FAQ

1. What is Lymphoedema? Lymphoedema is a collection of lymph fluid in the body tissues; the normal flow of lymph is obstructed, creating a collection of lymph, typically, in the extremities.
2. What is lymph? Lymph is the normal body fluid which gets collected in the intercellular spaces during the normal activity. Rich in proteins and fat lymph is almost like plasma, but does not contain the Red Blood Cells. This fluid circulates through the lymphatic plexus and drains into the blood stream through the thoracic duct.
3. What is Lymphatic Filariasis? Lymphatic filariasis (LF), commonly known as elephantiasis. It is a parasitic, infectious disease that is caused by thread-like filarial nematode worms (the larval forms are known as ‘microfilariae’) Wuchereria bancrofti, Brugiamalayi and Brugiatimori. These worms occupy the lymphatic system, damage the lymph nodes or cause dilatation of the lymphatic vessels and impair flow of lymph.
4. What is the life span of a filarial worm? Life span of a filarial worm is 7 to 10 Years
5. Is Lymphatic Filariasis a hereditary disease? Lymphoedema is classified as primary and secondary. In Primary cases the hereditary form of lymphoedema is present and it is caused by a mutation in genes. Two genes have been identified in the causation of hereditary lymphoedema – FLT4 and FOXC2. Hereditary lymphoedema is rare. In India, the most common cause of lymphoedema is Lymphatic Filariasis but it is not hereditary. Primary lymphoedema may occur in the child hood or during the puberty and can be hereditary in nature
6. Are females affected more than males? This disease equally affects males and females.
7. Is the disease completely curable? Lymphoedema occurs due to damage of the lymphatic vessels. In Filariasis, there is dilatation of lymph vessels and normal contractibility is lost (lymphatic vessels carry lymph; its damage causes improper drainage that results in oedema/swelling). Our treatment procedures result in the drainage of lymph, possibly through collateral circulation. As is the case in heart diseases and diabetes, lymphoedema is not completely curable but we have observed that, following treatment, control of infection and a significant reduction in swelling occurs due to which the patient can return to normal activities. For best results, Lymphoedema/Filariasis patients have to be on long term and life-long treatment.
8. Does Filariasis spread from person to person? Only mosquitoes can spread the disease from an infected person (In active infection stage). This is the period when a person carries microfilareal worms in his body. Once the patient shows the symptoms of lymphoedema then the patient is not in active infection stage. The active infection stage is once the person gets mosqueto bite (which contains filarial worms) till the person shows the symptoms. It is nearly 8-9 years from mosquito bite.
9. How is Lymphatic Filariasis transmitted from one person to another? The adult produces millions of very small, immature larvae known as microfilariae, which circulate in the peripheral blood with marked nocturnal periodicity. The worms usually live and produce microfilariae for 4-6 years. Lymphatic lymphedema is transmitted through mosquito bites. The microfilariae enter the body of a mosquito when it feeds on the blood of a person carrying microfilariae in their blood (mf carriers). It takes 7-21 days for the microfilariae to develop inside the body of the mosquito.
10. Can a patient suffering from Filariasis donate blood? Patients can donate blood except during transmission stage of the disease or when there is an inflammatory episode. If patients have taken several courses of the DEC tablet it is unlikely that microfilariae is circulating in the bloodstream. Generally, it is advisable for patients to avoid donating blood between 9 p.m. and 3 a.m.
11. Can a woman suffering from Filariasis conceive and give birth to a child? If yes, is there a chance of the child being affected by the disease?
    Yes, a woman with lymphedema can conceive and give birth to a child. Only in the hereditary forms of the disease may it transmit to the child.
