Cardio for Weight Loss: Types, Benefits, Myths & More!
Introduction
Have you ever felt out of breath just walking up a hill or climbing the stairs? Or maybe you’re trying really hard to lose weight and wish you could see results more quickly? If so, you’re just like many others!
When people want to get fit and lose weight, one kind of exercise always comes up is Cardio, this just means any activity that gets your heart pumping, like walking fast, jogging, cycling, or dancing. Cardio is popular because it’s a fantastic way to make your body work harder, which burns off calories and helps you shed pounds. It’s the go-to exercise to help you not only reach your weight loss goals but also feel more energetic every day!
Let us explore the benefits of cardio for weight loss and overall health and see the different types of cardio exercises you can do to find the perfect fit for your routine!
What is Cardio and How Does It Help in Weight Loss?
Cardio exercise, also known as cardiovascular or aerobic exercise, is any physical activity that significantly increases and sustains your heart rate, prompting your heart to pump faster and harder to deliver the extra oxygen required by your working muscles1. Cardio exercise makes your heart and lungs work harder, which strengthens your lung health and improves blood flow throughout your body2.
If you are wondering ‘Is Cardio good for weight loss’, then the answer is, yes! Cardio exercise works by accelerating calorie expenditure and enhancing metabolic efficiency to help to lose weight. It:
Increases Total Calorie Burn: Whether you choose steady or high intensity exercise, cardio expands your daily energy expenditure, helping you achieve the calorie deficit needed for weight loss3.
Boosts Metabolism: High-intensity cardio can lead to an after-burn effect, which keeps your body burning calories even after your workout is finished. This boosted metabolism further supports weight loss3.
While cardio can accelerate fat loss, it is not necessary to do it in excess. Prioritizing nutrition remains a critical factor for achieving your fat loss goals.
Types of Cardio Exercises
Cardiovascular exercise is typically categorized by the intensity level maintained during the workout. This helps determine how hard your heart and lungs are working.
1. Low Intensity Steady State Cardio (LISS)
This refers to any activity maintained for 30 minutes or more at a low pace, where the goal is to keep the heart rate controlled and steady throughout the duration.
Activities include walking, jogging, swimming, and cycling at a consistent speed.
The main benefits are improved endurance, enhanced fat-burning, and a low impact on your joints4.
2. Moderate Intensity Aerobic Physical Activity
Image Source: freepik.com
This intensity level signifies working at a pace that causes harder breathing, an elevated heart rate, and a noticeable sweat. You know you have hit moderate intensity when you can talk freely but find it too difficult to sing your favourite tune.
Activities include fast walking, water aerobics, riding a bike on level ground or with few hills, playing doubles tennis etc5.
Exercising regularly at a moderate pace is great for getting in shape, losing body fat, and keeping your heart healthy6.
3. High Intensity Interval Training (HIIT)
This technique involves rapidly switching between short intervals of maximum intensity exercise and quick, controlled breaks for rest or light activity.
Activities include sprint intervals, jump rope circuits, burpees, and cycling.
This method efficiently burns more calories in less time, while simultaneously increasing cardiovascular efficiency, and boosting metabolism post-workout4.
While HIIT quickly maximizes calorie burn, LISS is better suited for prolonged periods of fat burning4.
Health Benefits of Cardio Exercises
Regular cardio training offers a profound array of health benefits. Here is list of the health benefits of cardio exercises:
1. Cardiovascular Health
Regular cardio is a powerful workout for your heart and lungs, significantly strengthening them to boost cardiorespiratory endurance (the ability of your body to efficiently supply oxygen to muscles and utilize it for physical activities). They help improve blood circulation and regulate blood pressure, thereby avoiding the risk of hypertension. Moreover, regular cardio helps balance cholesterol levels, raising beneficial HDL (high density lipoprotein) and lowering harmful LDL (low density lipoprotein), keeping arteries clear and reducing the overall risk of heart disease and stroke3.
2. Supports Healthy Metabolism and Weight Management
Cardio is essential for weight control because it actively burns calories during exercise3. Beyond immediate fat loss, this increased metabolic activity, when combined with a calorie-deficit diet, helps prevent weight regain and is crucial for maintaining a healthy body composition over time7.
