Ways to Reduce Risk for Lung Cancer

Lung cancer remains one of the leading causes of cancer-related deaths globally (1). Despite its prevalence, lung cancer can be largely preventable. By understanding the risk factors and adopting preventive measures, individuals can significantly reduce their chances of developing this chronic disease.

Overview of the Risk for Lung Cancer

Lung cancer primarily affects the respiratory system, starting in the lungs and potentially spreading to other parts of the body. While smoking remains the most significant risk factor, non-smokers are not entirely immune. Other factors such as exposure to second-hand smoke, radon gas, asbestos, air pollution, and genetic predispositions also contribute to the risk.

Ways to Prevent Lung Cancer

1. Avoid Smoking

The most effective way to reduce the risk of lung cancer is to avoid smoking altogether (2). Cigarette smoke contains carcinogens that damage lung tissue, leading to cancer. For smokers, quitting can drastically reduce the risk. According to the World Health Organisation (WHO), the relative risk of lung cancer decreases steadily after smoking cessation, dropping to half after 10 to 15 years of cessation (3).

2. Minimise Exposure to Second-hand Smoke

Non-smokers exposed to second-hand smoke have a significantly higher chance of developing lung cancer. Second-hand smoke, or passive smoke, is a major risk factor for lung cancer among non-smokers, increasing the risk by about 20-30% (4). No amount of exposure to second-hand smoke is safe. Ensuring homes and vehicles are smoke-free can protect non-smokers from the harmful effects of tobacco smoke.

4. Avoid Exposure to Carcinogens at Work

Certain occupations expose workers to carcinogens such as asbestos, arsenic, and diesel exhaust (5). Ensuring proper safety measures, using protective equipment, and following safety protocols can significantly reduce the risk of lung cancer associated with occupational exposure. Employers are also mandated by law to provide a safe working environment, and employees should be proactive in adhering to safety guidelines.

5. Maintain a Healthy Diet

A diet rich in fruits and vegetables can help lower the risk of lung cancer. These foods contain antioxidants and phytochemicals that protect cells from damage. Studies have shown that a high intake of vegetables and fruits, particularly cruciferous vegetables like broccoli and cabbage, is associated with a reduced risk of lung cancer (6).

6. Reduce Air Pollution Exposure

Prolonged exposure to polluted air can increase the risk of lung cancer. Air pollution, particularly in highly polluted cities, has been identified as a significant risk factor for lung cancer. During periods of poor air quality, staying indoors, using air purifiers, and wearing masks can help reduce exposure to harmful pollutants. According to estimates from the World Health Organisation, air pollution causes over 4 million unnecessary deaths globally each year and Lung cancer is one of the primary causes (7).

Conclusion

Reducing the risk of lung cancer involves a combination of lifestyle changes, environmental awareness, and proactive health measures. By avoiding smoking, minimizing exposure to second-hand smoke and other carcinogens, maintaining a healthy diet and exercise routine, and being mindful of air quality, individuals can significantly lower their chances of developing lung cancer.

References

1. Barta, J. A., Powell, C. A., & Wisnivesky, J. P. (2019). Global Epidemiology of Lung Cancer. Annals of Global Health, 85(1). https://doi.org/10.5334/aogh.2419
2. Benefits of Reduced Smoking on Lung Cancer. (2024, February 9). Cancer.gov; Cancer.gov. https://dceg.cancer.gov/news-events/news/2024/reducing-smoking-lung-cancer#:~:text=A%20new%20analysis%20quantifies%20the
3. Faselis, C., Nations, J. A., Morgan, C. J., Antevil, J., Roseman, J. M., Zhang, S., … & Ahmed, A. (2022). Assessment of lung cancer risk among smokers for whom annual screening is not recommended. JAMA oncology, 8(10), 1428-1437. https://jamanetwork.com/journals/jamaoncology/fullarticle/2794805
4. CDC. (2022, November 28). Health problems caused by secondhand smoke. Www.cdc.gov; CDC. https://www.cdc.gov/tobacco/secondhand-smoke/health.html
5. Cani, M., Turco, F., Butticè, S., Vogl, U. M., Buttigliero, C., Novello, S., & Capelletto, E. (2023). How Does Environmental and Occupational Exposure Contribute to Carcinogenesis in Genitourinary and Lung Cancers? Cancers, 15(10), 2836. https://doi.org/10.3390/cancers15102836
6. Ağagündüz, D., Şahin, T. Ö., Yılmaz, B., Ekenci, K. D., Duyar Özer, Ş., & Capasso, R. (2022). Cruciferous Vegetables and Their Bioactive Metabolites: from Prevention to Novel Therapies of Colorectal Cancer. Evidence-Based Complementary and Alternative Medicine, 2022, 1–20. https://doi.org/10.1155/2022/1534083
7. Lung Cancer. (n.d.). www.singaporecancersociety.org.sg. https://www.singaporecancersociety.org.sg/learn-about-cancer/types-of-cancer/lung-cancer.html#risk-factors