12. For how long a person can use DEC? In general, the course of treatment is 2 to 21 days. It is recommended to take a combination of Ivermectin, Albandazole and DEC once a year for five years. The government distributes these medicines once a year.
13. Does continuing DEC have any beneficial effects? There is no additional benefit with continuing the DEC.
14. Do we need to take precautions with the unaffected limb? One must take care of the unaffected limb and avoid getting injured in that limb. No precautionary treatment is required.
15. Who is at risk for infection? Many mosquito bites over several months to years are needed to get lymphatic lymphedema. People living for a long time in lymphoedema endemic areas where the disease is common are at the greatest risk for infection. Short-term tourists have a very low risk. The infection can be detected by night blood survey.
16. What are the symptoms of lymphatic Lymphedema? At first, most people do not know they have lymphatic lymphedema. They usually do not feel any symptoms until after the adult worms die. The disease usually is not life threatening, but it can permanently damage the lymph system and kidneys. Because the lymph system does not work right, fluid collects and causes swelling in the arms, breasts and legs. The name for this swelling is lymphedema. For men, the genital area also becomes swollen, a condition known as hydrocele. The entire leg, arm, or genital area may swell to several times its normal size. Also, the swelling and the decreased function of the lymph system make it difficult for the body to fight germs and infections. These people will have more bacterial infections in the skin and lymph system. This causes hardening and thickening of the skin, which is called elephantiasis.
17. What is the impact of this disease? Lymphatic filariasis is a leading cause of permanent and long-term disability worldwide. People with the disease can suffer pain, disfigurement, and sexual disability. Many women with visible signs of the disease will never marry, or their spouses and families will reject them. Affected people frequently are unable to work because of their disability. This hurts their families and their communities.
18. How can I prevent infection? Prevention includes giving entire communities medicine that kills the microscopic worms and controlling mosquitoes. Avoiding mosquito bites is another form of prevention. The mosquitoes that transmit the filarial worms usually bite between the hours of dusk and dawn. If you live in an area with lymphatic filariasis take the following precaution:
    • Sleep under a mosquito net/insecticide treated mosquito net.
    • Use mosquito repellent on exposed skin between dusk and dawn.
    • Consuming DEC treatment 2 to 21 days. It is recommended to take a combination of Ivermectin, Albandazole and DEC once a year for five years. The government distributes these medicines once a year.
19. What is the treatment for lymphatic filariasis? People infected with adult worms can take a yearly dose of medicine (DEC) that kills the circulating microfilariae in the blood. While this does not kill all the adult worms, it does prevent infected people from giving the disease to someone else. Even after the adult worms die, lymphoedema can develop. To prevent lymphoedema from getting worse by following several basic principles:
    • Carefully wash the swollen area with soap and water every day.
    • Use anti-bacterial cream on any wound. This stops bacterial infections.
    • Elevate and exercise the swollen arm or leg to move the fluid and improve the lymph flow
20. At what intervals should the compression bandage should be replaced by new ones? When it loses its elasticity it should be replaced.
21. If I could not arrange the attendant can i come alone for the treatment?> If the size of the limb is small and if you are confident then it can be a self-care home based treatment. But the percentage of reduction will be less.
22. Do you give treatment to patients with congenital lymphoedema also? If yes, is there any difference in the treatment given to this type of lymphoedema? Yes, treatment of all kind of Lymphoedema is practiced in our institute. Treatment is same but duration of treatment will be reduced.
