ibu mengkonsumsi vitamin prenatal, Ibujuga harus tetap mengkonsumsi makanan bergizi yang berasal dari makanan. Sumberzat gizi makanan dapat dilihat di tabel di bawah ini.

Zat Gizi	Sumber Makanan
Protein (71 gram)	Daging, telur, produk susu, kacang, produk kedelai (tahu)
Kalsium (1200 mg)	Produk susu, sayuran berdaun hijau, tahu, kacang
Asam Folat (0,4 mg)	Hati, telur, brokoli, kacang, jeruk, padi-padian, buncis
Zat Besi (30 mg)	Hati, unggas, ikan , daging, kuning telur, sayuran berdaun hijau, kacang, buah kering
Magnesium (320 mg)	Coklat, seafood, buncis, kacang, padi-padian
Vitamin B6 (2,2 mg)	Hati, padi-padian, daging
Vitamin E (10 mg)	Ikan, telur, susu, daging, sereal
Zinc (15 mg)	Seafood, susu, kacang, daging, buncis

Tips: Hati-hati Keguguran

Hati-hatiterhadap risiko keguguran pada trimester pertama. Angka kejadian aborsimeningkat dengan bertambahnya usia Ibu dan terdapatnya riwayat aborsisebelumnya. Penyebab abortus spontan bervariasi meliputi infeksi, faktorhormonal, kelainan bentuk rahim, faktor imunologi (kekebalan tubuh), danpenyakit dari ibu. Apabila Ibu merasakan nyeri perut bagian bawah, keram padarahim, perdarahan dari kemaluan, dan keluarnya embrio dari dalam rahim makasegera hubungi dokter kandungan Ibu.

~Minggu : 9

PergerakanEmbrio Pertama Kali

Umurku 7 minggudan beratku 2 gram. Panjangku saat ini 22-30 mm. Jari-jariku mulai terbentukdan aku mulai bergerak! Tinggal 31 minggu lagi!

Minggu ini mataembrio sudah memiliki lensa, iris, retina, kornea, dan kelopak mata. Mata janinbelum terbuka karena kelopak mata belum terbentuk sempurna. Pigmentasi retinadidapatkan pada embrio. Saat ini embrio Ibu sudah menjadi janin yang berarti‘muda’. Meskipun masih tergolong sangat kecil, embrio Ibu sudah terlihat miripdengan bayi. Selama perkembangan organ, lengan atas lebih cepat tumbuhdibanding paha dan betis. Lengan sudah berada di lokasi final dan jari-jarimulai memisah. Lekukan yang menandai perkembangan jari tangan di kemudian harisudah terbentuk.

Tonjol rahangatas (maksila) menyatu dengan tonjol hidung ketika bibir atas terbentuk.Herniasi umbilikus atau masuknya organ pencernaan (usus, lambung) yang beradadi luar perut embrio ke dalam perut mulai terjadi minggu ini.

Pankreas, kandungempedu, duktus biliaris, dan anus (dubur) sudah siap di posisi masing-masing.Hati embrio sudah terbentuk dan mulai menghasilkan sel darah merah yangdipompakan ke seluruh tubuh oleh jantungnya yang kecil. Jantung embrio sendirisaat ini sudah terbagi atas 4 ruangan dan berdebar 150x/menit.

Perkembangan luarbiasa minggu ini adalah embrio Ibu yang mulai bergerak. Meskipun sudah mulaibergerak, Ibu masih belum bisa merasakannya. Gigi yang sangat kecil sudahberada di bawah gusi, pita suara dan kelenjar ludah mulai terbentuk, sertajanin akan mulai membuka mulutnya minggu ini. Pertumbuhan alat kelamin janinIbu akan dimulai. Panjang janin Ibu saat ini adalah 22-30 mm dengan berat badansekitar 2 gram.

Ibu:

Ibu akan mulaimerasakan peningkatan dari lingkar pinggul minggu ini, meskipun Ibu masih belumterlihat jelas sedang hamil. Apabila Ibu sering sekali bolak-balik ke kamarmandi untuk buang air kecil, maka kurangi konsumsi kafein yang terkandung didalam kopi dan teh, namun jangan mengurangi asupan cairan secara keseluruhan.

Selama hamil,volume darah akan meningkat sekitar 50%. Peningkatan volume darah ini pentinguntuk memenuhi kebutuhan rahim yang sedang berkembang dan melindungi Ibu danbayi dari efek yang membahayakan ketika Ibu berbaring atau berdiri. Peningkatanvolume darah ini juga berfungsi sebagai pelindung selama persalinan karenakemungkinan banyaknya kehilangan darah.

Peningkatan beratbadan Ibu selama kehamilan akan terbagi atas:

	•	3,5 kg untuk janin
	•	3,5 kg untuk simpanan Ibu (lemak, protein, nutrisi lain)
	•	2 kg untuk peningkatan volume cairan
	•	1 kg untuk pembesaran payudara
	•	1 kg untuk rahim
	•	1 kg untuk cairan amnion
	•	0,75 kg untuk plasent

Total dari semuapeningkatan berat badan Ibu selama kehamilan ini adalah sekitar 12 – 13 kg.

Tips: Gizi Kehamilan

Untuk giziselama kehamilan, sebaiknya Ibu setiap hari makan 1 atau 2 buah yang kaya akanvitamin C dan minimal 1 kali sayuran berwarna hijau tua atau kuning tua untukzat besi ekstra, serat, dan asam folat. Makanlah daging merah sebagai sumberdari zat besi. Berhati-hatilah selalu akan makanan yang Ibu makan, beberapajenis makanan dapat mengandung bakteri yang berbahaya bagi perkembangan janin.

~Minggu : 10

Pembesaran Pembuluh Vena Ibu Hamil

Beratku sekitar 4sampai 5 gram dengan panjang 31 sampai 42 mm. Umurku 8 minggu denganjari-jariku yang sudah lengkap terbentuk. Telinga dan tunas gigiku sudah ada.Tinggal 30 minggu lagi!

Embrio saat inimemiliki panjang 31 sampai 42 mm dengan perkiraan berat badan sekitar 4-5 gram.Embrio Ibu sudah memiliki jari-jari tangan dan kaki yang bebas sehingga membuatIbu dapat merasakan tendangan di perut. Tungkai semakin memanjang dan membengkokdi daerah siku dan lutut. Penulangan tulang anggota badan akan dimulai padaakhir masa embrio. Saat ini tulang embrio mulai terbentuk dan indentasi di kakiyang akan membentuk lutut dan tumit mulai mengeras.

Telinga sudahmulai berbentuk dan kelopak mata sudah tidak transparan lagi. Tonjolan untukpembentukan gigi yang berada di bawah gusi mulai terbentuk (meskipun bayi Ibunantinya baru memiliki gigi pada usia 6-7 bulan setelah lahir). Menjelangperkembangan minggu ke-10, lamina dentis yang berada di sepanjang rahang atasdan rahang bawah membentuk tunas gigi, masing-masing 10 buah pada setiaprahang. Wajah embrio saat ini sudah menyerupai manusia dengan ekornya yangsudah menghilang. Herniasi umbilikus akan bertahan sampai minggu ke-15.

Otak embrio akanmembentuk 250.000 sel saraf baru setiap menitnya, ginjal embrio Ibu sudah mulaimemproduksi air seni, lambungnya mulai memproduksi asam lambung, dan bilaembrio Ibu laki-laki, dia akan mulai memproduksi hormon testosteron. Detakjantung janin sudah mulai dapat terdeteksi oleh suatu alat yang bernamaDoppler. Kemungkinan keguguran janin akan menurun setelah minggu ke-10. Parusudah terbagi atas 3 lobus di sebelah kanan, dan 2 lobus di sebelah kiri,lengkap dengan selaputnya.

Ibu:

Minggu ini plasentasudah mulai berfungsi mengatur hormonal embrio. Karena hal inilah maka gejaladari mual dan muntah Ibu atau morning sickness mulai menurun. Meskipunbegitu, fluktuasi kadar hormonal di dalam tubuh masih menyebabkanketidakstabilan emosional atau mood yang naik turun pada Ibu hamil. Janganheran bila tiba-tiba Ibu merasa sedih atau depresi, dan di menit berikutnya Ibumerasa baik-baik saja dan sangat bahagia.

Suatu penandadari volume darah yang meningkat adalah terlihatnya pembuluh vena yang membesardi permukaan kulit Ibu hamil. Umumnya aliran garis biru ini dapat Ibu lihat dipayudara, perut, tangan, dan kaki. Peningkatan volume darah sekitar 20-40% padaIbu hamil memang diimbangi dengan pembesaran vena agar pembuluh darah tersebutdapat mengangkut aliran darah yang meningkat. Pembesaran vena ini akanperlahan-lahan menghilang setelah bayi dilahirkan dan Ibu tidak lagi menyusui.

Ibu masih belummebutuhkan baju hamil sekarang, namun ibu mungkin merasakan bahwa pakaian ataubaju sehari-hari mulai terasa tidak nyaman atau terasa ketat dan bra Ibu mulaiterasa sempit akibat dari pembesaran payudara. Untuk mengatasi hal tersebut,pakailah celana yang memiliki karet elastis pada bagian pinggang, Ibu dapatmembeli bra baru yang nyaman (ukuran payudara dapat meningkat 1-2 ukuran), danpakailan pakaian yang longgar.

Peningkatan beratbadan Ibu selama kehamilan:

Ibu dengan berat badan kurang (IMT<18,5)                  :      15 kg – 20 kg
Ibu dengan berat badan normal (IMT 18,5 –22,9)           : 12,5kg – 15 kg
Ibu dengan berat badan berlebih (IMT >22,9)                : 7,5 kg – 12,5 kg

Tips: OlahragaSelama Kehamilan

Olahraga sepertiberenang dan berjalan setiap hari selama 30 menit adalah pilihan tepat dikala hamil. Olahraga dapat meningkatkan kekuatan otot, tonus otot, danketahanan tubuh-tiga kualitas yang dapat membantu Ibu selama 9 bulan kehamilan,membantu mengurangi stress saat melahirkan, dan membuat pembentukan tubuhsetelah melahirkan menjadi lebih mudah.

Tips: Vaksinasi SelamaKehamilan

Imunisasi yangdirekomendasikan untuk digunakan selama kehamilan adalah vaksin DPT. Rubellaselama kehamilan dapat menyebabkan keguguran atau cacat pada janin. Oleh karenaitu, vaksin MMR sebaiknya diberikan sebelum kehamilan atau setelah persalinanVaksin campak yang hidup tidak diberikan pada wanita hamil, sedangkan vaksinasipolio hanya diberikan pada wanita yang memiliki risiko tinggi terhadap paparanpolio.

Tips: PemeriksaanChorionic Villus Sampling

Chorionic VillusSampling (CSV) adalah tesyang digunakan untuk mendeteksi kelainan genetik. CSV berguna untuk mendeteksikelainan genetik pada janin seperti Sindroma Down. Tes ini dilakukan padaminggu ke 9 – 11 kehamilan menggunakan amniosintesis. Alat CSV akan ditempatkandi leher rahim untuk memindahkan jaringan janin dari plasenta. Risiko keguguranketika melakukan CSV berkisar 1 – 2%.

~Minggu : 11

Penyempurnaan OrganJanin

Minggu ini akumemasuki masa janin. Organ tubuhku sudah terbentuk lengkap. Panjangku sekitar4-6 cm dengan berat sekitar 8 gram. Umurku 8 minggu, saat ini aku memasukitahap pembesaran, pemanjangan, dan penyempurnaan. Tinggal 29 minggu lagi!

Janin saat inimemiliki panjang dari kepala sampai bokong sekitar 44 sampai 60 mm denganperkiraan berat janin sekitar 8 gram, kurang lebih sebesar telapak tangan Ibu.Tahap gangguan atau kecacatan pada janin sudah terlewat minggu ini, minggupembentukan organ sudah selesai dan sekarang memasuki tahap pembesaran,pemanjangan, dan penyempurnaan.

Tangan janin akanmulai terbuka dan membentuk kepalan tinju, nail bed atau dasar dari kukumulai terbentuk, tonjolan di bawah giginya mulai terbentuk, dan beberapatulangnya mulai mengeras. Janin akan memulai refleks menelan dan mencium.