Understanding Lung Cancer: What Every Singaporean Should Know

Lung cancer is a prevalent health concern in Singapore. Understanding its nature, types, and symptoms can empower you to take proactive steps for your health. This article provides a comprehensive overview of lung cancer, helping you stay informed and vigilant. 

Overview of Lung Cancer

Lung cancer often begins in the cell lining of the lung’s air passage. It is one of the most common cancers worldwide.

In Singapore, lung cancer has the highest mortality rate among males and the third highest among females. According to the Singapore Cancer Registry 2019 Annual Report, lung cancer made up 25.6% of cancer deaths in males and 15.5% of deaths in females in Singapore between 2015-2019(1)

Lung cancer had the second poorest survival rate for males 25.5% and the lowest survival rate for females 29.3%.(2)

While anyone can develop lung cancer, it is more prevalent among:

• Smokers : Smokers are 15-30 times more likely to get lung cancer.
• Individuals exposed to secondhand smoke: Secondhand smoke increases the risk by 20-30%.
• People exposed to pollutants and certain chemicals.

Types of Lung Cancer

Lung cancer is broadly classified into two main types:

1. Non-Small Cell Lung Cancer (NSCLC): This is the most common type, accounting for about 85% of cases. It includes subtypes such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
2. Small Cell Lung Cancer (SCLC): Less common but more aggressive, SCLC accounts for about 15% of cases. It tends to spread quickly and is often found in heavy smokers.(3)

There are also other types of cancer that may affect the lung.

Signs and Symptoms

Early detection of lung cancer can significantly improve treatment outcomes. Here are the common signs and symptoms to watch out for:

• Persistent Cough: A cough that doesn’t go away or gets worse over time.
• Chest Pain: Discomfort or pain in the chest that may worsen with deep breathing, coughing, or laughing.
• Shortness of Breath: Difficulty breathing or feeling winded with minimal exertion.
• Hoarseness: A change in voice or hoarse sound.
• Weight Loss: Unexplained loss of appetite and weight.
• Coughing Up Blood: Even a small amount of blood in the cough can be a sign of lung cancer.
• Fatigue: Persistent tiredness and lack of energy.

If you experience any of these symptoms, it is important to consult a healthcare professional promptly.

Stay informed and proactive about your health. Early detection and treatment can make a significant difference in managing lung cancer effectively. Seek medical advice without delay If you have any concerns.

Remember, your health is in your hands. Stay vigilant and take charge of your well-being!

References:

• What Is Lung Cancer – Health365.sg
• Singapore Lung Cancer Statistics – Health365.sg
• https://www.cancer.org/cancer/types/lung-cancer/about/what-is.html

Understanding Liver Cancer

Liver cancer is a significant health concern worldwide, with a particularly high incidence in Asia, including Singapore. As the primary filtration system for our blood, the liver plays a crucial role in maintaining overall health. Understanding the differences between liver cancer and liver disease is essential for early detection, effective treatment, and prevention.

Overview of Liver Cancer

Liver cancer, also called hepatic cancer, begins in the liver cells. The most common type is hepatocellular carcinoma (HCC), accounting for about 75% of all liver cancers. (1) Less common types include intrahepatic cholangiocarcinoma and hepatoblastoma.

According to the Singapore Cancer Registry, there were over 1,500 new cases of liver cancer diagnosed between 2015 and 2019.