23. How long would the treatment be in your place? Depends on the condition of the affected limb. Treatment duration is 14 or 21 days.
24. The Patient is already taking medicines for filaria, thyroid, diabetes mellitus and blood pressure. As our stay there may be for 2 weeks should we bring 2 weeks supply of the above medicines with us? Medicine for co-morbidities should be continued. Treatment and medication for Filariasis will be given from our institute after getting examined by doctors.
25. Does the patient need to bring past medical records with her? Yes.
26. What is the follow up after the initial treatment is performed? Three follow up. 1st month, 3rd month and 6 month
27. Is the treatment for initial one week is continuous treatment in the hospital or is it like an outpatient treatment for couple of hours? Outpatient treatment (three hours)
28. After the completion of six months can we reduced the time for doing yoga and massage? No, you can’t reduce the time of doing yoga and massage because only through the procedures we can enable the movement of lymph.
29. Whether yogasanas are same for male and female? Yes, yogasanas are same for both genders.
30. Is there any necessity to have compression bandage life long? Yes, compression bandage should be used life long, for maintaining proper drainage of lymph. After attaining normal size bandage can be replaced by stockings if it is convenient. Stockings are more expensive.
31. Why can’t we use stockings instead of bandage? Since the swelling gets reduced after doing our treatment protocols, appropriate pressure is needed for further reduction. But stocking may lose its elasticity by continuous use and at the same time limb volume will be reduced. Finally, it will be leading to improper compression. So we do not recommend stocking in initial stages of treatment
32. Why bystander is compulsory? As our treatment is home based self-help training, we are training bystanders to do massage and bandaging as it becomes more effective during the initial stage. It is to be realized that at least last five days of training period bystander should be available.
33. Why it is paining on the unaffected limb? It is mostly due to improper method of walking. Patients are giving more pressure to the unaffected limb because of the heaviness of the affected limb and leads to degenerative changes in joints which cause pain in joints or patients will have compensatory movements if one of the limbs gets affected. Due to that compensatory movement unaffected limb will have more weight/pressure leading to degenerative changes in joints. This will cause pain in joints.
34. Can we avoid bandage for one or two days in case of emergency? Compression bandage helps to drain the lymph throughout the day. So it is essential that compression must be retained. Otherwise lymph will not be properly drained from lower limbs. During fever affecting the limbs we don’t recommend to use compression bandages
35. Whether we can go for cycling? Yes, you can do cycling. This is one of the good exercise which help the drainage of lymph.
36. Whether there is any side effect for this treatment? Our treatment mainly focused on patient education regarding, yoga, manual lymph drainage and compression bandaging and care of entry points. Short term antibiotic courses are given whenever necessary to prevent inflammatory episodes. Minor side effects are seen rarely due to oil and the use of antibiotics in sensitive patients. Only a few patients had intolerance to oral ayurvedic medications
37. Whether a filariasis patient can donate blood? Yes, off course, patients can donate blood except during the transmission stage and when there is inflammatory episode.
38. How many days are needed for treatment? Normally we recommend 15 days of stay for treatment and training. It may vary according to size and complications. For them 21 days may be needed for treatment and training.
39. Can we meet doctors from all three systems: allopathy, ayurveda & homeopathy? Yes
40. Do we need to stay back on the day of follow up? No
41. How to take appointment? Call us on 04994-240862 or 240863 for booking appointment. Online appointment facility is also available.