Janin akan mulaibergerak dan menggeliat dan gerakan tersebut akan semakin bertambah seiringdengan perkembangan tubuhnya yang makin sempurna. Namun gerakan ini hanyaterlihat dengan pemeriksaan Ultrasonografi (USG). Ibu sendiri baru akanmerasakan gerakan janin dalam beberapa minggu ke depan. Meskipun testis danindung telur sudah sempurna terbentuk minggu ini, jangan buru-buru menyiapkandekorasi kamar bayi, Ibu baru dapat melihat jenis kelamin janin dalam waktubeberapa minggu lagi. Bila bayi Ibu perempuan, perkembangan rahim dan vaginanyasudah dimulai.

Ibu:

Minggu ini mualdan muntah akan mulai berkurang, Ibu akan merasa lebih nyaman dan dapat makantanpa diiringi rasa mual. Plasenta yang sempurna dan pertumbuhan kelenjar akanmengambil alih produksi hormon. Ibu dapat fokus ke hal lain yaitu peningkatanberat badan Ibu dan janin yang signifikan di trimester kedua.

Jangan khawatirapabila kondisi mual trimester pertama membuat Ibu tidak bisa makan. Pada 3bulan pertama, kenaikan berat badan Ibu memang berkisar 1 - 2,5 kg. Nafsu makanIbu akan kembali setelah fase ini terlampaui dan selanjutnya kenaikan beratbadan Ibu berkisar 0,5 kg/minggu. Namun saat ini bukan berarti Ibu boleh makantidak terkontrol, makan terus menerus tanpa memperhatikan gizi tidak akan adamanfaat bagi janin. Pilihlah makanan yang bergizi seperti sayuran, gandum, danikan. Nutrisi yang baik sangat berpengaruh di dalam perkembangan otak dan tubuhjanin.

Sayangnyabeberapa keluhan selama kehamilan seperti konstipasi (hambatan pengeluaran darisisa-sisa makanan yang berkaitan dengan kesulitan BAB akibat tinja yang kerasdisertai dengan nyeri pada perut.), heart burn (sensasi rasa panas ataurasa tidak nyaman yang dirasakan dibalik tulang dada atau tenggorokan ataukeduanya), kembung, bersendawa, dan buang gas yang berkaitan dengan perubahanhormon mulai dirasakan. Progesteron akan merelaksasi otot polos di tubuh Ibu.Sakit kepala juga dapat Ibu rasakan akibat dari peningkatan kadar hormon. Ibudapat mencegah terjadinya sakit kepala dengan makan teratur, tingkatkan asupancairan, istirahat dan tidur teratur, serta hindari stres.

Tips:Hindari Makanan Berbahaya

Makanan danminuman yang sebaiknya dihindari sewaktu hamil meliputi susu yang tidakdipasteurisasi, produk susu yang tidak dipasteurisasi seperti keju lunak(Camembert, Brie, feta, dan Roquefort). Daging dan seafood yang tidak dimasakmatang karena mengandung listeriosis yang membahayakan janin. Ikan yangmengandung banyak merkuri sepertu hiu dan makarel, serta telur yang tidakdimasak matang. Minuman yang sebaiknya dihindari adalah alkohol, batasikonsumsi kafein (200 g sehari atau 6 gelas kopi). Hati-hati juga mengkonsumsimakanan yang mengandung kafein seperti teh, kola, dan coklat.

Tips:Memakai Sabuk Pengaman

Letakkan sabukpengaman di bawah perut Anda dan menyilang paha bagian atas Anda. Pasanglahsenyaman mungkin. Tali pengaman bahu juga dipasang senyaman mungkin. Letakkanposisi tali pengaman bahu di antara payudara Anda.

~ Minggu : 12

Refleks Janin MulaiTerbentuk

Umurku 10 minggudengan berat antara 8 – 14 gram dan panjang hampir 6 cm. Sel saraf danotakku berkembang sangat cepat. Refleksku sudah ada dan mataku dapat mengedip.Ibu dapat melihat aku dengan alat USG. Tinggal 28 minggu lagi!

Berat janin Ibusekarang antara 8 – 14 gram dengan panjang kepala sampai bokong hampir 60 mm.Janin Ibu tumbuh dan berkembang 2 kali lipat dalam 3 minggu terakhir.Perkembangan terbesar janin minggu ini adalah refleks bayi. Jari janin Ibu akanmulai terbuka, ibu jari kaki janin akan mulai menekuk, otot mata akanberkontraksi dimana janin dapat mengedipkan mata, dan mulut janin akanmembentuk gerakan menghisap. Usus janin Ibu yang berkembang dengan sangat cepatsampai membuat suatu tonjolan di tali pusat akan mulai masuk ke rongga abdomen(perut), dan ginjal janin akan mulai menghasilkan air seni ke dalam kantongkemih. Minggu ini berat hati kurang lebih 10% dari seluruh berat badan janinseluruhnya karena banyaknya sel-sel darah yang sedang giat berkembang. Padasaat lahir nanti, berat hati hanya mencapai 5% dari seluruh berat badan bayi.

Sementara itu selsaraf janin berkembang sangat cepat dan di dalam otak janin sinaps atau aliranlistrik saraf juga mulai terbentuk. Mata janin akan berpindah dari sisi sampingke depan kepala. Telinga janin bergeser ke sisi kepala, di tempat yangseharusnya. Janin mulai dapat menelan cairan amnion (ketuban) di mana janin Ibusedang berenang-renang sekarang. Jangan khawatir janin Ibu tidak bisa bernapasdan tenggelam di dalam cairan amnion. Janin mendapatkan oksigen dari darah yangdipompakan ke dalam tubuh oleh plasenta dikarenakan janin belum dapat bernapasmenggunakan paru-paru.

Minggu ini tunasgigi akan melakukan invaginasi sehingga menghasilkan tahap tudung perkembangangigi. Keluarnya gigi desidua atau gigi susu terjadi 6 – 24 bulan setelah bayilahir. Sebagian besar organ janin sudah sempurna terbentuk minggu ini. Sekarangjanin akan memasuki masa maintenance yaitu masa pematangan fungsi sistimorgan agar organ dapat berfungsi sempurna dalam 28 minggu ke depan.

Ibu:

Rahim Ibu saatini teraba tepat di atas simpisis pubis atau di atas tulang kemaluan. Dariukuran yang sangat kecil, rahim Ibu sekarang berdiameter 12-14 cm, sebesar bolakasti. Rahim Ibu akan perlahan-lahan membesar sekitar 1 cm setiap minggunya.Pada saat melahirkan, rahim Ibu akan berdiameter sekitar 37 – 42 cm. Beratrahim Ibu akan meningkat dari 70 gram sebelum kehamilan menjadi hampir1100 gram ketika melahirkan. Ibu sudah mulai dapat berbelanja baju kehamilansaat ini dan akan lebih baik dan lebih nyaman bila Ibu mulai menggunakanpakaian longar.

Ibu disarankanuntuk menjaga kebersihan dari giginya dengan cara menggosok gigi dan berkumursetelah makan. Hal ini dikarenakan kebersihan rongga mulut yang tidak terjagadapat mengakibatkan penyakit gingivitis dan periodontitis. Kesehatan ronggamulut dan gigi yang tidak terjaga dapat menjadi sumber infeksi yang berkaitandengan kelahiran prematur dan bayi dengan Berat Badan Lahir Rendah (BBLR).

Perasaaan heartburn pada Ibu saat ini terjadi karena plasenta yang memproduksi hormonprogesteron merelaksasi katup yang memisahkan esofagus dan lambung sehinggamemudahkan terjadinya refluks atau naiknya asam lambung ke esofagus sehinggamenimbulkan sensasi panas atau terbakar di dada.

Kulit ibu berubahselama kehamilan. Pada sebagian besar wanita akan muncul garis vertikalberwarna coklat kehitaman di kulit sepanjang bagian tengah perut yang disebutdengan linea nigra. Garis ini akan ada selama kehamilan dan akan menghilangsetelah melahirkan. Jaring-jaring vaskuler dan palmar eritema (kemerahan ditelapak tangan) dapat terjadi akibat pelebaran dari pembuluh darah dantingginya kadar estrogen selama kehamilan. Gejala ini hanya sementara, tidakberbahaya, dan akan menghilang setelah melahirkan.

Tips:Latihan Kegel

Sekarang adalahsaat yang tepat untuk melakukan latihan Kegel. Kegel dapat menguatkan ototdasar panggul, tonus vagina, dan area perineum. Lakukan minimal 25x/hari.Kontraksikan otot yang berada di sekitar vagina Ibu dan tahan 8 – 10 detik.Berlatihlah menghentikan proses berkemih ketika di kamar mandi bila Ibu tidakyakin Ibu melakukan latihan Kegel secara benar.

Tips: Lakukan Pemeriksaan USG Minggu Ini

Minggu ini, Ibudapat melakukan pemeriksaan ultrasonografi (USG) di dokter kebidanan Ibu.Melalui pemeriksaan USG tersebut Ibu dapat melihat bentuk janin Ibu untukpertama kalinya sebagai bentuk manusia yang sempurna. USG juga dapatmemperlihatkan pertumbuhan janin, mengidentifikasi kelainan pada janin,membedakan antara kehamilan normal dan kehamilan ektopik, serta mendeteksigerakan janin. Ibu juga dapat mendengar detak jantung janin Ibu secara jelasmenggunakan alat yang bernama doppler.

(klikdokter.com)

Psoriasis Triggers

2011-12-02T03:54:00.001+07:00

The cause of psoriasis isn’t fully known, but it's thoughtto be related to the immune system and its interaction with the environment inpeople who have the genetic susceptibility. More specifically, one key cell isa type of white blood cell called a T lymphocyte or T cell. Normally, T cellstravel throughout the body to detect and fight off foreign substances, such asviruses or bacteria. If you have psoriasis, however, the T cells attack healthyskin cells by mistake, as if to heal a wound or to fight an infection.

Overactive T cells trigger other immune responses. Theeffects include dilation of blood vessels in the skin around the plaques and anincrease in other white blood cells that can enter the outer layer of skin.These changes result in an increased production of both healthy skin cells andmore T cells and other white blood cells. This causes an ongoing cycle in whichnew skin cells move to the outermost layer of skin too quickly — in days ratherthan weeks. Dead skin and white blood cells can't slough off quickly enough andbuild up in thick, scaly patches on the skin's surface. This usually doesn'tstop unless treatment interrupts the cycle.

Just what causes T cells to malfunction in people withpsoriasis isn't entirely clear, although researchers think genetic andenvironmental factors both play a role.

Psoriasis triggers

Psoriasis typically starts or worsens because of a trigger that you may be ableto identify and avoid. Factors that may trigger psoriasis include:

Infections, such as strep throat or thrush
Injury to the skin, such as a cut or scrape, bug bite, or a severe sunburn
Stress
Cold weather
Smoking
Heavy alcohol consumption
Certain medications — including lithium, which is prescribed for bipolar disorder; high blood pressure medications such as beta blockers; antimalarial drugs; and iodides.

Stress

Studies have shown stress can worsen psoriasis. When you'restressed, your body reacts. And while stress is known to make psoriasis worse,psoriasis can make you more stressed out.

Breathe deep and count to 10. Take a relaxing soak in thetub. Call up a friend to vent. Meditate. Focus on the positive and incorporaterelaxation techniques into your daily routine. All are ways to bust stress andperhaps help keep psoriasis flares at bay.

Allergies

Arepsoriasis and allergies linked? The immune system appears to play a key role inboth.
Researchershave found that people with psoriasis are more likely to have a greater numberof inflammatory mast cells (see left) -- the kind that trigger allergicreactions, such as swelling and itching -- than people without it. Althoughpsoriasis may be a reaction of the immune system, it is not proven to be anallergic reaction. Studies have found no link between allergens and psoriasis.

Alcohol

Manylifestyle choices can affect psoriasis. Drinking alcohol has been associatedwith psoriasis and its severity. While more research is needed, it's believedthat heavy drinking can trigger flares in some people. Doctors say avoidalcohol altogether to help prevent psoriasis flare-ups.
Anotherreason to put down your drink? Some psoriasis medications and drinking don'tmix.
Instead, trya nonalcoholic thirst-quencher like iced tea. Or walk around the block tounwind. Getting exercise and up to 20 minutes of sunlight a day can soothepsoriasis.