Signs and Symptoms of Liver Cancer

Early detection of liver cancer can be challenging as the symptoms often do not appear until the disease is in an advanced stage. However, recognising the early signs is crucial for timely medical intervention. Common symptoms include:

• Unexplained Weight Loss: Sudden and unexplained weight loss is a common symptom. (2)
• Loss of Appetite: A noticeable decrease in appetite and feeling full after eating small amounts.
• Abdominal Pain and Swelling: Persistent pain or discomfort in the upper right side of the abdomen, which can sometimes spread to the back or shoulder.
• Nausea and Vomiting: Frequent episodes of nausea and vomiting.
• General Weakness and Fatigue: Persistent tiredness and weakness that does not improve with rest.
• Jaundice: Yellowing of the skin and eyes, indicating a liver problem.
• White, Chalky Stools: Changes in stool color can also be a sign. (3)

Risk Factors for Liver Cancer

Several behaviors and conditions increase the risk of developing liver cancer:

• Obesity: Being overweight or having obesity increases the risk.
• Diabetes: Having diabetes can increase the risk of liver cancer.
• Smoking: Cigarette smoking is linked to a higher risk of liver cancer.
• Alcohol Consumption: Drinking alcohol excessively can lead to liver damage and increase cancer risk.
• Hemochromatosis: This condition, where the body stores more iron than needed, can increase risk. (4)
• Chronic Hepatitis Infections: Long-term hepatitis B or hepatitis C virus infections are significant risk factors.
• Cirrhosis: This scarring of the liver, often caused by hepatitis or alcohol use, significantly raises cancer risk.
• Nonalcoholic Fatty Liver Disease (NAFLD): The presence of extra fat in the liver not caused by alcohol is a risk factor.
• Aflatoxin Exposure: Consuming foods contaminated with aflatoxins, a type of fungus that grows on improperly stored grains and nuts, is a risk factor. (5)

How Liver Cancer Differs from Liver Disease

Liver cancer is a specific malignancy within the broader category of liver diseases. While both can cause liver dysfunction, they differ in cause, progression, symptoms, diagnosis, and treatment. Liver cancer often arises from chronic infections (hepatitis B/C), cirrhosis, or excessive alcohol intake, and progresses rapidly, with symptoms like weight loss and jaundice appearing later. Conversely, liver disease encompasses a wider range of conditions like hepatitis, fatty liver disease, and genetic disorders, with variable progression and symptoms depending on the type. Diagnosing both may involve blood tests, imaging scans, and biopsies, but treatment differs significantly. Liver cancer treatment focuses on removing or destroying cancerous tissue (surgery, ablation), while liver disease treatment depends on the cause, ranging from antiviral medications (hepatitis) to lifestyle changes and potentially liver transplant (cirrhosis).

While liver cancer is a specific type of cancer affecting the liver cells, liver disease is a broader term encompassing various conditions that impair liver function. The primary differences between liver cancer and liver disease include their causes, progression, and treatment.

Prevention and Early Detection

Preventing liver cancer involves addressing the risk factors associated with liver disease. Key preventive measures include:

• Regular Screening: Individuals at high risk, such as those with chronic hepatitis or cirrhosis, should undergo regular screening for early detection of liver cancer.
• Healthy Lifestyle: Maintaining a healthy weight, limiting alcohol consumption, and avoiding exposure to aflatoxins can reduce the risk of liver disease and cancer.
• Safe Practices: Using clean needles, practicing safe sex, and ensuring blood products are tested can prevent hepatitis B and C infections.
• Vaccination: Hepatitis B vaccination helps protect against preventable chronic liver disease. (6)

References

1. Types of Liver Cancer: Common, Rare and More Varieties. (2018, October 5). Cancer Treatment Centers of America. https://www.cancercenter.com/cancer-types/liver-cancer/types  
2. Bhattacharya, R., Hwang, J. H., & Ko, C. (2020). The Patient with Unexplained Weight Loss. Yamada’s Handbook of Gastroenterology, 37.
3. Mayer, L., & Bhikha, R. (2014). Changes in Colours of the Body–the Determinants of Disease. skin, 1, 270.
4. Elmberg, M., Hultcrantz, R., Ekbom, A., Brandt, L., Olsson, S., Olsson, R., … & Askling, J. (2003). Cancer risk in patients with hereditary hemochromatosis and in their first-degree relatives. Gastroenterology, 125(6), 1733-1741.
5. Jackson, P. E., & Groopman, J. D. (1999). Aflatoxin and liver cancer. Best Practice & Research Clinical Gastroenterology, 13(4), 545-555.
6. Hepatitis B Foundation: Hepatitis B Vaccination. (n.d.). Www.hepb.org. https://www.hepb.org/prevention-and-diagnosis/vaccination/

What is Hepatitis A?