FAQs on INTEGRATIVE TREATMENT PROCEDURE OF THE IAD

1. What kind of treatment do you provide? We follow a self-care, home-based integrated treatment protocol for Lymphoedema patients and this protocol is exclusively developed by IAD. It involves the participation of different health systems such as Ayurveda, Allopathy, Yoga, Physiotherapy and Homeopathy as is required.
2. What is the duration of the entire treatment? Generally, it is a life-long treatment procedure. Depending on the recovery of the skin condition the doctors may advise a reduction in the treatment duration.
3. How long does the treatment procedure last on a day? Supervised treatment procedure at IAD takes about 3 hours a day and the duration will be reduced to one and a half hours a day after discharge.
4. Can you treat both limbs together? Yes
5. Do we get treatment immediately? Yes, except in cases of complicated limbs with recent infections or Filarial fever. The doctors will decide the need for immediate treatment, after counseling and examination.
6. Is the treatment surgical? No
7. What investigations do you perform to diagnose if the disease is Filariasis? Routinely there is no need for a confirmatory test. Filariasis is a clinical diagnosis. A test may be used to confirm the type of worm causing the disease.
8. How long will it take for an affected part to return to normal size? The time depends on the grade of disease progression and patients’ compliance. You have to follow the procedures for a long duration; a near-normal size of the affected part can be expected over a period of time.
9. How much reduction can be obtained after treatment? It depends on the skin condition and the stage of Lymphoedema at the time of admission.
10. Will the frequencies of fever reduce after treatment? Yes, our treatment protocol aims at reducing entry points (factor causing fever). Analysis has shown that post-treatment fever episodes reduced by 16%.
11. What else do we have to bring during our treatment visit? Bring along your daily wear clothing. Also bring a well-fitting footwear pair that will fit your feet after bandaging. Please do not forget to bring along your previous medical records, if any.
12. What is the course of the medicine? A minimum of 3 months of oral medication and self-care treatment has to be continued until the doctor further advises.
13. Can the treatment be done on one’s own? Yes, it is a home-based self-care procedure.
14. Does the treatment have any side effects? Our treatment mainly focuses on patient education regarding Yoga, Manual lymph drainage and Compression bandaging and care of entry points. Short-term antibiotic courses may be prescribed to prevent fever episodes. Minor side effects with the oils used or the antibiotics (in sensitive patients) are rarely seen. Only 4/1000 patients have been found to have intolerance to oral ayurvedic medications.
15. Is there any food restriction? Yes, we recommend a diet chart that has to be followed after discharge.
16. Is by-stander a must? It is useful to have the support of a family member for at least 5 days of treatment at the centre. Lymphoedema treatment is a home-based care procedure that has to be continued after the patient returns back home. It becomes helpful if the family member also learns the simple home care techniques. In those cases, where support is not available, we teach self-care methods.
17. Can you provide a home-nurse? No. The patients are allowed to arrange their own nurse. If it is difficult to arrange for a By-stander, we will teach you self-care/self-help procedures.
18. What happens if we stop the compression, massage and yoga? The disease is likely to recur if treatment is stopped as in the case of Diabetes where if you stop medications your blood sugar levels will increase again. So it is advisable to not stop any of the procedures if you want to see results.
19. What is the need of a follow-up? At each follow-up, we check to see if all procedures are being followed and correct any errors that may exist. Doctors will make changes in medication if required. Follow-up counseling is necessary for best results.
20. After completion of 6 months when is the next visit? Our treatment protocol suggests a compulsory follow-up schedule up to 6 months. After the completion of 6 months you may visit any time for advice or consultation. Try to visit regularly once every 4-6 months.
21. Do we need to stay back on the day of follow-up? No.
22. What is the approximate treatment cost? The treatment cost depends on the size and circumference of limb, duration of treatment, time needed to manage your condition, materials and medicines needed. For Lymphedema (including Lymphatic Filariasis) it ranges from Rs. 40,000 to Rs. 85,000.
23. How many patients have you treated so far? We have treated about 6000 patients. The reduction in volume in 14 days in small limbs is 13.3% and in large limbs 23% and in 90 days it is 23% in small limbs and 40% in large limbs. The episodes of fever also reduced from 80% to 90% in 3 months.
24. Could you give us the contact numbers of treated patients? There are patients willing to share their experiences; so on request we could give you their numbers. Read our Service section for more details. We have published new letters about patients’ experiences.
25. Why didn’t we get the expected results? It is possible to achieve best results only if you promptly follow and perform all procedures as instructed and demonstrated during training. Also remember, results vary depending on skin condition, grade of limb and your compliance to treatment.
26. Is food/ accommodation available at/around the center? Treatment is on an outpatient basis so the patient will have to stay at rooms available nearby or hotels in Kasaragod town, which is at a distance of 5 km from IAD.
27. Do you have published articles? Yes, we have published scientific articles in National and International journals like ‘Lymphology’ published in USA, ‘Journal of Lymphoedema’ in UK, ‘Wounds UK’ in UK, and ‘Journal of Alternative and Contemporary Medicine’ in USA.
28. Will you publish our photos? We take photographs of only the affected parts (eg., limbs) of patients on the first day of treatment and training, on the last day of the supervised training and again at the time of follow-ups (each appointment). This is done for comparison of results during the treatment period. No face identification is possible. Also, without your consent we do not publish any photographs.
29. Whether you have treatment for other diseases in your institution? Yes, we are providing treatment for all type of chronic skin diseases especially vitiligo, lichen planus, psoriasis, urticaria and others in an integrated way. However, our dermatologists give allopathy treatment for all skin disease. Ayurveda doctors treat other common non infectious diseases and homeopathy doctors have expertise in treating sexual dysfunction, wart etc.
30. Do you have any treatment centre at any other place? We have a treatment centre only at Kasaragod and we do not have other branches.
31. Whether this institution is a private or government undertaking? IAD is a Non-Governmental, not for profit charitable, Organization.
32. What are the working hours of IAD? 8 AM-6PM