Cold or DryWeather

Winter canbe especially hard on those who live with psoriasis. Cold, dry weather canworsen psoriasis, while warm, sunny climates may help alleviate it.
Keep yourskin well moisturized. Use thick, creamy lotions after showers and baths andthroughout the day. Look for lotions and soaps that are fragrance-free anddesigned for sensitive skin to help reduce irritation.
You can alsouse a humidifier in your home during dry months to help keep your skin moist.Keeping the skin moist can help reduce itching and tenderness.

Tattoos

Tattoos canlook cool, but to psoriatic skin the tattooing process can be a nightmare.Repeatedly piercing the skin and injecting it with dyes is a major trauma.Trauma to the skin can cause new lesions to appear, often 10 to 14 days later.
Tattoos canalso lead to infection -- another psoriasis trigger.
Treat yourskin with care. Avoid tattoos and acupuncture, and talk with your doctor aboutshots.

Medications

Some drugsused to treat high blood pressure, heart disease, arthritis, and psychiatricdisorders can trigger psoriasis.
ACEinhibitors, beta-blockers, and lithium are common offenders that can causepsoriasis flare-ups as well as malaria drugs, such as Plaquenil andhydroxychloroquine, and NSAIDs. Oral steroids such as prednisone work tocontrol flares but may cause a worsening of the condition after coming offlong-term use.
Talk to yourdoctor if your medication is worsening your psoriasis.

Infections

Commoninfections are doubly difficult for people with psoriasis. Yeast infections,thrush, strep throat, respiratory infections, and staph infections are allknown psoriasis triggers.
The goodnews? Once you treat the infection, your psoriasis flare may also calm down.

Cuts andBruises

Slice yourhand in the kitchen or scrape a knee and -- pow! -- new lesions may appearwhere you were injured. This is called Koebner's phenomenon.
Avoid skininjury and trauma when you can.
Wear gloveswhile working in the garden. Prevent bug bites and sunburn. And use care whentrimming nails and shaving.

Smoking

Researchshows smoking is directly linked to the severity of your psoriasis. The moreyou smoke, the worse your flare-ups, with outbreaks most often appearing on thehands and feet.
Kicking thehabit may reduce the number of psoriasis flares and, for some, endthem.
You don'thave to take on the challenge alone. Ask your doctor about ways to smooth thetransition to becoming smoke-free.

Hormones

Psoriasiscan start at any age in both men and women. But it seems to peak in peoplebetween the ages of 20 and 30 as well as those between the ages of 50 and 60.Both puberty and menopause also seem to trigger psoriasis patches. Hormones areoften thought to be the link.
Interestingly,one study found that high levels of estrogen during pregnancy seemed to improvepsoriasis in some women.

Types of psoriasis

2011-12-02T03:04:00.001+07:00

Many forms of psoriasis

Psoriasisoccurs when the life cycle of skin cells speeds up, resulting in a rapidbuildup of rough, dead skin cells. These skin cells accumulate, forming thicksilvery scales and itchy, dry, red patches that are sometimes painful. In somecases, pus-filled blisters appear.
Psoriasispatches can range from a few spots of dandruff-like scaling to major eruptionsthat cover large areas.
Thoughpsoriasis signs and symptoms vary from person to person, psoriasis types aretypically identified by their hallmark appearance. Here's a look at psoriasispictures, showing classic signs and symptoms.

Plaquepsoriasis

Plaquepsoriasis, the most common form of psoriasis, causes dry, raised, red skinlesions (plaques) covered with silvery scales. The plaques itch or may bepainful and can occur anywhere on your body. You may have just a few plaques ormany, and in severe cases, the skin around your joints may crack and bleed.
Lifestylemeasures, such as using a nonprescription cortisone cream and exposing skin tosmall amounts of natural sunlight, may improve mild cases. Moderate or severecases may require light therapy, prescription steroid creams, oral medicationsor a combination of these.

Scalppsoriasis

Scalppsoriasis appears as red, itchy areas with silvery-white scales. You may noticeflakes of dead skin in your hair or on your shoulders, especially afterscratching your scalp. The scaly patches, which may bleed when removed, mayextend beyond your hairline.
Treatmentfor scalp psoriasis includes medicated shampoo, steroid foam or lotion, andoral medications.

Nailpsoriasis

Psoriasiscan affect fingernails and toenails, causing pitting, abnormal nail growth anddiscoloration. Psoriatic nails may become loose and separate from the nail bed(onycholysis). Severe cases may cause the nail to crumble.
Nailpsoriasis often accompanies another type of psoriasis, such as plaquepsoriasis. Treatment options include oral medications and light therapy.

Guttatepsoriasis

Guttatepsoriasis is usually triggered by a bacterial infection such as strep throat.It's marked by small, water-drop-shaped sores on your trunk, arms, legs andscalp. The sores are covered by a fine scale and aren't as thick as typicalplaques are. You may have a single outbreak that goes away on its own, or youmay have repeated episodes.
Guttatepsoriasis typically responds to treatment, which includes light therapy,prescription steroid creams and oral medications. It may also improve withtreatment of the underlying cause or infection, if identified.

Inversepsoriasis

Inversepsoriasis causes smooth patches of red, inflamed skin primarily in the armpits,groin, under the breasts and around the genitals. Inverse psoriasis is morecommon in obese people and is worsened by friction and sweating.
Treatmentof inverse psoriasis may include taking a prescription oral medication.

Pustularpsoriasis

Pustularpsoriasis can occur in widespread patches or in smaller areas on your hands,fingertips or feet, as shown here. It can develop quickly, with pus-filledblisters appearing just hours after your skin becomes red and tender. Theblisters dry within a day or two but may reappear every few days or weeks. Thereaction can result from medications, an infection, severe irritation or lightsensitivity.
Smallpatches of pustular psoriasis may be treated with a steroid cream. Largerpatches usually require prescription oral medication, elimination of theunderlying cause, if possible, and other topical and systemic therapies. Lighttherapy may be useful once the blisters resolve and the skin is less irritated.

Erythrodermicpsoriasis

Erythrodermicpsoriasis, the least common type of psoriasis, can cover your entire body witha red, peeling rash that can itch or burn intensely. It may be triggered bycorticosteroids or other medications, severe sunburn or sensitivity to lightduring phototherapy treatment, or by another type of psoriasis that's poorlycontrolled.
Treatmentof erythrodermic psoriasis usually requires prescription oral medication,medicated wet dressings and topical steroids. Combination therapies andhospitalization may be necessary for severe cases.

Psoriasis

2011-11-30T17:43:00.001+07:00

Psoriasis is a common skin disease that affects thelife cycle of skin cells. Psoriasis causes cells to build up rapidly on thesurface of the skin, forming thick silvery scales and itchy, dry, red patchesthat are sometimes painful.

Psoriasis is a persistent, long-lasting (chronic)disease. You may have periods when your psoriasis symptoms improve or go intoremission alternating with times your psoriasis worsens.

For some people, psoriasis is just a nuisance. Forothers, it's disabling, especially when associated with arthritis. There's nocure, but psoriasis treatments may offer significant relief. Lifestylemeasures, such as using a nonprescription cortisone cream and exposing yourskin to small amounts of natural sunlight, can improve your psoriasis symptoms.

The most common type of psoriasis is called plaquepsoriasis. It causes a thick, patchy, red rash with silvery, white scales. Itcan appear anywhere but most often occurs on the scalp, elbows, knees, andlower back. The condition is not contagious, and it's fairly common, affecting2% to 3% of Americans. Psoriasis is more common in adults than children.

Symptoms

Psoriasissigns and symptoms can vary from person to person but may include one or moreof the following:

Red patches of skin covered with silvery scales
Small scaling spots (commonly seen in children)
Dry, cracked skin that may bleed
Itching, burning or soreness
Thickened, pitted or ridged nails
Swollen and stiff joints

Psoriasispatches can range from a few spots of dandruff-like scaling to major eruptionsthat cover large areas. Mild cases of psoriasis may be a nuisance; more-severecases can be painful, disfiguring and disabling.

Mosttypes of psoriasis go through cycles, flaring for a few weeks or months, thensubsiding for a time or even going into complete remission. In most cases,however, the disease eventually returns.

Severaltypes of psoriasis exist. These include:

Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques itch or may be painful and can occur anywhere on your body, including your genitals and the soft tissue inside your mouth. You may have just a few plaques or many, and in severe cases, the skin around your joints may crack and bleed.
Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails may become loose and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
Scalp psoriasis. Psoriasis on the scalp appears as red, itchy areas with silvery-white scales. You may notice flakes of dead skin in your hair or on your shoulders, especially after scratching your scalp.
Guttate psoriasis. This primarily affects people younger than 30 and is usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped sores on your trunk, arms, legs and scalp. The sores are covered by a fine scale and aren't as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes, especially if you have ongoing respiratory infections.
Inverse psoriasis. Mainly affecting the skin in the armpits, in the groin, under the breasts and around the genitals, inverse psoriasis causes smooth patches of red, inflamed skin. It's more common in overweight people and is worsened by friction and sweating.
Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters dry within a day or two, but may reappear every few days or weeks. Generalized pustular psoriasis can also cause fever, chills, severe itching and fatigue.
Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely. It may be triggered by severe sunburn, by corticosteroids and other medications, or by another type of psoriasis that's poorly controlled.
Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes pitted, discolored nails and the swollen, painful joints that are typical of arthritis. It can also lead to inflammatory eye conditions, such as conjunctivitis. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn't as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.

Nail Psoriasis

Up to half of people with skin plaques havepsoriasis of the nails as well. This makes the nails look yellowish-red. Thenails may also crumble, become pitted, or develop grooved lines. Nearlyeveryone with psoriasis of the nails also has psoriasis somewhere on the skin.

Psoriatic Arthritis

About 15% of people with psoriasis developpsoriatic arthritis, a painful and sometimes disabling inflammation of thejoints. Psoriatic arthritis can occur at any age but is most common between theages of 30 and 50.

Causes

The exact cause of psoriasis is unknown, but expertsbelieve that the immune system, genes, and environmental factors play centralroles. Normally, old skin cells are replaced with new ones every fourweeks. In people with psoriasis, the immune system triggers inflammation,causing new cells to move to the surface every three or four days. Theresulting buildup forms the rash. Psoriasis cannot be passed from person toperson, but it does tend to run in families.

In psoriasis, the life cycle of your skin cells greatly accelerates,leading to a buildup of dead cells on the surface of the epidermis.

Psoriasis Triggers

People with psoriasis may find their conditionflares up at certain times. Common triggers include:

Skin injury or infection
Emotional stress
Certain medications
Smoking or drinking alcohol

Anyone can develop psoriasis, butthese factors can increase your risk of developing the disease:

Family history. Perhaps the most significant risk factor for psoriasis is having a family history of the disease. About 40 percent of people with psoriasis have a family member with the disease, although this may be an underestimate.
Viral and bacterial infections. People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.
Stress. Because stress can impact your immune system, high stress levels may increase your risk of psoriasis.
Obesity. Excess weight increases your risk of inverse psoriasis. In addition, plaques associated with all types of psoriasis often develop in skin creases and folds.
Smoking. Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.

Complications

Depending on the type and locationof the psoriasis and how widespread the disease is, psoriasis can causecomplications. These include:

Thickened skin and bacterial skin infections caused by scratching in an attempt to relieve severe itching
Fluid and electrolyte imbalance in the case of severe pustular psoriasis
Low self-esteem
Depression
Stress
Anxiety
Social isolation

If you have psoriasis, you’re atgreater risk of developing certain diseases, such as metabolic syndrome, acluster of conditions that include high blood pressure and elevated insulinlevels; inflammatory bowel disease; cardiovascular disease; and, possibly,cancer.

In addition, psoriatic arthritis canbe debilitating and painful, making it difficult to go about your dailyroutine. Despite medications, psoriatic arthritis can cause joint damage.

The Stigma of Psoriasis

For some people, psoriasis can affect theiremotions and self-image. A stubborn, unsightly rash can transform a confident,outgoing person into a wallflower. People may avoid dates, social events, orjob interviews. All of this can increase the risk of depression and anxiety,which can worsen the symptoms of psoriasis.

Tests anddiagnosis

In most cases, diagnosis ofpsoriasis is fairly straightforward.

Physical exam and medical history. Your doctor usually can diagnose psoriasis by taking your medical history and examining your skin, scalp and nails.
Skin biopsy. Rarely, your doctor may take a small sample of skin (biopsy) that's examined under a microscope to determine the exact type of psoriasis and to rule out other disorders. A skin biopsy is usually done in a doctor's office using a local anesthetic.