Hepatitis A is a vaccine-preventable liver infection caused by the hepatitis A virus (HAV) (1), typically spreads through contaminated food or water, or close contact with someone infected with the virus. (2)

In Singapore, historically, most reported cases of Hepatitis A stemmed from consuming contaminated raw or undercooked shellfish (3).

Due to improved sanitation and food safety measures, the incidence of Hepatitis A in Singapore has significantly declined. However, it’s still crucial to be aware of the risks, especially for travelers visiting regions with high HAV prevalence (4).

Symptoms of Hepatitis A

Hepatitis A symptoms may not always appear, especially in children. However, when present, they can include (5):

• Fatigue
• Loss of appetite
• Nausea and vomiting
• Abdominal pain or discomfort
• Fever
• Dark-colored urine
• Pale stools
• Jaundice (yellowing of the skin and whites of the eyes)

Preventing Hepatitis A with Immunisation

The best defense against Hepatitis A infection is vaccination. There are two main types of hepatitis A vaccines:

• Single-antigen vaccine: Protects solely against hepatitis A.
• Combination vaccine: Protects against both hepatitis A and hepatitis B, typically recommended for adults 18 years and older (6).

Protecting Yourself

Beyond vaccination, practicing good hygiene is essential to prevent Hepatitis A infection. This includes (7):

• Thorough hand washing with soap and water after using the toilet and before preparing food
• Drinking only treated or boiled water, particularly when traveling to regions with high HAV prevalence
• Consuming thoroughly cooked food, especially shellfish
• Avoiding close contact with individuals infected with Hepatitis A

By understanding the symptoms and importance of vaccination and good hygiene practices, you can effectively protect yourself from Hepatitis A. Talk to your doctor about getting vaccinated and discuss any concerns you might have.

References

1. NCI Thesaurus. (n.d.). Ncit.nci.nih.gov. Retrieved June 18, 2024, from https://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C3096
2. Fiore, Anthony E. (2004). Hepatitis A Transmitted by Food. Clinical Infectious Diseases, 38(5), 705–715. https://doi.org/10.1086/381671
3. Goh, K. T., Doraisingham, S., Monteiro, E. H., & Ling, A. E. (1987). Acute hepatitis A in Singapore: importance of shellfish ingestion in a non-epidemic period. Annals of the Academy of Medicine, Singapore, 16(4), 591–594.
4. Cao, G., Jing, W., Liu, J., & Liu, M. (2021). The global trends and regional differences in incidence and mortality of hepatitis A from 1990 to 2019 and implications for its prevention. Hepatology International, 15(5), 1068–1082. https://doi.org/10.1007/s12072-021-10232-4
5. World Health Organization. (2023, July 20). Hepatitis A. Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/hepatitis-a
6. (2024, May 6). Hepatitis A Vaccine. Hepatitis A. https://www.cdc.gov/hepatitis-a/vaccination/index.html
7. Services, D. of H. & H. (n.d.). Hepatitis A. Www.betterhealth.vic.gov.au. https://www.betterhealth.vic.gov.au/node/1313

Heart Disease in Men

Heart disease is an umbrella term for several heart conditions, including coronary artery disease and heart attack. Let’s find out the signs and symptoms specific to men’s heart disease for early detection and treatment.

Signs and Symptoms of Heart Disease in Men

While some men might experience no symptoms at all, here are some common signs and symptoms of heart disease in men to be aware of:

• Chest pain or discomfort: This is often described as a squeezing, pressure, or tightness in the chest. It can also radiate to the shoulders, arms, jaw, neck, or back.
• Shortness of breath: This can occur at rest or during exertion.
• Pain in the arm, jaw, or shoulder: This pain can sometimes be mistaken for indigestion or heartburn.
• Fatigue: This can be a general feeling of tiredness or lack of energy and is occasionally a non-specific sign of heart problems.
• Dizziness or lightheadedness: This can be a sign that the heart is not pumping blood effectively to the brain.
• Sweating: This can be a sign of a heart attack, especially if it is accompanied by other symptoms.
• Swollen legs or ankles: This can be a sign of heart failure, a condition in which the heart is not able to pump blood effectively. The blood instead starts to pool.