1. What is Lichen Planus? Lichen planus is a benign (not cancer) condition that affects either the skin or the inside of the mouth. Occasionally both areas will be affected. Rarely oral ulcerative lichen planus are painful and require repeated biopsy. The specific treatments for Lichen Planus in modern medicine are oral steroids and exposure to narrow band UVB rays. Sometimes medications for other diseases can induce this disease and ask your doctor if the current medication you are receiving could have caused this disease.
2. Is Lichen Planus contagious? Lichen Planus is not contagious
3. What does lichen planus look like? On the skin, lichen planus appears as small, itchy, red-purple, flat-topped bumps that occur in clusters on the forearms and thighs primarily. Lichen planus in oral cavity looks like a white lace.
4. How long one will have Lichen Planus? The duration or severity of the disease is not predictable. Some patients have lichen planus for many years and other patients find the disease will disappearing after a few months but many reoccur.
5. Is Lichen Planus lesions always painful? The lesions are not painful .Sometime oral lesion become ulcerated and cause pain.
6. Will stress increase Lichen Planuslesions? Stress influences any disease.
7. Does Lichen Planuslesions/symptom increase by consuming any food item? Itching many increase after taking certain food items. A detailed diet analysis will help to identify the food which causes allergy.
8. What are the lab tests recommended for Lichen Planus? Urine and blood investigations including liver function test, kidney function tests and lipid profile areroutinely done.
9. How will the diagnosis confirmed? A biopsy is usually not necessary to confirm the diagnosis. However clinical diagnosis is always possible in the absence of precipitating factors.
10. If Lichen Planuslesion doesn’t reduce after treatment should biopsy repeated? If oral Lichen Planus lesion does not respond to treatment within one year then biopsy should be repeated
11. Is there any bad effect of Smoking or Drinking in Lichen Planus conditions ?Any disease can worsen with this habits
12. Is Lichen Planus curable? How much time it takes? Lesion will disappears within two years IADs integrative treatment heals it much faster but dark pigmentation may persist, and may reoccur
13. Any diet should be followed during treatment? Yes, patient has to follow strict diet restrictions. A list of restricted and allowed dietary constituents is provided at the time of consultation. This is decided on patients’ condition.
14. What is the follow up schedule? Follow up for every 2 months is advised to find out the status of the disease and change the medication as per the condition
15. Should any change in lesion be informed? If the lesion turn red,painful with pus formation, severe itching then it should be informed to the concerned.
16. Please click here to know more about the Lichen Planus
    www.americanskin.org/resource/lichen.php

1. What is psoriasis? Psoriasis is a chronic skin disease presents with red, often itchy and scaly patches which may vary from a small sized lesion in one or two areas to entire body including the head, palms, soles or nails. Injury due to scratch may increase the lesions which are termed as Koebners phenomenon.
2. Is psoriasis contagious? Psoriasis is not contagious.
3. What causes psoriasis? While the exact causes of psoriasis have yet to be discovered, the immune system and genetics play major roles in its development. The immune system is mistakenly triggered, which speeds up the growth cycle of skin cells among other immune reactions. It can be triggered due to consumption of certain medications, excessive alcohol, cigarette smoking, and obesity, scratching the lesions, genetic predisposition, psychological stress and sometimes environmental factors.
4. How is psoriasis diagnosed? No special blood tests or diagnostic tools exist to diagnose psoriasis. A dermatologist or other health care provider usually examines the affected skin and determines if it is psoriasis. Skin biopsy is not routinely necessary. However it is advised to do routine urine and blood examinations to monitor the parameters during long term treatment
5. Is there a cure for psoriasis? Reoccurrence can be reduced by medication, maintaining a proper diet and reducing stress.
6. Is psoriasis hereditary? Often the person with psoriasis has a parent or grandparents with same condition, If any member in family has psoriasis, it doesn’t mean other individual will have psoriasis.
7. Can psoriasis affect all parts of the body? Psoriasis most commonly appear on the scalp, knees, elbows and toes. But psoriasis can develop anywhere, including the nails, palms, soles, genitals, and very infrequently on the face.
8. Can psoriasis occur at any age? Psoriasis often appears between the ages of 15 and 35, but it can develop at any age.
9. Is psoriasis more prevalent in men or women? Psoriasis is equally seen in men and women.
10. Will psoriasis causes hair fall? According to Allopathy psoriasis itself will not cause the hair to fall out. The very thick scales in the scalp (psoriatic lesion) can entrap hair and the attempt to remove the scales, can cause hair loss in the process. However it is common to observe hair loss in Indian psoriatic patients.
11. Will there be any change in lesion according to the climate? During the winter months, the humidity is generally lower; the skin will be dry and itchy. Scratching the affected skin will worsen the psoriasis and can even cause new lesions to form..
12. Can psoriatic lesion develop after skin damage? Psoriasis patients can develop lesions at the site of significant skin trauma, especially during a period of active disease. Psoriasis worsens in areas of skin scrapes, scratches, and cuts (such as surgical wounds) it is also important not to pick, scratch, or scrub the lesions and scales