Conditions that can look likepsoriasis
Other conditions that may look like psoriasis include:

Seborrheic dermatitis. This type of dermatitis is characterized by greasy, scaly, itchy, red skin. It's often found on oily areas of the body, such as the face, upper chest and back. Seborrheic dermatitis can also appear on the scalp as stubborn, itchy dandruff.
Lichen planus. This is an inflammatory, itchy skin condition that appears as rows of itchy, flat-topped bumps (lesions) on the arms and legs.
Ringworm of the body (tinea corporis). Ringworm is caused by a fungal infection on the top layer of your skin. The infection often causes a red, scaly ring or circle of rash.
Pityriasis rosea. This common skin condition usually begins as one large spot (herald patch) on your chest, abdomen or back, which then spreads. The rash of pityriasis rosea often extends from the middle of the body, and its shape resembles drooping pine-tree branches. This condition usually clears within six to eight weeks.

A doctor can usually diagnose psoriasis byexamining your skin, scalp, and nails. A biopsy can be done to confirm thediagnosis. If you have swelling and pain in your joints, your doctor may alsoorder blood tests and X-rays to check for arthritis. Psoriasis cannot be cured,but treatments can relieve symptoms and control the condition.

Treatmentsand drugs

Psoriasis treatments aim to:

Interrupt the cycle that causes an increased production of skin cells, thereby reducing inflammation and plaque formation.
Remove scales and smooth the skin, which is particularly true of topical treatments that you apply to your skin.

Psoriasis treatments can be dividedinto three main types: topical treatments, light therapy and systemicmedications.

~ Topical treatments

Used alone, creams and ointments that you apply to your skin can effectivelytreat mild to moderate psoriasis. When the disease is more severe, creams arelikely to be combined with oral medications or light therapy. Topical psoriasistreatments include:

Topical corticosteroids. These powerful anti-inflammatory drugs are the most frequently prescribed medications for treating mild to moderate psoriasis. They slow cell turnover by suppressing the immune system, which reduces inflammation and relieves associated itching. Topical corticosteroids range in strength, from mild to very strong. Low-potency corticosteroid ointments are usually recommended for sensitive areas, such as your face or skinfolds, and for treating widespread patches of damaged skin. Your doctor may prescribe stronger corticosteroid ointment for small areas of your skin, for persistent plaques on your hands or feet, or when other treatments have failed. Medicated foams and scalp solutions are available to treat psoriasis patches on the scalp. Long-term use or overuse of strong corticosteroids can cause thinning of the skin and resistance to the treatment's benefits. To minimize side effects and to increase effectiveness, topical corticosteroids are generally used on active outbreaks until they're under control.
Vitamin D analogues. These synthetic forms of vitamin D slow down the growth of skin cells. Calcipotriene (Dovonex) is a prescription cream or solution containing a vitamin D analogue that may be used alone to treat mild to moderate psoriasis or in combination with other topical medications or phototherapy. This treatment can irritate the skin. Calcitriol (Rocaltrol) is expensive, but may be equally effective and possibly less irritating than calcipotriene.
Anthralin. This medication is believed to normalize DNA activity in skin cells. Anthralin (Dritho-Scalp) can also remove scale, making the skin smoother. However, anthralin can irritate skin, and it stains virtually anything it touches, including skin, clothing, countertops and bedding. For that reason doctors often recommend short-contact treatment — allowing the cream to stay on your skin for a brief time before washing it off. Anthralin is sometimes used in combination with ultraviolet light.
Topical retinoids. These are commonly used to treat acne and sun-damaged skin, but tazarotene (Tazorac, Avage) was developed specifically for the treatment of psoriasis. Like other vitamin A derivatives, it normalizes DNA activity in skin cells and may decrease inflammation. The most common side effect is skin irritation. It may also increase sensitivity to sunlight, so sunscreen should be applied while using the medication. Although the risk of birth defects is far lower for topical retinoids than for oral retinoids, your doctor needs to know if you're pregnant or intend to become pregnant if you're using tazarotene.
Calcineurin inhibitors. Currently, calcineurin inhibitors — tacrolimus (Prograf) and pimecrolimus (Elidel) — are approved only for the treatment of atopic dermatitis, but studies have shown them to be effective at times in the treatment of psoriasis. Calcineurin inhibitors are thought to disrupt the activation of T cells, which in turn reduces inflammation and plaque buildup. The most common side effect is skin irritation. Calcineurin inhibitors are not recommended for long-term or continuous use because of a potential increased risk of skin cancer and lymphoma. Calcineurin inhibitors are used only with your doctor's input and approval. They may be especially helpful in areas of thin skin, such as around the eyes, where steroid creams or retinoids are too irritating or may cause harmful effects.
Salicylic acid. Available over-the-counter (nonprescription) and by prescription, salicylic acid promotes sloughing of dead skin cells and reduces scaling. Sometimes it's combined with other medications, such as topical corticosteroids or coal tar, to increase its effectiveness. Salicylic acid is available in medicated shampoos and scalp solutions to treat scalp psoriasis.
Coal tar. A thick, black byproduct of the manufacture of petroleum products and coal, coal tar is probably the oldest treatment for psoriasis. It reduces scaling, itching and inflammation. Exactly how it works isn't known. Coal tar has few known side effects, but it's messy, stains clothing and bedding, and has a strong odor. Coal tar is available in over-the-counter shampoos, creams and oils. It's also available in higher concentrations by prescription.
Moisturizers. By themselves, moisturizing creams won't heal psoriasis, but they can reduce itching and scaling and can help combat the dryness that results from other therapies. Moisturizers in an ointment base are usually more effective than are lighter creams and lotions.

Light therapy (phototherapy)
As the name suggests, this psoriasis treatment uses natural or artificialultraviolet light. The simplest and easiest form of phototherapy involvesexposing your skin to controlled amounts of natural sunlight. Other forms oflight therapy include the use of artificial ultraviolet A (UVA) or ultravioletB (UVB) light either alone or in combination with medications.

Sunlight. Ultraviolet (UV) light is a wavelength of light in a range too short for the human eye to see. When exposed to UV rays in sunlight or artificial light, the activated T cells in the skin die. This slows skin cell turnover and reduces scaling and inflammation. Brief, daily exposures to small amounts of sunlight may improve psoriasis, but intense sun exposure can worsen symptoms and cause skin damage. Before beginning a sunlight regimen, ask your doctor about the safest way to use natural sunlight for psoriasis treatment.
UVB phototherapy. Controlled doses of UVB light from an artificial light source may improve mild to moderate psoriasis symptoms. UVB phototherapy, also called broadband UVB, can be used to treat single patches, widespread psoriasis and psoriasis that resists topical treatments. Short-term side effects may include redness, itching and dry skin. Using a moisturizer may help decrease these side effects.
Narrowband UVB therapy. A newer type of psoriasis treatment, narrowband UVB therapy may be more effective than broadband UVB treatment. It's usually administered two or three times a week until the skin improves, then maintenance may require only weekly sessions. Narrowband UVB therapy may cause more severe and longer lasting burns, however.
Goeckerman therapy. Some doctors combine UVB treatment and coal tar treatment, which is known as Goeckerman treatment. The two therapies together are more effective than either alone because coal tar makes skin more receptive to UVB light. Once requiring a three-week hospital stay, a modification of the original treatment can be performed in a doctor's office. Another method, the Ingram regimen, combines UVB therapy with a coal tar bath and an anthralin-salicylic acid paste that's left on your skin for several hours or overnight.
Photochemotherapy, or psoralen plus ultraviolet A (PUVA). Photochemotherapy involves taking a light-sensitizing medication (psoralen) before exposure to UVA light. UVA light penetrates deeper into the skin than does UVB light, and psoralen makes the skin more responsive to UVA exposure. This more aggressive treatment consistently improves skin and is often used for more-severe cases of psoriasis. PUVA involves two or three treatments a week for a prescribed number of weeks. Short-term side effects include nausea, headache, burning and itching. Long-term side effects include dry and wrinkled skin, freckles, and increased risk of skin cancer, including melanoma, the most serious form of skin cancer.
Excimer laser. This form of light therapy, used for mild to moderate psoriasis, treats only the involved skin. A controlled beam of UVB light of a specific wavelength is directed to the psoriasis plaques to control scaling and inflammation. Healthy skin surrounding the patches isn't harmed. Excimer laser therapy requires fewer sessions than does traditional phototherapy because more powerful UVB light is used. Side effects can include redness and blistering.
Pulsed dye laser. Similar to the excimer laser, the pulsed dye laser uses a different form of light to destroy the tiny blood vessels that contribute to psoriasis plaques. Side effects can include bruising for up to 10 days after treatment. There is a slight risk of scarring.
Combination light therapy. Combining UV light with other treatments such as retinoids frequently improves phototherapy's effectiveness. Combination therapies are often used after other phototherapy options are ineffective.

~ Oral or injected medications
If you have severe psoriasis or it's resistant to other types of treatment,your doctor may prescribe oral or injected drugs. Because of severe sideeffects, some of these medications are used for only brief periods and may bealternated with other forms of treatment.

Retinoids. Related to vitamin A, this group of drugs may reduce the production of skin cells if you have severe psoriasis that doesn't respond to other therapies. Signs and symptoms usually return once therapy is discontinued, however. Side effects may include dryness of the skin and mucous membranes, itching, and hair loss. And because retinoids such as acitretin (Soriatane) can cause severe birth defects, women must avoid pregnancy for at least three years after taking the medication.
Methotrexate. Taken orally, methotrexate helps psoriasis by decreasing the production of skin cells and suppressing inflammation. It may also slow the progression of psoriatic arthritis in some people. Methotrexate is generally well tolerated in low doses, but may cause upset stomach, loss of appetite and fatigue. When used for long periods it can cause a number of serious side effects, including severe liver damage and decreased production of red and white blood cells and platelets.
Cyclosporine. Cyclosporine suppresses the immune system and is similar to methotrexate in effectiveness. Like other immunosuppressant drugs, cyclosporine increases your risk of infection and other health problems, including cancer. Cyclosporine also makes you more susceptible to kidney problems and high blood pressure — the risk increases with higher dosages and long-term therapy.
Hydroxyurea. This medication isn't as effective as cyclosporine or methotrexate, but unlike the stronger drugs it can be combined with phototherapy. Possible side effects include a decrease in red blood cells (anemia) and a decrease in white blood cells and platelets. It should not be taken by women who are pregnant or planning to become pregnant.
Immunomodulator drugs (biologics). Several immunomodulator drugs are approved for the treatment of moderate to severe psoriasis. They include alefacept (Amevive), etanercept (Enbrel), infliximab (Remicade) and ustekinumab (Stelara). These drugs are given by intravenous infusion, intramuscular injection or subcutaneous injection and are usually used for people who have failed to respond to traditional therapy or who have associated psoriatic arthritis. Biologics work by blocking interactions between certain immune system cells and particular inflammatory pathways. Although they're derived from natural sources rather than chemical ones, they must be used with caution because they have strong effects on the immune system and may permit life-threatening infections. In particular, people taking these treatments must be screened for tuberculosis.
Thioguanine. Nearly as effective as methotrexate and cyclosporine, this drug has fewer side effects. However, this drug is more likely to cause anemia, and women who are pregnant or planning to become pregnant must avoid it because it may cause birth defects.

Treatment considerations
Although doctors choose treatments based on the type and severity of psoriasisand the areas of skin affected, the traditional approach is to start with themildest treatments — topical creams and ultraviolet light therapy(phototherapy) — and then progress to stronger ones only if necessary. The goalis to find the most effective way to slow cell turnover with the fewestpossible side effects.

In spite of a range of options,effective treatment of psoriasis can be challenging. The disease isunpredictable, going through cycles of improvement and worsening, seemingly atrandom. Effects of psoriasis treatments also can be unpredictable; what workswell for one person might be ineffective for someone else. Your skin also canbecome resistant to various treatments over time, and the most potent psoriasistreatments can have serious side effects.

Talk to your doctor about youroptions, especially if you're not improving after using a particular treatmentor if you're having uncomfortable side effects. He or she can adjust yourtreatment plan or modify your approach to ensure the best possible control ofyour symptoms.