Risk Factors for Heart Disease in Men

There are several factors that can raise a man’s risk of heart disease. Some of the most typical ones include:

• Age: As men get older, their risk of heart disease increases (1).
• High blood pressure: Uncontrolled high blood pressure can damage the heart and blood vessels.
• High cholesterol: High levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol can increase the buildup of plaque in the arteries.
• Diabetes: Diabetes can damage the heart, blood vessels, and nerves.
• Overweight and obesity: Carrying excess weight can put a strain on the heart.
• Smoking: Smoking damages the blood vessels and increases the risk of blood clots.
• Physical inactivity: A lack of exercise can increase the risk of heart disease.
• Unhealthy diet: A diet high in saturated fat, trans fat, cholesterol, sodium, and sugar can increase the risk of heart disease.
• Stress: Chronic stress can increase blood pressure and damage the heart (2).
• Sleep apnea: A sleep disorder that causes breathing to stop and start during sleep (3).

Ways to Take Care of Your Heart

The good news is that there are many ways to reduce their risk of heart disease and live a longer, healthier life:

• Maintain a healthy weight: Losing even a small amount of weight can improve heart health for overweight or obese individuals.
• Eat a healthy diet: Choose a diet that is low in saturated fat, trans fat, cholesterol, sodium, and sugar. Focus on plenty of fruits, vegetables, and whole grains.
• Get regular exercise: The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week (4).
• Quit smoking: Smoking is one of the leading causes of heart disease. The best thing you can do for your heart health is to stop smoking.
• Manage stress: Find healthy ways to cope with stress, such as exercise, relaxation techniques, or spending time with loved ones.
• Control your blood pressure: Have your blood pressure checked regularly and take medication as prescribed by your doctor.
• Control your cholesterol: Have your cholesterol levels checked regularly and take medication as prescribed by your doctor
• Get regular checkups: Schedule regular checkups with your doctor to monitor your blood pressure, cholesterol, and other risk factors for heart disease. Your heart health can be considerably improved by early detection and treatment.
• Limit alcohol consumption: Excessive alcohol consumption can increase your risk of heart disease. The Ministry of Health Singapore recommends that men limit their alcohol intake to two standard drinks per day (5).
• Get enough sleep: Aim for 7-8 hours of sleep each night. Sleep deprivation can be detrimental to your overall health and has been found to increase your risk of heart disease (6).
• Manage diabetes: If you have diabetes, it is important to manage your blood sugar levels carefully to reduce your risk of heart disease.
• See a doctor if you experience any symptoms: Don’t ignore any symptoms of heart disease and consult a doctor right away if you experience any of the symptoms mentioned above. Early diagnosis and treatment can make a big difference in your health outcome.

Heart disease is a serious health condition, but it is preventable. By making healthy lifestyle choices and managing your risk factors, you can significantly reduce your risk of developing heart disease. Don’t wait till you have a heart attack to take action. Start taking care of your heart today!

References

1. https://pubmed.ncbi.nlm.nih.gov/22499900/
2. https://link.springer.com/chapter/10.1007/978-1-4615-3712-0_9
3. https://pubmed.ncbi.nlm.nih.gov/11208620/
4. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
5. https://www.moh.gov.sg/news-highlights/details/alcohol-recommended-limits-and-public-education
6. https://pubmed.ncbi.nlm.nih.gov/29206050/

Men Health Conditions

In our fast-paced lifestyle, it causes us to often neglect our health. But staying informed is essential! Here are some health conditions every man should watch out for.

1. Heart Disease

Heart disease remains the leading cause of death among men.In Singapore, it is the second leading cause of death among men, accounting for 19.7% of total male deaths in 2022 (1)^. Factors like high blood pressure, high cholesterol, and smoking significantly increase your risk.

Maintaining heart health involves:

• Regular exercise with cardio activities such as brisk walking, jogging or cycling
• A balanced diet with less sugar and salt intake, more leafy greens and healthy fats.
• Routine check-ups

Early detection is key to mitigating these risks! Being proactive can help you live a longer, more energetic life and have a healthy heart.

2. Prostate Cancer

Prostate cancer is one of the most common cancers in men. From 2017 to 2021, there were 6,912 reported cases of prostate cancer, accounting for 16.8% of all male cancer cases (2). It’s vital to understand the symptoms, which include difficulty urinating, blood in urine, and pelvic discomfort.