About IAD’S integrative treatment

1. How it is treated in IAD? We treat psoriasis in an integrative approach. Initially the patient will spend time with the counselor and discuss about the disease, current treatment available and modality of our treatment procedure. Then the patient will be evaluated by Ayurvedic, Allopathy Homoeopathy doctors and a dietician separately. Doctors will discuss among themselves and prepare a treatment protocol for the condition. Later a detailed prescription will be generated and given to the patient
2. What will be the medications? Usually there will be oral medications from three systems either singly or in combination, local applications and procedure based therapies. The treatment will be selected after patient consultation.
3. Is there any side effects by taking all the systems together? Safety w is the primary focuss while treating the patients. We will consider utmost safety while prescribing the medicine to the patients. We follow prescribed guidelines to estimate the possible drug reactions and interactions.IAD follow all guidelines strictly.
4. Is there any investigations done? Apart from routine blood and urine investigations sometimes Thyroid, liver and kidney function tests are done. Photo acquisition is done in all patients .We compare baseline photo with follow up photos, to know the reduction in disease condition

1. How it is treated in IAD? In IAD we treat Vitiligowith an integrative approach. Initially Nurse Counsellor will explain the details and ways of integrative treatment for Vitiligo. The counselor will explain in detail about the disease, current treatment available and modality of our treatment procedure. This may take over half an hour to make the patient understand the need to adhere to long term treatment. If patient decides to continue treatment at IADthe next step is evaluation by Ayurvedic, Allopathy and homeopathy doctors and dietician separately. Clinical notes and impression of doctors, nurses, counsellors and dietitician will be reviewed in a team meeting on the same day or on the following day. This discussion will follow a detailed prescription to the patient.
2. What will be the medications? The treatment will be selected after patient consultation.Usually there will be oral medications from all the three systems either singly or in combination along with local applications and sometimes additional treatment procedure could be done.
3. Is there any side effects by taking all the systems together? Patient safety is main concern while treating the patients. We often conduct a thorough serach of scieitific publications and books and constantly in look out for such unfortunate events. In our experience such sides effects are rate and when occurs it can be managed. We dont use any medicines that harm patients more than they benefit. We dont use steroids or immunosuppressive therapies or mineral based (known as rasoushadha ) drugs of ayurveda. IAD follows available guidelines to monitor the possible drug reactions and interactions.
4. Is there any investigations done? We are suggesting woods lamp examination for identifying hidden patches along with routine blood and urine investigations.Photo acquisition is done in all patients to compare baseline photo with follow up photos. In selected patients patch test and other investigations may be necessary. These investigations are repeated during every follow up visit to monitor side effects.
5. Is there any diet restrictions? Yes, patient has to follow diet restrictions. A list of restricted and allowed dietary constituents is provided by the dietician after a detailed diet evaluation at the time of consultation.
6. Whether I have to stay in Kasaragod for the treatment? Hospitalization is not necessary for usual cases of Vitiligo.. One full day is required for the consultation. In many occasions the evaluation may extend the entire day and patients may have to stay for the next day for discussions and prescriptions. We insist consultation on prior appointments to avoid undue delay in the process.
7. What is the duration of treatment? Duration of teatment in Vitiligo is generally long Patients have to commit for at least two years of treatment.
8. Is it completely curable? The aim of our treatment is to arrest the progress of the disease and also to promote re pigmentation at least in exposed areas. It depends on patient condition. However Vitiligo of prolonged duration is difficult to cure although exposed areas could regenerate the lost pigments.
9. What is the cost of treatment? The cost of treatment and medicine will vary from patient to patient. The first consultation of Vitiligo may cost each patient INR 3,500 to 4,500. Subsequently approximate cost is INR 2,500-4,500 for a month.