Lifestyleand home remedies

Although self-help measures won'tcure psoriasis, they may help improve the appearance and feel of damaged skin.These measures may benefit you:

Take daily baths. Bathing daily helps remove scales and calm inflamed skin. Add bath oil, colloidal oatmeal, Epsom salts or Dead Sea salts to the water and soak for at least 15 minutes. Avoid hot water and harsh soaps, which can worsen symptoms; use lukewarm water and mild soaps that have added oils and fats.
Use moisturizer. Blot your skin after bathing, then immediately apply a heavy, ointment-based moisturizer while your skin is still moist. For very dry skin, oils may be preferable — they have more staying power than creams or lotions do and are more effective at preventing water from evaporating from your skin. During cold, dry weather, you may need to apply a moisturizer several times a day.
Cover the affected areas overnight. To help improve redness and scaling, apply an ointment-based moisturizer to your skin and wrap with plastic wrap overnight. In the morning, remove the covering and wash away the scales with a bath or a shower.
Expose your skin to small amounts of sunlight. A controlled amount of sunlight can significantly improve lesions, but too much sun can trigger or worsen outbreaks and increase the risk of skin cancer. If you sunbathe, it's best to try short sessions three or more times a week. Keep a record of when and how long you're in the sun to help avoid overexposure. And be sure to protect healthy skin with a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours — or more often if you're swimming or perspiring. Before beginning any sunbathing program, ask your doctor about the best way to use natural sunlight to treat your skin.
Apply medicated cream or ointment. Apply an over-the-counter cream or ointment containing hydrocortisone or salicylic acid to reduce itching and scaling. If you have scalp psoriasis, try a medicated shampoo that contains coal tar. For best results, follow label directions.
Avoid psoriasis triggers, if possible. Find out what triggers, if any, worsen your psoriasis and take steps to prevent or avoid them. Infections, injuries to your skin, stress, smoking and intense sun exposure can all worsen psoriasis.
Avoid drinking alcohol. Alcohol consumption may decrease the effectiveness of some psoriasis treatments.
Eat a healthy diet. Although there's no evidence that certain foods will either improve or aggravate psoriasis, it's important to eat a healthy diet, particularly when you have a chronic disease. A healthy diet includes eating a variety fruits and vegetables of all colors and whole grains. If you eat meat, focus on lean cuts and fish. If you think certain foods make your symptoms better or worse, keep a food diary to see what effect different foods have.

Alternativemedicine

Many alternative therapies areavailable to ease the symptoms of psoriasis, including special diets, creams,dietary supplements and herbs. Some alternative therapies are deemed generallysafe, and they may be helpful to some people in reducing signs and symptoms,such as itching and scaling.

Aloe vera. Taken from the leaves of the aloe vera plant, aloe extract cream may reduce redness, scaling, itching and inflammation. You may need to use the cream several times a day for a month or more to see any improvements in your skin.
Fish oil. Omega-3 fatty acids found in fish oil supplements may reduce inflammation associated with psoriasis, although results from studies are mixed. Taking 3 grams or less of fish oil daily is generally recognized as safe, and you may find it beneficial.

If you're considering dietarysupplements or other alternative therapy to ease the symptoms of psoriasis,consult your doctor. He or she can help you weigh the pros and cons of specificalternative therapies.

Coping andsupport

Coping with psoriasis can be achallenge, especially if the disease covers large areas of your body or is inplaces readily seen by other people, such as your face or hands. The ongoing,persistent nature of the disease and the treatment challenges only add to theburden.

Here are some ways to help you copeand to feel more in control:

Get educated. Find out as much as you can about the disease and research your treatment options. Understand possible triggers of the disease, so you can better prevent flare-ups. Educate those around you — including family and friends — so they can recognize, acknowledge and support your efforts in dealing with the disease.
Follow your doctor's recommendations. If your doctor recommends certain treatments and lifestyle changes, be sure to follow them. Ask questions if anything is unclear.
Find a support group. Consider joining a support group with other members who have the disease and know what you're going through. You may find comfort in sharing your experience and struggles and meeting people who face similar challenges. Ask your doctor for information on psoriasis support groups in your area or online.
Use cover-ups when you feel it necessary. On those days when you feel particularly self-conscious, cover the psoriasis with clothing or use cosmetic cover-up products, such as body makeup or a concealer. These products can mask redness and psoriasis plaques. They can irritate the skin, however, and shouldn't be used on open sores, cuts or unhealed lesions.

Stress Reduction

Stress tends to worsen psoriasis, so relaxationtechniques may help control flare-ups. Anything that helps you relax, whetherit's yoga, deep breathing, or a long walk, may help ease your symptoms.

Acne

2011-10-18T02:10:00.000+07:00

Acne Vulgaris

Acne vulgaris is themedical name for common acne -- the presence of blackheads, whiteheads, andother types of pimples on the skin. The most common spots for breakouts are theface, chest, shoulders, and back. Although mild acne may improve withover-the-counter treatments, more severe forms should be treated by adermatologist.

Comedones

A comedo, or basic acnelesion, is a hair follicle that has become clogged with oil and dead skincells. Comedones (the plural of comedo) can develop into bumps calledwhiteheads and blackheads. Products that may trigger comedones are called"comedogenic." Makeup labeled "noncomedogenic" is lesslikely to clog pores and contribute to acne.

Blackheads

Blackheads are comedonesthat are open at the surface of the skin. They are filled with excess oil anddead skin cells. It's not dirt that causes the comedone to turn black. Theoil's reaction to air causes the black color. Blackheads can frequently betreated with over-the-counter medications.

Whiteheads

Comedones that stay closedat the surface of the skin are called whiteheads. This happens when oil andskin cells prevent a clogged hair follicle from opening. Many of the sameover-the-counter medicines that treat blackheads are also effective againstwhiteheads.

Papules

Papules are comedones thatbecome inflamed, forming small red or pink bumps on the skin. This type ofpimple may be sensitive to the touch. Picking or squeezing can make theinflammation worse and may lead to scarring. A large number of papules mayindicate moderate to severe acne.

Pustules

Pustules are another kindof inflamed pimple. They resemble a whitehead with a red ring around the bump.The bump is typically filled with white or yellow pus. Avoid picking orsqueezing pustules. Picking can cause scars or dark spots to develop on theskin.

Nodules

Nodules are large, inflamedbumps that feel firm to the touch. They develop deep within the skin and areoften painful. Nodules should be treated by a dermatologist. Over-the-countertreatments may not be powerful enough to clear them up, but prescription drugscan be effective.

Cysts

Cysts are large, pus-filledlesions that look similar to boils. Like nodules, cysts can be painful andshould be treated by a dermatologist. People who develop nodules and cysts areusually considered to have a more severe form of acne.

Mild Acne

Acne falls into the"mild" category if you have fewer than 20 whiteheads or blackheads,fewer than 15 inflamed bumps, or fewer than 30 total lesions. Mild acne isusually treated with over-the-counter topical medicine. It may take up to eightweeks to see a significant improvement.

Moderate Acne

If you have 20 to 100whiteheads or blackheads, 15 to 50 inflamed bumps, or 30 to 125 total lesions,your acne is considered moderate. Dermatologists usually recommend prescriptionmedication for moderate to severe acne. It may take several weeks to notice animprovement, and your acne may appear to get worse before it gets better.

Severe Nodulocystic Acne

People with severenodulocystic acne have multiple inflamed cysts and nodules. The acne may turndeep red or purple. It often leaves scars. Prompt treatment by a dermatologistcan minimize scarring. In some cases, a doctor may inject corticosteroidsdirectly into nodules and cysts to reduce the size and painful inflammation.

Acne Conglobata

Acne conglobata is one ofthe most severe forms of acne. It involves many inflamed nodules that areconnected under the skin to other nodules. It can affect the neck, chest, arms,and buttocks. It often leaves scars. This type of acne is more common in menand is sometimes caused by taking steroids or testosterone. Timely treatment bya dermatologist is essential.

Acne Mechanica

Acne mechanica is caused byheat, friction, and pressure against the skin, often the result of wearingsports gear such as a helmet or baseball cap. It is sometimes called"sports-induced acne" because it occurs frequently in athletes.Preventive measures include wearing an absorbent material under sportsequipment and showering immediately after activity.

Topical Therapy

Topical therapy is acnemedication that is applied directly to the skin, like gels or creams.Over-the-counter topical products can often help mild acne. They may containingredients like benzoyl peroxide, resorcinol, salicylic acid, or sulfur.Prescription products such as antimicrobial or retinoid creams can treat mildto moderately severe acne. These can be prescribed alone or in combination withother ingredients.

Systemic Therapy

Systemic therapy refers toacne medication that is taken by mouth. Antibiotics like tetracycline,minocycline, doxycycline, or erythromycin may treat moderate to severe acne bytargeting bacteria and reducing inflammation. Other systemic therapies includeoral contraceptives, which can reduce acne in some women, spironolactone, ananti-androgen hormone pill, and isotretinoin (high-dose prescription vitaminA). Isotretinoin is used only in certain severe, cystic acne cases, or in caseswhere other treatments don't work. A course of isotretinoin treatment requiresregular appointments with your dermatologist.

Foot Problems

2011-09-22T18:16:00.000+07:00

Is a bunion,corn, ingrown toenail or a bad case of athlete's foot causing you foot pain orembarrassment? Keep your feet healthy by learning to recognize and treat commonfoot problems.

Bunion

A bony bump atthe base of the big toe, a bunion causes that toe to deviate toward the others.Throwing foot bones out of alignment and producing the characteristic bump atthe joint's base, a bunion can be very painful due to pressure or arthritis,and may also lead to corns. Pain relievers, pads to cushion the bunion, customshoe inserts, or surgery may help, as will wearing roomy shoes and avoidinghigh heels.

Corns andCalluses

Friction causesthe thick, hardened, dead skin of corns and calluses, which form to protectsensitive skin. Appearing cone–shaped, corns point into the skin, and usuallyoccur on areas that bear little weight. Calluses may appear anywhere there'sfriction, and are more diffuse. Both may be caused by ill–fitting shoes andwill fade when friction stops. Moleskin pads can help relieve a corn; callusescan be trimmed or surgically corrected.

Gout

A form ofarthritis, gout is characterized by sudden pain, redness, swelling, andstiffness, usually in the large joint of the big toe. Gout can also occur inthe foot, ankle, or knees. and is caused by too much uric acid (UA) in thebody, which can form hard crystals in joints. Attacks can last days or weeks,and may be treated with anti–inflammatories or UA–lowering medication. Talk toyour doctor about diet changes that help break down UA.

Plantar Warts

Plantar warts aretough, horny growths that develop on the soles of the feet. Contagious, they'recaused by a virus entering through broken skin, and often spread via publicpools and showers. Plantar warts are harmless and can be left untreated, but inmany cases they're too painful to ignore. Topical salicylic acid may help,while burning, freezing, laser therapy, and surgical removal are moreaggressive options for more severe cases.

Athlete's Foot

A fungalinfection that can cause peeling, redness, itching, burning, and sometimesblisters and sores, athlete's foot is mildly contagious, passed by directcontact or by walking barefoot in areas such as locker rooms, or near pools.The fungi then grow in shoes, especially tight ones without air circulation.Athlete's foot is usually treated with topical antifungal lotions or oralmedications for more severe cases.

Fungal NailInfection

Occuring whenmicroscopic fungi enter through a break in the nail, a fungal infection canmake your nails thick, discolored and brittle. If left untreated, the nailinfection won't go away — and can be hard to treat. Thriving in warm, wetplaces, the fungi can be spread from person to person. Topical creams may helpmild cases but antifungal pills are your best chance of curing a severeinfection.

Hammertoe

When toe musclesget out of balance, they can cause painful toe problems. While some people areprone to hammertoe, other risks include tight footwear. Hammertoe generallycauses the middle joint of the toe to bend downward, with toes appearing raisednear the foot. Well–fitted footwear with the correct amount of space in the toebox, shoe supports, and surgery may offer relief.

Ingrown Toenail

A toenail thathas grown into the skin, an ingrown toenail can result in pain, redness,swelling, even infection. Cutting nails too short or not straight across,injury to the toenail, and wearing tight shoes are culprits. For mild cases, soakthe foot in warm water, keep it clean, and wedge a small piece of cotton underthe corner of the ingrown nail to lift it off the skin. Minor surgery canremove all or part of the nail.