To stay proactive:

• Schedule annual screenings for a comprehensive health check
• Staying informed about your family history

These steps can significantly increase early detection and successful treatment rates. If you face any discomfort or symptoms, seek help from your healthcare provider immediately.

3. Diabetes

Type 2 diabetes is on the rise, affecting millions of men worldwide. About one in 10 (9.5%) of Singapore residents aged 18 to 74 years had diabetes mellitus during the period 2019-2020. A higher proportion of males (10.6%) were diabetic compared to females (8.4%) (3).

 It’s essential to watch for symptoms such as increased thirst, frequent urination, and unexplained weight loss.

Managing and preventing diabetes involves:

• Having a proper diet to adopt a healthy lifestyle
• Include regular exercise to your daily routine, like taking the stairs or doing household chores

By consistently following your health plan, individuals can effectively prevent or better manage this condition.

Taking proactive steps towards a healthier lifestyle can make a significant difference. Stay informed, get regular check-ups, and don’t ignore symptoms. Addressing these health concerns early can lead to better outcomes and a higher quality of life.

References

1. https://www.moh.gov.sg/docs/librariesprovider5/default-document-library/nphs-2020-survey-report.pdf
2. Cancer Statistics (nccs.com.sg)
3. Singapore Health Facts: Principal Causes of Death

Menopause

We are delving into a topic that affects countless woman: menopause. A prevalent concern and a condition that women frequently seek help for. Here are the common symptoms that women face, but not limited to:

• Hot flashes
• Sweating
• Sleep disturbances
• Mood issues
• Skin dryness
• Vaginal dryness
• Sexual issues
• Urinary complaints
• Other systems in your body like one’s bone health (e.g. osteoporosis) 

Natural menopause, which is defined as the menstrual cycle permanently ceasing (diagnosed after 12 months¹), is a normal and physiological aspect of aging in women. It also signifies the end of their ability to reproduce. It typically occurs when a woman is around the age of 50², this phase of life is characterised by a decline in the body’s production of hormones such as progesterone and estrogen, which can impact woman in different various ways such as the symptoms mentioned above.

That being said, perimenopausal (before/after menopause) and menopausal symptoms can vary widely among individuals. The treatment and management of menopause are usually holistic and based on the severity of the symptoms. There are various treatment options available, so we recommend consulting your healthcare provider for further guidance.

Disclaimer:
All content in this publication is for informational and educational purposes only. It does not constitute any form of medical advice or clinical care nor is it intended to be a substitute for professional medical care. Please speak to your healthcare provider if you have any questions pertaining to your healthcare.

1) https://emedicine.medscape.com/article/264088-overview

2) https://www.singhealth.com.sg/patient-care/conditions-treatments/menopause

Stressed out? It shows on your skin

Contributed by Dr Kok Wai Leong, Senior Consultant Dermatologist, StarMed Specialist Centre

Is stress wreaking havoc on your skin? If you’re noticing rashes, acne breakouts, or other skin issues, it may be more than just a coincidence. 

I often get asked by patients whether there is a link between stress and skin health – the short answer is a resounding yes. Many of us have experienced outbreaks of rashes, acne, or sensitive skin during stressful periods. This is your body’s response to stressors from environmental changes or personal challenges.

Stress stems from various sources, from preparing for an important presentation to coping with loss or a devastating life event. When feeling stressed, your body triggers a chain reaction of increased levels of hormones and chemical signals. These changes can manifest in various skin, hair, and nail issues, including:

• Sensitive skin
• Inflammation in the skin
• Hair loss
• More oil and sebum production
• Skin infection and delayed wound healing

Sensitive skin
During periods of stress, your body’s immune response undergoes changes that can lead to more sensitive and reactive skin. As a result, you may notice redness and itching, or stress-induced hives characterised by raised, itchy bumps or patches.

Inflammation in the skin
Stress is a catalyst for various inflammatory skin conditions, notably atopic dermatitis and rosacea. Atopic dermatitis, a form of eczema, flares up due to heightened inflammation levels during stressful periods. Similarly, rosacea, characterised by facial redness, worsens as stress triggers increased blood flow to the skin, intensifying the symptoms.