3. Enhances Lung Function
As mentioned, cardio exercises help improve cardiopulmonary endurance and strengthen your heart and lungs. During exercise, your lung activity increases to meet the body’s demand for energy and the need to remove waste. When you do regular exercise, your lung capacity increases overtime to meet this demand8.
4. Boosts Mental Well-being and Sleep Quality
Regular activity releases mood elevating hormones like endorphins, serotonin, dopamine, and oxytocin, while simultaneously reducing the stress hormone cortisol. This powerful combination lessens anxiety and depression, enhances cognitive functions (memory and focus), and helps reset the circadian rhythm for deeper, more restorative sleep3.
5. Improves Energy Level and Stamina
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When you exercise, your heart and lungs become more efficient, which means you won’t get tired as easily and will feel more awake. Stick to a daily cardio routine to boost your staying power. You may notice yourself getting fitter and faster every single day9.
6.Helps in Chronic Health Condition
Exercise is a powerful tool for dealing with certain chronic conditions. It reduces pain for people with arthritis (joint inflammation) and helps those with disabilities stay strong enough to handle daily life on their own9.
Thus, regular cardio exercise is a powerful step to your long-term physical and mental health, offering benefits that span from a stronger heart to improved mood and sleep.
Best Cardio Exercises for Weight Loss
Cardiovascular exercise is crucial for creating a calorie deficit, which is essential for losing weight. The American Heart Association recommends doing 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity per week, which would be approximately 30 min a day for 5 days5. Following are some best cardio exercises for weight loss:
1. Walking
Walking is an accessible and highly beneficial form of physical activity that is suitable for individuals across all fitness levels, if you have a treadmill this can be done at home itself.
For a good workout, aim to walk about 5 km, maintaining a brisk pace of 13 to 17 minutes per km. Try to do this 3 to 5 times a week.
If you are a beginner, for the first 3 weeks, just begin with a 10-minute brisk walk every day. Your speed should be comfortable enough to cover a mile in about 17 to 20 minutes. After that, gradually increase your walking time by 5 more minutes each week until you reach a total of 30 minutes per day, do this 6 day a week10.
2. Running or Jogging
High-intensity exercises, such as running, are excellent for burning your calories, which aids in weight management when combined with healthy eating.
Start improving your health with just 10 minutes of running daily. For greater benefits, aim to safely run for 30-45 minutes, 5 days a week.
Before beginning a running program, a medical check-up is advisable, particularly if you are over 40 years of age, have a chronic medical condition, are pregnant, or are currently recovering from an injury or illness11.
3. Cycling
Image Source: freepik.com
Cycling (or bike riding) is an excellent, environmentally friendly activity that benefits your mental and physical health at the same time allows you to enjoy the outdoors and travel efficiently.
You can start by 15 minutes and increase it to 30 minutes a day for 5 days a week12.
Cycling puts less stress on your joints than running, making it an ideal choice for people with joint conditions like osteoarthritis.
Make sure to use all your safety equipment (helmet, sunglasses, lights etc.) before cycling13.
4. Swimming
Swimming is a versatile, low impact sport suitable for all ages and fitness levels. By increasing your speed, swimming can become a high-intensity activity that significantly contributes to your fitness.
You can start by 10-15 minutes a day and increase it to 30 minutes a day for 5 days a week12.
If you are new to swimming and over 55, it is important to consult your doctor before starting14.
5. Jumping rope
This fitness option is inexpensive, compact, and portable, making it an excellent tool for getting into shape quickly.
Begin with a 3-minute warm-up, followed by alternating 60-second of maximum speed jumping with 30 seconds of rest; repeat this cycle for a total of 15–20 minutes15.
6. Dancing
Image Source: freepik.com
Dancing is a fun and social work out that strengthens your heart, bones, and muscles at the same time improves your balance. It is such an enjoyable way to stay active that you might not even realise you are exercising.
Moderate Intensity: Ballroom dancing is similar to brisk walking; it may burn about 260 calories per hour.
High Intensity: Faster styles like salsa or zumba are comparable to jogging, which may help in burning up to 500 calories per hour16.