You may view following links to get more information on Vitiligo

• Indian Association of Dermatologists: //www.iadvl.org/files/peb1.pdf
• National Institute of Health, USA: //www.niams.nih.gov/health_info/vitiligo/vitiligo_ff.asp

1. What determines skin color? Melanin is the substance that normally determines the color of skin, hair, and eyes. This pigment is produced in cells called melanocytes. If melanocytes failed to produce melanin or if their number decreases, skin colour will become lighter or completely white as in Vitiligo.
2. What are the types of Vitiligo?
   The commonest manifestation of Vitiligo are:
   • Acrofacial Vitiligo: depigmentation occurs in face and extremities.
   • Lip and tip Vitiligo: the lesions appear in lip, tip of the finger and tip of the penis, genital organs.
   • Vitiligo lesions can appear in hairy and non hairy areas or both. Depigmentation also occurs after wounds, scars and burns
3. What is the cause of Vitiligo? The cause of Vitiligo is not known. Many people report pigment loss shortly after an injury. Others relate the onset of Vitiligo to emotional trauma associated with an accident, death in the family, divorce etc.
4. How does Vitiligo develop? The beginning of Vitiligo and the severity of pigment loss differs with each patient. People with dark skin may observe the onset of Vitiligo at any time.
5. Can Vitiligo develop at any age? Vitiligo is most commonly seen in the age group of 10-30 years of which 50% of these patients are between 10-20 years old. The incidence of Vitiligo in children is increasing.
6. Will Vitiligo spread? For some people, it will not spread for years or will only spread very slowly, for others it will spread rapidly. However we developed a chart to determine the possibility and we assess this during the patient examination on each follow up visits .
7. Is depigmentation ever accompanied by itching? Some, though not all patients, do experience itching of the skin prior to or while depigmentation is occurring. Our research has documented this event in many patients. Ayurveda consider this as kaphadosha.It offers treatment for reducing kapha imbalance.
8. Is Vitiligo at all contagious? Vitiligo is NOT contagious.
9. Is it true that exposure to certain chemicals can cause Vitiligo? Some chemicals, particularly Phenols can trigger Vitiligo in those who are susceptible. Phenols can also be found in many types of hair colorings, household stains, and similar products. There are other industrial chemicals and substances which may also trigger the onset of Vitiligo. Rubber is a common cause for depigmentation.We do patch testing for such individuals.
10. Are there any other symptoms? Other than the white patches of skin and itching, there are no other specific physical symptoms of Vitiligo. As a secondary effect, Vitiligo patches will tend to sunburn more easily, and sunscreen is often recommended in fair individuals.
11. How is Vitiligo diagnosed? Vitiligo can be diagnosed by clinical examination .In doubtful cases woods lamp can be used. Skin biopsy is also used but it is seldom useful.
12. Is it true that Vitiligo could not be treated ? Vitiligo is a difficult to treat skin disease; but Vitiligo can be treated, though the results can take longer time. It is true that results of treatment cant be guaranteed in spite of the best efforts.
13. Is sunscreen recommended? Yes in those patients who have burning in lips, facial skin etc following sun exposure.