Immune-related conditions, also known as autoimmune diseases, occur when the body’s immune system mistakenly attacks its own healthy cells, including those of the skin. Individuals with vitiligo, a condition characterised by white patches on the skin, may experience exacerbations triggered by extreme or sudden stress.

Hair loss
Hair loss, known as telogen effluvium, is another common consequence of stress. This condition often occurs after significant physical or emotional stressors, resulting in temporary hair loss and nail abnormalities.

More oil and sebum production
Individuals with acne may notice flare-ups during times of stress. This occurs due to heightened cortisol levels, which stimulate increased activity in the oil glands. Similarly, skin infections like cold sores may flare up, and wounds may take longer to heal when stress levels are high.

Skin Infection and delayed wound healing
Skin infections such as cold sores are typically more active during periods of stress. Also, you might find that your skin does not heal as well when you are stressed.

Behavioural and lifestyle effects
Stress can indirectly affect your skin in many ways through behavioural and lifestyle changes. It can disrupt sleep patterns, leading to insomnia or difficulty falling asleep, and exacerbate tendencies to scratch or touch the skin, which can further aggravate existing rashes or acne.

Furthermore, individuals under stress may resort to unhealthy coping mechanisms, such as excessive consumption of sugary and dairy-laden comfort foods or increased alcohol and tobacco use. These actions may aggravate skin inflammation and worsen conditions like psoriasis, eczema, or urticaria.

Caring for your skin during times of stress

Stress is an inevitable part of life, affecting everyone to varying degrees. While it’s impossible to completely eradicate stress from our daily routines, there are effective strategies for mitigating its impact on both our minds and skin.

Begin by prioritising relaxation techniques such as mindfulness exercises. These practices can significantly reduce stress levels, benefiting you’re your mind and your skin. Additionally, adopting healthy habits like staying hydrated, eating a balanced diet, and ensuring you get enough sleep can work wonders for your skin health.

Here are some additional tips to keep in mind:

• Stick to a consistent healthy lifestyle routine, as your skin requires good habits for repair and restoration.
• Adhere to any additional skincare routines recommended by your dermatologist to address specific concerns.
• Be mindful of your urge to scratch or touch your face. Instead, try distraction techniques like tapping and keep your hands clean.
• If you find yourself struggling to cope with stress, don’t hesitate to seek professional help. Behavioural therapy and other therapeutic options can provide valuable support.

By being mindful of the impact of stress on our skin and taking proactive steps to manage it, you can safeguard your skin’s health and appearance. Remember to continue implementing these lifestyle and skincare practices, and if your skin concerns persist, consult with a dermatologist for personalised guidance.

References

1. Hunter HJA, Momen SE, Kleyn CE, et al. The impact of psychosocial stress on healthy skin. Clin Exp Dermatol. 2015;40(5):540–546.
2. Patel A, Jafferany M, et al. Multidisciplinary and Holistic Models of Care for Patients With Dermatologic Disease and Psychosocial Comorbidity: A Systematic Review. JAMA Dermatol. 2020;156(6):686–694.

Difference among Heart Diseases

Cardiovascular diseases are the leading cause of death globally. According to the World Heart Organisation, there were 17 million premature deaths (under age 70) worldwide, 38% of whom were due to cardiovascular diseases. (1)

In Singapore alone, according to the Singapore Heart Foundation, 1 out of 3 deaths is due to heart disease or stroke. On average, 23 individuals die from heart disease each day in Singapore. From data collected in 2022, cardiovascular disease accounted for 31.4% of all deaths in Singapore. (2)

An overview of Cardiovascular Disease

The term cardiovascular disease encompasses a wide range of diseases related to the heart, the blood vessels, or both. These disorders can seriously hamper a person’s quality of life and survival as their implications are often systemic and complications may further damage other vital organs such as the brain (as in stroke).

Cardiovascular diseases may originate as a consequence of intrinsic heart dysfunction. This group of disorders include heart rhythm abnormalities, conduction defects of the heart, dysfunctions of the myocardium, and diseases of the heart valves. This can cause ineffective pumping of the blood, resulting in heart failure.

On the other hand, some cardiac diseases may be due to systemic pathologies of blood vessels. These may be primary disorders such as essential hypertension, caused by the age-related stiffening of blood vessels. In addition, such disease may be secondary to some other systemic pathology such as diabetes and high cholesterol.