Flatfoot (PesPlanus)

Flatfoot ischaracterized by the sole of the foot coming into complete or near–completecontact with the ground. It may be inherited, caused by an injury, or by acondition, such as rheumatoid arthritis. Flatfoot symptoms are rare, thoughweight gain, ill–fitting shoes, or excessive standing may cause pain. Treatmentincludes foot–strengthening exercises, and shoes with good arch support ororthotics.

Nails and Health…Read the Signs

2011-09-20T19:57:00.001+07:00

Did you know yournails can reveal clues to your overall health? A touch of white here, a rosytinge there, or some rippling or bumps may be a sign of disease in the body.Problems in the liver, lungs, and heart can show up in your nails. Keep readingto learn what secrets your nails might reveal.

Pale Nails

Very pale nailscan sometimes be a sign of serious illness, such as:

Anemia
Congestive heart failure
Liver disease
Malnutrition

White Nails

If the nails aremostly white with darker rims, this can indicate liver problems, such ashepatitis. In this image, you can see the fingers are also jaundiced, anothersign of liver trouble.

Yellow Nails

One of the mostcommon causes of yellow nails is a fungal infection. As the infection worsens,the nail bed may retract, and nails may thicken and crumble. In rare cases,yellow nails can indicate a more serious condition such as severe thyroiddisease, lung disease, diabetes or psoriasis.

Bluish Nails

Nails with abluish tint can mean the body isn't getting enough oxygen. This could indicatean infection in the lungs, such as pneumonia. Some heart problems can beassociated with bluish nails.

Rippled Nails

If the nailsurface is rippled or pitted, this may be an early sign of psoriasis orinflammatory arthritis. Discoloration of the nail is common; the skin under thenail can seem reddish-brown.

Cracked or SplitNails

Dry, brittlenails that frequently crack or split have been linked to thyroid disease.Cracking or splitting combined with a yellowish hue is more likely due to afungal infection.

Puffy Nail Fold

If the skinaround the nail appears red and puffy, this is known as inflammation of thenail fold. It may be the result of lupus or another connective tissue disorder.Infection can also cause redness and inflammation of the nail fold.

Dark LinesBeneath the Nail

Dark linesbeneath the nail should be investigated as soon as possible. They are sometimescaused by melanoma, the most dangerous type of skin cancer.

Gnawed Nails

Biting your nailsmay be nothing more than an old habit, but in some cases it's a sign ofpersistent anxiety that could benefit from treatment. Nail biting or pickinghas also been linked to obsessive-compulsive disorder. If you can't stop, it'sworth discussing with your doctor.

Nails Are OnlyPart of the Puzzle

Though nailchanges accompany many conditions, these changes are rarely the first sign. Andmany nail abnormalities are harmless -- not everyone with white nails hashepatitis. If you're concerned about the appearance of your nails, see adermatologist.

Boils (Abscess)

2011-09-20T00:41:00.000+07:00

Aboil is a common, painful infection of a hair follicle and the surroundingskin. It begins as a red lump, then fills with pus as white blood cells rush into fight the infection. Good home care can often clear up a single boil, alsoknown as a skin abscess. A doctor's care is needed when a boil resiststreatment or develops in certain vulnerable areas of the body.

Boil Symptoms

Boils are usuallypea-sized, but can grow as large as a golf ball. Symptoms can include:

Swelling, redness, and pain
A white or yellow center or tip
Weeping, oozing, or crusting

You may also havea general feeling of ill health, fatigue, or a fever, which is reason to call adoctor.

Where Do BoilsForm?

Boils can formanywhere on the body, but they're most common on the face, neck, armpits,shoulders, back, and buttocks. Hairy, sweaty areas are typical sites, as wellas areas of friction, such as the inner thighs. Boils can also develop aroundthe ear or near the nose. The pain often worsens as pus collects under theskin, then eases as fluids begin to drain.

What CausesBoils?

Most boils arecaused by staph bacteria (Staphylococcus aureus), which many healthypeople carry on their skin or in their noses without a problem. When a scrape,cut, or splinter breaks the skin, the bacteria can enter a hair follicle andstart an infection. Others boils, such as those associated with acne,develop from clogged pores that become infected.

Ordinary Boil orMRSA Infection?

MRSA can lookexactly like an ordinary boil: red, swollen, pus-filled, and tender. But MRSAinfections are caused by one particular type of staph that is resistant to manyantibiotics. If a skin infection spreads or doesn't improve after 2-3 days ofantibiotics, your doctor may suspect MRSA. The right treatment isimportant to heal a MRSA infection and prevent a deeper, more dangerousinfection.

Are BoilsContagious?

Not exactly, butthe germs that cause boils (staph) are easily spread through skin-to-skincontact and contaminated objects. These bacteria usually do no harmunless they find a break in your skin. To avoid spreading staph, don't sharetowels, bedding, clothes, or sports gear while you have a boil. Avoid touchingthe boil, and keep it covered. Frequent hand washing can also help prevent spreadingthe bacteria.

Early Warning:Folliculitis

Folliculitis isan inflammation or infection of the hair follicles that can develop into aboil. Tiny pimples with whiteheads appear around individual hairs, sometimessurrounded by red skin. It can be itchy, tender, and uncomfortable, but istypically not as painful or deep as a boil. Shaving or friction from tightclothing can let staph bacteria slip under the skin -- the most common cause ofboth folliculitis and boils.

Boil Type:Carbuncle

When severalboils form close together and join beneath the skin, it's called a carbuncle.They are most commonly found on the back and the neck but can develop anywhere.Men are more likely to develop carbuncles than women. A carbuncle tends to liedeeper beneath the skin than a boil and can take longer to heal.

Boil Type:Cystic Acne

Cystic acne is atype of skin abscess that forms when oil and dead skin cells clog a hairfollicle, creating a place where bacteria grow and thrive. It affects deeperskin tissue than regular acne, leading to firm, painful cysts. It's mostcommon on the face and shoulders and typically occurs in the teenage years

Boil Type:Armpit and Groin

When lumps andpus-filled abscesses repeatedly develop in these areas of the body, it may be achronic condition called hidradenitis suppurativa. Infection starts in sweatglands and hair follicles that become blocked. Mild cases heal with home care.Several drugs and treatments are available for more serious and recurringcases.

Boil Type: PilonidalAbscess

When a boil formsin the skin just above the buttocks crease, it may be a pilonidal abscess. Hair is believed to play a role, and irritation, pressure, and prolongedsitting may also contribute to the development of a cyst here. If a cyst becomesinflamed and infected, it becomes an abscess. Some children are born with a"pilonidal dimple" where infections can crop up. Signs of infectionrequire a doctor's attention.

Boil Type: Stye

The familiar"stye on the eye" is a boil, usually caused by staph bacteria. Itstarts in the follicle of an eyelash and may be red, warm, swollen, anduncomfortable. A stye is sometimes confused with a chalazion, which is also alump on the eyelid, but a chalazion is usually painless and is caused by ablocked oil gland, not an infection.

Who Gets Boils?

Anyone candevelop a boil. Your risk increases with:

Close contact with an infected person
Acne, eczema, or other causes of breaks in the skin
Diabetes
A weakened immune system

Treatment: HomeCare

You can take careof most boils at home. Apply warm, moist compresses several times a day to helpa boil open and drain. After it starts draining, keep it clean, and continueusing warm compresses - a clean one every time. Change the bandage often andwash your hands well. Resist the urge to squeeze or pop the boil. This can makethe infection worse.

When to Call theDoctor

If a boil doesn'theal after a week of home care, call your doctor. Other reasons to callinclude:

A boil on the face or spine
A fever or red streaks coming from the sore
A very large or painful boil
A boil that keeps coming back

Treatment:Procedures

If the fluidinside a boil doesn't drain by itself, your doctor may prick the top of thesore with a sterile instrument to be sure it drains completely. A deepinfection may be packed with sterile gauze so it continues to drain.Antibiotics are sometimes given to help with healing.

Treatment:Recurrent Boils

For some people,boils are a recurring problem. In addition to standard treatment, your doctormay try to eliminate or reduce staph bacteria throughout the body. This caninclude washing up with a special antiseptic soap, using an antibiotic ointmentinside the nose, or 1-2 months of antibiotics by mouth, or all three.

BoilComplications

Most boils healwith home treatment or a doctor's visit. Sores on the face may requireantibiotics because they're so close to the eyes and brain. Rarely, the staphbacteria from a boil or carbuncle can get into the bloodstream, which can thenaffect the heart and other internal organs.

How to PreventBoils

Since bacteriaare everywhere in our environments and on many people's skin, the best defenseagainst boils includes:

Hand washing or use of alcohol-based hand sanitizer
Careful cleaning of cuts, scrapes, and other wounds
Keeping wounds covered
Not sharing towels, sheets, razors, etc.

Launder towels,sheets, and anything else in contact with an infected area in very hot water.Throw away any wound dressings in a tightly sealed bag.

Eczema

2011-09-19T11:15:00.000+07:00

Eczemahas been called "the itch that rashes" because the itching usuallyoccurs first. This group of skin rashes may first appear in babies andtoddlers, becoming a drier, flaky rash in older children. Adults may see scaly,leathery patches or a stubborn hand eczema. Atopic dermatitis is a common,often inherited form, but there are other types, as well as many treatmentoptions.

Eczema Symptoms

Itching is thedefining symptom. Once you start scratching, the skin becomes inflamed -- andeven itchier. The appearance can vary greatly and may include:

Red, scaly areas
Small, rough bumps
Thick, leathery patches
Bumps that leak fluid and crust over

In darker-skinnedpeople, the affected area might be lighter or darker.

Eczema in Babies

Infants who arejust 6 to12 weeks old can develop atopic dermatitis as a patchy facial rash. Itcan progress, becoming red and scaly, and may appear on the forehead or scalp.Moisture from drooling worsens the rash. In some cases, the condition goes awayby age 2. But about half of people who had atopic dermatitis as a child willhave the condition as an adult.

AtopicDermatitis or Cradle Cap?

"Cradlecap" in babies is actually a condition known as seborrheic eczema orseborrheic dermatitis. It appears as yellow, oily, scaly patches on the scalpand will usually clear up without treatment at 8 to 12 months of age. Incontrast, atopic dermatitis (AD) in infants usually appears as a red rash. It'smore often found on the cheeks, but AD can also affect the scalp.

Eczema inChildren

Children maydevelop the rash on the inside of their elbows or behind the knees, aroundtheir mouths, on the sides of their necks, or on wrists, arms, and hands. Thosewith atopic dermatitis are more likely to have food allergies, includingallergies to peanuts, milk, or other nuts. However, experts say you shouldn'trestrict foods unless there is a confirmed food sensitivity. Reassure childrenthat it isn't contagious.

Eczema in Adults

Adults typicallynotice itchy patches on the hands, elbows, and in the "bending" areasof the body, such as the inside of the elbows and back of the knees. But eczemacan appear anywhere, including the neck, chest, even the eye lids. Those whohad atopic dermatitis as a child may see drier, scaly rashes as adults. Theskin may be discolored or thickened.

DiagnosingEczema

If a rashpersists, causes significant discomfort, or develops a crust or pus-filledblister, you may want to see your health care provider. A diagnosis of eczema is usually based on a detailed medical history, symptoms, measurablephysical signs, and a family history of allergic conditions. Your doctor mayalso order allergy tests or a microscopic exam of a skin scraping (seen here)to rule out infections.

Who Gets Eczema?

There's a linkbetween atopic dermatitis and hay fever or asthma. If a parent has hay fever orasthma, their children are more likely to have the skin condition. And abouthalf of children with atopic dermatitis will go on to develop hay fever orasthma.

Eczema andAllergies

The substancesthat bring on an allergy attack -- dust mites, pollen, animal dander, mold --can cause some people with atopic dermatitis to break out in a rash. Foodallergies also can trigger a flare-up. These allergens cause the immune systemto overreact, activating cells that produce inflammation in the skin.

Other EczemaTriggers

Irritants cancause inflammation and itching, bringing on a bout of eczema. Touching harshchemicals can cause a nasty rash in anyone, but people with eczema may besensitive to mild irritants, such as wool, detergents, astringents, orfragrances. Emotional stress can trigger a flare-up, as can sweating andfrequent wetting and drying of the skin -- even everyday hand-washing.