1. 1. Which are the medicines you will prescribe?It is integrative treatment and includes Ayurvedic, allopathy, homeopathy and yoga as decided by doctors.
   2. Are there any side effects by taking all the systems together?Patient safety is main aim while treating the patients. We will consider utmost safety while prescribing the medicine to the patients.
   3. Which are the diseases treated at your institute by integrative treatment?Lymphoedema, Lymphatic filariasis, lichen Planus, vitiligo, Psoriasis, and chronic wounds using integrative treatment methods.
   4. Whether you have treatment for other diseases in your institution?Yes, we are providing treatment for all type of chronic skin diseases especially vitiligo lichen planus, psoriasis, urticaria and others in an integrative way. However our dermatologists give allopathy treatment for all skin disease. Ayurveda doctors treat other common non infectious diseases and homeopathy doctors have expertise in treating sexual dysfunction, wart etc..
   5. How long is the stay for treatment?In case of Lymphoedema, lymphatic f ilariasis patient who comes for treatment have to stay for 14 to 21 days , in case of Lichen planus,psoriasis and Vitiligo one day is sufficient
   6. Where is IAD situated in Kasaragod?IAD is situated at Uliyathadka, Madhur Road, Kasaragod Kerala
      Refer to Contact us
   7. How to contact?Ph: 04994 240862, 240863 or 09895588735, 09446449920. You may please e-mail to iadorg@gmail.com , for more details please
   8. How to reach there?Train/ bus; nearest airport is Mangalore (IXE) situated 1 ½ hour drive from Kasaragod for more details please click the contact details in the website
   9. What are the working hours in IAD?8 AM-6PM including Sundays and all government holidays.
   10. Is there any holiday for the institution?No, except during political unrest such as bandh, shut down and harthal (frequent in Kerala). Therefore please call at front office before you depart from your place. If you want to come on Sundays and national holidays please confirm your appointment twice. On these days only limited appointments are given.
   11. Do you have any branches any where?

       IAD HAS NO BRANCHES OUTSIDE KASARAGOD KERALA

   12. Can we meet doctors from all three systems: allopathy, ayurveda & homeopathy?Yes, by taking prior appointment.
   13. What is counseling?Explaining about the integrative treatment procedures followed at the Institute of Applied Dermatology
   14. Do we need to stay back on the day of counseling?

1. Is there free treatment slots?We have treated 25% of patients free so far. Now a days we get only a few partial sponsorships. Beneficiaries are selected strictly based on counselor’s recommendations. Give India Mumbai and a few philanthropists donate to support who are in need of financial difficulty
2. Is there any sponsorship available for treatment?All treatment programs are currently unsponsored. We do get small sponsorships to treat Lymphatic Filariasis occasionally. We are making constant efforts towards obtaining sponsorships to treat the poor and the needy.
3. Is there accommodation and food facility?Kindly note that we are a day care centre and serve on outpatient basis. Accommodation is locally available near to the premises of our Institute as well as in Kasaragod municipal area.
   Some Hotel telephone numbers-Hotel A.M Land-9846247150, Hotel C –Park-8281495434, Hotel City tower-04994 220570, kindly communicate in Hindi, English, Malayalam)
   You can also book hotels through online services like OYO, Make my trip etc.
   We don’t have canteen facility at IAD, but local rural standard vegetarian hotels are available in Kasaragod.
4. Is there any fee for follow up? Yes Per day treatment charge is applicable
5. Do we need to stay back on the day of follow up?NO, as soon as the treatment procedures are over you can return back
6. Can we get medicine by post/courier?Yes, provided you make advance payment
7. Do you provide treatment to any other diseases?Yes ,we treat Lichen Planus, Vitiligo, Psoriasis, and chronic wounds using integrative treatment methods.
8. Is your institute registered under CGHS goverement of India?Our hospital is registered under Section 25 of company’s act1956.Our institute is a non profit oriented charitable organization engaged in health system research and development. We are focused on R and D activities to constantly improve our services
9. Whether this institution is private or government?Our institute is a Non- profit oriented charitable organization run through private donations, providing treatment service. We are a nongovernmental organization
10. Mediclaim policy?Several patients get reimbursed of their expenses by their health insurance companies. There is no cash back facility available.
11. What are all the keywords people commonly use to search the treatment for Filariasis in the website?Commonly used key words: Filariasis, Lymphatic Filariasis, Filarial Lymphoedema, Lymphoedema, Primary Lymphoedema, Filariasis Treatment, Treatment for Filariasis, Elephantiasis, Mosquito borne disease, Lymphatic block, Leg swelling, Swelling in leg, Leg oedema, Filaria, Filaria fever, Ulcer, Filarial Parasite, Wuchereria Bancrofti, Culex, varicose vain, Oedema in leg, Scrotal edema, Manth, Massage, Hydrocele, Ayurveda treatment for filaria, Skin disease, LF