Explaining the terminology – Difference in Cardiovascular, Heart Disease & Coronary Heart Disease (3)

Cardiovascular Disease – It is a more general term under which all illnesses related to the heart or blood vessels are classified. It includes arrhythmias, high blood pressure, cardiac arrest, coronary artery disease, cardiac failure, peripheral artery disease, stroke, cardiomyopathy and congenital heart defects.

The primary risk factors for cardiovascular disease are smoking, diabetes, high cholesterol, physical inactivity, obesity, alcohol consumption and genetic predisposition. Such risk factors ultimately compromise the function of the heart directly or most commonly through the buildup of plaques in the arteries.

The primary symptoms of cardiovascular disease are shortness of breath, chest pain and discomfort, easy fatiguability, palpitations, and dizziness for which immediate medical help must be sought.

Heart Disease – Although this term is used interchangeably with cardiovascular disease, it is important to differentiate the two. The term “heart disease” refers to conditions in which there is a local pathology limited to the heart only such as problems with cardiac muscles, cardiac conduction systems or heart valves. Thus, every cardiovascular disease is not a heart disease but every heart disease is classified under the umbrella of cardiovascular disease.

Heart disease if not properly managed may ultimately lead to heart failure, where the heart is unable to pump the blood efficiently. So, the treatment of heart failure must be accompanied by the treatment of the primary heart disease which leads to heart failure.

Coronary Heart Disease – This is a disorder related specifically to the blood vessels which supply the muscles of the heart, the coronary arteries. Like all other muscles of the body, the muscles of the heart also need oxygen-rich blood for proper functioning.

In coronary heart disease, the supply of oxygen-rich blood is interrupted due to the narrowing of the coronary vessels or their spontaneous spasm. Such narrowing happens due to the build-up of ‘plaque’, the primary cause of which is atherosclerosis. Over time this narrowing worsens and the heart tissue is further compromised due to lack of enough oxygen. Ultimately this results in a severe emergency, the symptoms of which are called “heart attack”.

How to prevent Cardiovascular Disease? (4)

References

• https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
• https://www.myheart.org.sg/health/heart-disease-statistics/
• https://heartresearch.org.uk/whats-the-difference-between-cardiovascular-disease-and-coronary-heart-disease/
• https://www.nhs.uk/conditions/coronary-heart-disease/prevention/

Managing Chronic Rhinitis: Tips for Health-Conscious Individuals

Living in Singapore, a vibrant metropolis nestled amidst lush greenery, often comes with its fair share of sniffles and sneezes. But for those afflicted with chronic rhinitis, it’s much more than seasonal sniffles. It’s a constant battle against a runny nose, stuffy head, and frustratingly itchy eyes. 

Chronic Rhinitis 101

Chronic rhinitis, affecting many Singaporeans, is a long-term inflammation of the nasal passages. It manifests in a persistent symphony of symptoms – a constantly runny or stuffy nose, postnasal drip, frequent sneezing, and reduced sense of smell. The two main culprits behind this symphony are:

• Allergic Rhinitis: Dust mites, mould, pollen and pet dander – these environmental allergens trigger your immune system, leading to the characteristic runny nose and itchy eyes.
• Non-Allergic Rhinitis: This encompasses a range of triggers like strong odours, pollution, cold temperatures, and even hormonal changes.

Identifying Your Triggers: The Key to Minimizing Misery

Understanding your triggers is the first step to managing chronic rhinitis effectively. Keep a symptom diary to track what sets off your sniffles and sneezes. Is it the morning after dusting your room? Does the first whiff of blooming jasmine leave you gasping for air? Once you identify the culprits, you can implement avoidance strategies:

• Environmental Control: Regularly vacuum and dust, invest in air purifiers, change bedsheets often and consider allergy-proof bedding.
• Outdoor Protection: Avoid peak pollen seasons, wear a mask during high-pollution days and keep windows closed at night.

Common Medications (please speak to your healthcare provider beforehand)

• Over-the-Counter Options: Antihistamines and nasal rinses are common medications that patients can buy over the counter.
• Prescription Medications: If over-the-counter options aren’t effective, your doctor may prescribe stronger medications (e.g., nasal corticosteroids and decongestant sprays) or recommend allergy testing to identify specific allergens.

A Final Note: Breathe Easy, Live Fully