Eczema and DrySkin

The outer layerof our skin normally acts as a barrier, protecting inner layers from irritantsand infection. People with atopic dermatitis have very dry skin that isn't asprotective. If you have eczema, use mild cleansers and apply a moisturizingcream or ointment after washing. A dry climate or the low humidity ofwinter can cause the condition to flare up. People with atopic dermatitis arealso more likely to get skin infections.

What CausesEczema?

We don't knowexactly what causes atopic dermatitis, the most common form of eczema. Expertsbelieve genetic, environmental, and skin factors all play a role. A malfunctionof the immune system may be involved, creating inflammation in the skin, evenwhen there is no infection to fight. Emotional disorders do not cause eczema,as doctors thought many years ago, but stress can make symptoms worse.

Stop theScratching

People withatopic dermatitis may scratch as many as 500 to 1,000 times a day. Thatscratching worsens the rash and can increase the risk of infection due tobreaks in the skin. Use a cold compress to lessen the itchy feeling. Distractchildren with activities. Moisturizers are soothing, and some medicated creamsor ointments may help, too.

Treatment:Corticosteroids

Over-the-counterhydrocortisone creams or ointments may help mild cases of eczema but should notbe used on children under 2 or for more than seven days without consulting adoctor. Stronger corticosteroid products may be necessary to control theinflammation. Side effects from extended use include skin thinning, infection,and stretch marks. In rare cases that haven’t responded to othertreatment, a doctor may prescribe oral or injectable corticosteroids.

Treatment:Antihistamines

Antihistaminesmay provide relief from the vicious cycle of itching and scratching for some,but not all, people with the atopic dermatitis type of eczema. Many OTC andprescription-only options are available, each with slightly different dosingand side effects. Check with your health professional for arecommendation.

Treatment:Immune Modulators

Prescription topicalmedicines that calm an overactive immune system, such as Elidel and Protopic,may help treat eczema from atopic dermatitis. Doctors generally prescribe themonly when other treatments have failed, for short-term use, in certainpatients. They're required by the FDA to carry a "black box" warningdue to concerns about an increased risk of cancer. However, the American Academy of Dermatology disagrees withthe FDA's safety warning. It's best to discuss the risks and benefits with yourhealth care provider.

Treatment: HandEczema

People withsevere hand eczema may get relief from a promising new drug. Studies have shownthat alitretinoin, a relative of vitamin A, can greatly improve or even clearup hand eczema that didn't respond to other treatments. It hasn't yet beenapproved by the FDA for this use. It can cause headaches or dry, flushing, orsun-sensitive skin. You should not become pregnant while taking alitretinoinbecause it can cause severe birth defects.

Treatment:Phototherapy

UV light affectsthe immune system and can improve moderate to severe cases of eczema fromatopic dermatitis or contact dermatitis. PUVA is a UV treatment combined withpsoralen, a medication. Because UV light can cause skin damage or prematureaging of the skin and increases the risk of skin cancer, you should discuss therisks and benefits with your health care provider. It may not help or worseneczema in some people.

Treatments forChildren

Corticosteroidsof various strengths may be used in children with atopic dermatitis, dependingon the severity of the condition. Potent corticosteroids can suppress growth inchildren. Prescription topicals Elidel and Protopic have beenapproved by the FDA for children 2 years of age or older. Lifestyle changes arealso important. Keep your child's fingernails short and their skin moisturized.Dress them in loose-fitting clothes and make sure they do not becomeoverheated.

Treatment:Bleach Baths

A small amount ofhousehold bleach in the bath may help control atopic dermatitis when there is astaph infection present, too. In one study, children with moderate tosevere atopic dermatitis and staph soaked in diluted bleach baths and used anantibiotic ointment in their noses. These treatments significantlyimproved their skin symptoms. Parents should consult a dermatologist orother health care provider first to see if bleach baths are appropriate.

Treatment: Herbsand More

Some promisingstudies showed that probiotics, oolong tea, or Chinese herbal medicine may easesymptoms. However, other studies have not been supportive. Herbs andsupplements are not regulated as closely as medicines and can sometimes haveharmful effects. Be sure to talk to your doctor or other health care providerbefore taking herbs or supplements. Stress-reducing therapies such as massageand relaxation may also be helpful.

Eczema andInfection

Almost all peoplewith atopic dermatitis have Staphyloccocus aureus bacteria on theirskin, compared with just about 5% of people without the skin condition. Be alertto the signs of infection, including honey-colored crusts, pus- or fluid-filledblisters, scaly red patches, swelling, or fever, and contact your doctor orhealth care provider.

Caring for DrySkin

Even when theeczema subsides, the dry skin remains. Hydrate the skin with short daily bathsin warm water. Pat the skin partially dry and apply a thick moisturizer --emollients and creams are usually more effective than lotions -- on top of anymedication and elsewhere on the body within three minutes of taking the bath.Apply moisturizers throughout the day and use only mild soaps or cleansers.Look for fragrance-free products to help prevent a reaction. Remember,"unscented" may just mean the product contains another ingredient tomask the scent.

Coping WithEczema

Your child mayfeel self-conscious about the appearance of the rashes. Help him or her avoidtriggers and cope with stress. The AmericanAcademy of Dermatology hosts Camp Discoveryat several locations around the country for kids with skin conditions. Adultsmay need to adjust their activities. Jobs that require a lot of hand-washing orexposure to chemicals or other irritants, such as health care, housecleaning,or hairdressing, may not be a good choice for someone with eczema.

Shingles (Herpes Zoster)

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Shingles (herpeszoster) is a painful rash caused by the same virus behind chickenpox. Thevirus is not fully cleared from the body and remains inactive. After a latencyperiod, it reactivates and shingles occur. The virus moves along nerve fibersand affects the skin, resulting in a rash.
Shown is amagnified, colorized view of varicella-zoster viruses.

Pain,itching, tingling, burning -- these are all symptoms of shingles that may occurbefore the outbreak of the rash. It starts as small blisters on a red base,with new blisters continuing to form for three to five days. It typicallyappears on one side of the body or face. Other symptoms may include fever,chills, fatigue, and headache. If you think you have shingles, see a doctor assoon as possible.

What CausesShingles?

After you've hadchickenpox, the virus lives in your nervous system, "sleeping" in thenerve roots. In some people, it remains asleep (dormant) forever. In others,the virus may "wake up," reproduce, and travel along nerve fibers tothe skin's surface. The result: shingles.

Who's at Riskfor Shingles?

Anyone who hashad chickenpox is at risk of developing shingles, although the most importantrisk factor for developing shingles is age. Shingles occurs most commonly inpeople over the age of 60. People with weakened immune systems from certainhealth conditions or medications are also at greater risk for shingles. Thereare an estimated 1 million cases of shingles each year in the U.S.

How Long DoesShingles Last?

The cluster ofblisters that forms with shingles fill with fluid, pop, then start to ooze.Eventually the affected areas crust over and heal like the rash shown here. Inmost people the lesions crust by 7-10 days. Once all of the blisters are crustedover, the person is no longer contagious.

Is ShinglesContagious?

The virus thatcauses shingles is contagious. The virus can spread to anyone who hasn't hadchickenpox through direct contact with the rash that has not crusted. Insteadof developing shingles, the newly infected person develops chickenpox. Oncethey've had chickenpox, they have the potential to develop shingles later inlife.

What areComplications from Shingles?

Generally,shingles heals well, resulting in few problems. Occasionally blisters canbecome infected, requiring treatment with antibiotics. The most commoncomplication of shingles is postherpetic neuralgia, where damaged nerves causepersistent pain even after the rash is gone. A more worrisome complication iswhen shingles affects the forehead and nose, which may spread to the eye andlead to loss of vision.

How is ShinglesTreated?

There is no curefor shingles, but treatment may help you get well sooner and prevent problems.Cool compresses and anti-itching lotions like calamine may provide relief, aswill bathing the affected area and cleaning with soap and water. Steroids,antiviral medicines, and pain medicines can also help ease recovery. Mostpeople with intact immune systems recover completely from shingles althoughrecurrences are possible.

Is There aShingles Vaccine?

In 2006, the FDAapproved the first vaccine to prevent shingles in adults. Recommended foradults 50 years and older who've already had chickenpox, the vaccine, Zostavax,is given as one shot and is not the same as the vaccine to preventchickenpox. The vaccine reduces the risk of shingles by 50%, and reducesthe incidence of postherpetic neuralgia by two-thirds. The vaccine does nottreat shingles that has already developed.

Fungus

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Fungal infections can be itchy and annoying, but they're rarely serious. Common infections such as athlete's foot, jock itch, and ringworm are caused by fungus and are easy to get and to pass around. In healthy people, they usually don't spread beyond the skin's surface, so they're easy to treat. If you spend a lot of time at the gym, take steps to protect yourself against fungal infections.

Athlete's Foot

Itchy, burning, cracked, and peeling feet? Athlete's foot (tinea pedis) usually develops between the toes and can spread via wet locker room floors, sweaty socks, and damp shoes. Prevent it by wearing shower shoes at the gym, washing your feet daily, drying them well, and wearing clean socks.

Jock Itch

A raised, itchy, red rash around your groin means you probably have jock itch (tinea cruris), which can affect men and women. It can be caused by sweating and the humid environment often created by athletic gear. You can prevent it by keeping your groin clean and dry, and wearing dry, clean underwear and loose pants after a workout.

Ringworm

Ringworm (tinea corporis) isn't caused by worms. This raised, red, circular, itchy fungal infection -- usually with clearer skin in the center -- can occur on the body or scalp (tinea capitis). You're at greater risk if your skin is often exposed to a warm, moist environment and you come in contact with ringworm from a person or pet. Prevent it by showering after sweating, then drying well. It's easily spread, so don't share towels, combs, or other personal items.

Nail Fungus

Brittle, discolored, thick nails may mean you have nail fungus (onychomycosis). Though more common in toenails, fungus can affect fingernails too, and is encouraged by warm, damp conditions. Prevent nail fungus by keeping nails short and wearing clean, dry socks, and changing them often. Wear wide-toed shoes (so toes aren't crammed together), and don't share nail clippers.

Caring for Gym Clothes

Change out of your gym clothes right after a workout. Sweaty gear provides a perfect home for fungi and other germs to thrive and grow. Wash exercise clothes after each use. Wear clean clothes before each workout.

Fungal Infections: Hygiene at Home

To prevent fungal infections from taking a foothold at home, your best defense is to keep skin clean and dry. Change underwear and socks daily. Let your sneakers air out and wash them regularly. Take your shoes off at home to expose your feet to the air.

Gym and Locker Room Hygiene

To fight fungal infections at the gym, wear shower shoes in the locker room and avoid sitting on wet benches. Don't share workout mats or towels. Wash your hands before and after a workout, and don't forget to wipe down gym equipment before and after using it.

Treating Fungal Infections

Despite your best efforts at prevention, you think you have a fungal infection. Now what? First, talk to your doctor. Other skin problems can look a lot like fungal infections, but require different treatment. For mild infections, topical medication may be all you need. More serious problems could require oral prescription drugs.

Can Fungal Infections Make You Sick?

Fungal infections may look bad, but they rarely lead to more than itch and irritation. Unless you have a weakened immune system, your body is usually good at tackling infection before it causes serious illness. Still, if you're worried about your jock itch, athlete's foot, or any rash, talk to your doctor.

Birthmarks

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Birthmark Basics

Birthmarks gain attention when there's a media blitz about someone with a visible mark, such as New Orleans Saints quarterback Drew Brees. News reports suggest that he was born with this birthmark on his right cheek, which doctors checked early on and found to be harmless. Folk wisdom calls such babies "touched by an angel," but a doctor's advice is best.

What Is a Birthmark?

A birthmark is a colored mark on or under the skin that's present at birth or develops shortly after birth.Some birthmarks fade with time; others become more pronounced. Birthmarks may be caused by extra pigment-producing cells in the skin or by blood vessels that do not grow normally. Most birthmarks are painless and harmless. In rare cases, they can cause complications or are associated with other conditions. All birthmarks should be checked by a doctor.

Seen here is former Soviet President Mikhail Gorbachev, who has a port wine stain on his forehead.

Salmon Patches

Salmon patches are nests of blood vessels that appear as small, pink, flat marks on the skin. They occur in one-third of newborn babies. Salmon patches can appear on the back of the neck ("stork bite"), between the eyes ("angel's kiss"), or on the forehead, nose, upper lip, or eyelids. Some fade as baby grows, but patches on the back of the neck usually don't go away. Salmon patches require no treatment.

Port Wine Stains

A port wine stain begins as a flat, pinkish-red mark at birth and gradually becomes darker and reddish-purple with age. Most will get bigger and thicker, too. Port wine stains are caused by dilated blood capillaries and occur in about three out of every 1,000 babies. Those on the eyelid may increase the risk of glaucoma. Port wine stains may be a sign of other disorders, but usually not. Treatment includes laser therapy, skin grafts, and masking makeup.

Mongolian Spots

Mongolian spots are flat, smooth marks that are present from birth. Frequently found on the buttocks or lower back, they're typically blue, but can also be bluish gray, bluish black, or brown. They may resemble a bruise. Mongolian spots are most common on darker-skinned babies. They usually fade by school age, but may never disappear entirely. No treatment is required.

Cafe-Au-Lait Spots

Cafe-au-lait spots are smooth and oval and range in color from light to medium brown, which is how they got their name, "coffee with milk" in French. They're typically found on the torso, buttocks, and legs. Cafe-au-lait spots may get bigger and darker with age, but are generally not considered a problem. However, having several spots larger than a quarter is linked with neurofibromatosis and the rare McCune-Albright syndrome. Consult a doctor if your child has several spots.

Strawberry Hemangiomas

Hemangiomas are a collection of small, closely packed blood vessels. Strawberry hemangiomas occur on the surface of the skin, usually on the face, scalp, back, or chest. They may be red or purple and are often raised, with sharp borders. These occur in 2 of every 100 babies born.

Strawberry hemangiomas usually develop a few weeks after birth. They grow rapidly through the first year before disappearing around age 9. Some slight discoloration or puckering of the skin may remain at the site. No treatment is required, but when they develop near the eye or mouth, or in a location that can bleed or become infected, they may need to be treated or removed.

Cavernous Hemangiomas

Present at birth, deeper cavernous hemangiomas are just under the skin and appear as a bluish spongy mass of tissue filled with blood. If they're deep enough, the overlying skin may look normal. Cavernous hemangiomas typically appear on the head or neck. Most disappear by puberty. A combination of cavernous and strawberry hemangioma can occur.

Venous Malformation

Venous malformations are caused by abnormally formed, dilated veins. Although present at birth, they may not become apparent until later in childhood or adulthood. Venous malformations appear in 1% to 4% of babies. They are often found on the jaw, cheek, tongue, and lips. They may also appear on other areas of the body. They will continue to grow slowly, and they don't shrink with time. Treatment -- often sclerotherapy or surgery -- may be necessary for pain or impaired function.

Congenital Nevi

Congenital nevi are moles that appear at birth. The surface may be flat, raised, or bumpy. These moles can grow anywhere on the body and vary in size from less than an inch to over 8 inches. Congenital nevi occur in 1% of newborns. Most moles are not dangerous. But congenital nevi, especially large ones, have an increased risk of developing into melanoma, the deadliest type of skin cancer. All moles should be monitored for changes.

Identifying Bugs and Their Bites

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Ticks

Many bugs give us reason for pause, including poisonous spiders, chiggers, bees and lice. But few get under our skin – quite literally – like the tick. If you enjoy the outdoors, be careful of ticks — they can attach as you brush past grass and plants. Ticks don't always carry diseases, and most bites are not serious. But they can carry diseases including Lyme disease and Rocky Mountain spotted fever.

Black-legged, or deer ticks, can transmit Lyme disease to humans

Tick Bites

Once a tick latches onto skin, it often moves to the warm, moist armpits and groin — feeding on blood and passing on any disease it carries. A tick bite can also trigger an allergic reaction. If you have a tick, it is important to remove it properly. To prevent tick bites, keep your arms, legs, and head covered when outdoors. Use tick repellant with DEET. Check for ticks after spending time in grassy or wooded areas.

Ticks latch onto skin where they feed on blood

Lyme Disease

In the U.S., the Western black–legged tick and the deer tick can carry Lyme disease bacteria. Infected ticks usually don't spread the disease until they've been attached for at least 36 hours. The first sign of infection is usually a circular skin rash. Early symptoms may also include fever, headache, and fatigue. Untreated Lyme disease may spread to other parts of the body, including the muscles, joints, heart, and nervous system. Most cases of Lyme disease can be treated successfully with antibiotics.

Ticks can cause Lyme disease which may cause a "bull's-eye" rash

Black Widow Spiders: Poisonous!

Wood piles and tree stumps — that's where poisonous female black widows hide. She is long–legged and glossy black, with a distinctive orange, red, or yellow "hourglass" shape on her underside. Most spiders are 2 inches wide, but some are smaller.

Female black widows have a bright-colored "hourglass" on their underside

Black Widow Spider Bites

Black widow spider bites may cause sharp, shooting pain up the limb, but they can also be painless. Look for one or two red fang marks, redness, tenderness, and a nodule at the bite site. Severe muscle cramps, nausea, vomiting, seizure, and a rise in blood pressure may follow soon after. Get medical care immediately. Anti–venom medicine is available. If possible, bring the spider with you for positive identification.

Tiny red fang marks – classic sign of widow spider bites

Brown Recluse Spiders Can Be Deadly

Hiding in attics and closets — in Midwestern and South central states — that's where you'll find brown recluse spiders. The spiders range in color from yellowish–tan to dark brown, with darker legs. Their venom is extremely poisonous, and their bite can cause serious wounds and infection. Yet you may not feel their bite.

Brown recluses have a "violin" pattern in the upper body, where legs attach

Brown Recluse Spider Bites

When the brown recluse bites, it is often painless — then skin reddens, turns white, develops a red "bull's–eye," blisters, and becomes painful. These bites can be deadly in rare cases. Get medical care immediately. If you can, bring the spider with you for positive identification.

A brown recluse spider's bite can cause tissue death — as shown here

Head Lice: Itchy!

In hair — that's where you'll find lice. They like to hide in the neck area of the scalp and behind the ears. If you have lice, you likely got it from sharing a hat, brush, or other item with a person who has lice. Lice are itchy, but scratching can lead to infection. In severe cases, hair may fall out.

Head lice are grayish-white, and no bigger than sesame seeds

Head Lice Remedies

To kill lice and their eggs (called nits), use lotions, creams, or shampoos from the drug store or prescribed by your doctor. Wash clothing, bedding, and brushes to prevent the spread of lice. Check all household members, and treat everyone who has nits or lice.

Scalp with skin infection from scratching; lice eggs are "glued" to the hair

Fleas: Not for Pets Only

Fleas are small, wingless, agile insects that live off the blood of their host – and they don't just bite pets. They dine on people, too.

A close look at a flea

Flea Bites

Some people are very sensitive to flea bites — but scratching can cause a wound or infection. The best solution is to get rid of fleas on pets and in your home. Keep pets out of your bed and be sure to vacuum rugs daily. Spray insecticides on infested areas. Consider using a once–a–month insecticide on your pet.

Flea bites result in raised itching spots with a puncture in the center

Bee, Wasp, Hornet, Yellow Jacket

When a bee stings, it loses the stinger and dies. But a wasp, hornet, or yellow jacket can inflict multiple stings because it does not lose the stinger. These stings can cause serious reactions in people who are allergic to them.

Wasps and yellow jackets can inflict multiple stings

Bee, Wasp, Hornet, Yellow Jacket Stings

If you don't have an allergic reaction, simply remove the stinger, clean the sting site, apply ice, take oral antihistamine for itching, and take ibuprofen or acetaminophen for pain relief. If you have a severe anaphylactic reaction, lie down and carefully remove the stinger. Use an EpiPen (epinephrine) if you have one. Get immediate medical care.

A wasp sting (left) and a severe allergic reaction to a wasp sting (right)

Fire Ants

Fire ants look much like ordinary ants — and are found in most of the Southeastern states. They produce large mounds in open areas and are aggressive when disturbed. During an attack, the fire ant latches onto the skin with its jaw, then stings from its abdomen. It may inject venom many times.

A close look at a red fire ant

Fire Ant Stings

The fire ant sting typically causes red hive–like lesions that burn and itch. Painful pus–filled lesions can also occur. Cold packs, pain relievers, and antihistamines can help relieve the discomfort. A large number of stings may trigger a toxic or severe life–threatening allergic reaction. Get emergency care.

Painful stings from the fire ant quickly fill with pus

Chiggers: Itchy!

Contrary to popular belief, chiggers are not insects; they are arachnids. Specifically, chiggers are the juvenile (or larval) form of a family of mites called Trombiculidae. They only dine on humans in their juvenile form, they later becoming vegetarians as adults. Their bites are painless, but lesions are very itchy. Itching usually peaks a day or two after the bite occurs.

Chiggers are less than 1/150th of an inch in diameter

Chigger Bites

After a few days of being attached to the skin, chiggers fall off — leaving itchy red welts. Over–the–counter products can help relieve itching. See your doctor if the skin appears infected or the welts appear to be spreading.

Itchy red welts can result from chigger bites

Stealthy Pests

When scabies mites get into the skin, they can cause a big skin problem. The mites spread through skin–to–skin contact with an infected person — or by sharing towels, bed linens, and other objects.

Scabies are tiny mites that burrow into your skin

Treating Scabies

Intense itching and skin sores don't appear until several weeks after mites get into skin. The itching is very severe and usually worse at night. The rash typically is seen on the sides and webs of the fingers, the wrist, elbows, genitals, and buttock. You'll need prescription lotion or pills to get rid of scabies. Wash all clothes, towels, and bedding in hot water.

Weeks may pass before itching and skin sores develop

Bedbugs: Hitching a Ride

Their name tells the tale, as these tiny insects tend to hide in bedding. They are often found in hotels, shelters, and apartment complexes — and can hitch a ride into your home aboard luggage, pets, and boxes.

Bedbugs are very tiny and can be seen by the astute observer

Bedbug Bites

Bedbugs leave itchy, red bites on the skin, usually on the arms or shoulders. More of a nuisance than a health hazard, it is possible to develop an infection from scratching. If you have an allergic skin reaction, use creams with corticosteroids and take oral antihistamines — and see your doctor.

Bedbug bites do not usually require treatment

Puss Caterpillar: Southern Stinger!

The most poisonous caterpillar in the U.S., puss caterpillars can be found in Southern states where they feed on shade trees like elm, oak, and sycamore. The poison is hidden in hollow spines among the hairs.

The puss caterpillar is close to 1 inch long

Puss Caterpillar Stings

When a puss caterpillar stings, you may get waves of intense pain, rash, fever, vomiting, and muscle cramps. Remove the broken–off spines by using cellophane tape or a commercial facial peel — and call your doctor.

Evidence of contact with a puss caterpillar

Scorpions: Deadly!

Not all scorpions are poisonous, but those that are can be deadly. Scorpions are found mostly in the Southwest and Western states. Symptoms of a sting include pain, swelling, itching, vomiting, increased sweating, and vision problems. Get medical care immediately.

The Arizona bark scorpion's venom is very dangerous

Deerflies : Painful !

These biting flies live in wetlands, forests, and other damp environs. Treat the painful bites with alcohol to prevent infection. Deerflies spread Tularemia, an infectious bacterial disease that requires medical attention. Insect repellant and protective clothing help prevent deerfly bites.

Deerflies are larger than a housefly and have a pattern on the wing

Mosquitoes: More Than Irritating!

Mosquitoes aren't just annoying. Scratching a bite can cause a skin infection. Also, mosquitoes can carry West Nile virus, dengue fever, and other diseases. To protect yourself from mosquitoes, apply insect repellent and cover up when you go outdoors. Use window screens, and get rid of standing water in your yard.

Mosquitoes can carry diseases such as West Nile virus and dengue fever

Houseflies: Dirty, Hairy!

A housefly is a dirty insect — carrying more than 1 million bacteria on its body. It can spread intestinal infections by contaminating food. To control flies, keep food and garbage in closed containers and use window screens on your home.

Houseflies don't bite, but they can carry harmful bacteria

Cockroaches: Ugly Trouble

They're not just ugly. Cockroaches carry diseases like salmonella. When they die, the carcasses trigger allergic reactions and asthma. If you live in a warm climate, getting rid of cockroaches can be difficult. It helps to use pesticides, keep a clean kitchen, and repair cracks and holes in floors and walls.