7. Hiking
Hiking is a long, walk in nature, usually on trails or through mountainous terrain, done for exercise and enjoyment.
For beginner start small, choose short (1-3 km), flat, and well-marked trails to build your stamina and fitness before advancing to more difficult routes.
Build strength and confidence by tackling varied terrain, such as steep climbs and rocky paths, that require navigating obstacles like roots and uneven surfaces17.
To avoid boredom and keep your routine engaging, plan to incorporate a variety of different exercises daily.
Note: Always consult your doctor before starting any new exercise plan, especially if you have an existing health condition.
Creating Your Cardio Routine for Beginners
Cardiovascular exercise, or cardio, should not be viewed as a burden or a chore; rather, it ought to be an activity that you find sustainable and genuinely enjoyable over long term. For this, you can make use of the following tips:
Build a sustainable routine: Start slowly with low-impact options (like walking, swimming, or cycling), set realistic short-session goals (10-15 minutes), and gradually increase duration while mixing up activities to prevent boredom3. Always include a warm-up before exercise and a cool down afterward.
Integrate cardio into your routine: Prioritize movement by taking the stairs, walking more and engaging in enjoyable activities like sports, dancing, or hiking instead of only formal workouts3.
Choose right intensity workout: LISS is ideal for consistent, long-term fat loss, HIIT maximizes caloric expenditure in minimal time. For a well-rounded plan, you can even combine HIIT and LISS4.
Make weekly cardio plan: Prioritize consistency over intensity (aiming for three to five sessions weekly), ensure balance with strength training to maintain muscle mass, and actively track your performance, endurance, and recovery to facilitate continuous improvement3.
Maintain motivation and accountability: Join classes or groups for social support, use engaging media like music or podcasts to make cardio less boring, and celebrate small, achievable milestones to sustain high motivation3.
Always prioritize your safety and be mindful of your physical limits. If you experience any pain or tightness in your chest, sudden shortness of breath, or dizziness, you must immediately stop exercising and rest. Do not hesitate to seek medical help if your symptoms persist or worsen.
Common Myths About Cardio and Weight Loss
It’s time to debunk the persistent myths surrounding cardio exercise and weight loss, some common myths are as follows:
1. Myth: To achieve results, you must dedicate hours of cardio exercise daily.
Fact: Shorter bursts of exercise are also beneficial; the recommended amount is 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity per week. You can break this up. Multiple 10 or 15-minute sessions throughout the day can be just as effective as one long session. Incorporate movement into your daily life by taking short activity breaks like stair climbing, 10-minute walks, or spontaneous dancing on your favourite music etc.
2. Myth: Cardio is the Only Exercise You Need for Weight Loss.
Fact: While cardio is useful for calorie burn, sustainable weight loss requires the triple combination of cardio, strength training, and a nutritional yet low calorie diet18.
3. Myth: Cardiovascular exercise grants you complete dietary flexibility.
Fact: While physical activity is essential, it must be paired with mindful eating, as fitness and nutrition both together can give a better result.
Conclusion
Cardio exercise is a fundamental pillar for weight loss. It efficiently burns calories and boosts your metabolism, offering flexibility through intensity options ranging from the sustained pace of LISS to the rapid calorie-burning bursts of HIIT. Beyond slimming down, consistent cardio profoundly benefits your health by strengthening your heart and improving your overall mood. However, to unlock the most effective and sustainable weight loss results, combining your chosen, consistent cardio routine (aiming for about 150 minutes weekly) with dedicated strength training to maintain muscle mass, and a proper nutritional support is important. Finally choose an activity you enjoy to ensure long-term consistency.
HIIT exercise like running and jogging are some best way to burn fat, you can plan and add on some strengthening exercise along with a healthy diet plan for a better result. If you are a beginner, start with mild exercise steps and gradually progress, rather than immediately attempting high-intensity interval training4.
How to burn 500 calories in 1 hour?
It is challenging but achievable to burn 500 calories in one hour. Focus on HIIT exercise like jumping rope, running, swimming etc. But listen to your body, don’t push through sharp pain; taking occasional rest is crucial for preventing injury and allowing muscles to recover and grow stronger19.
Will 30 minutes of cardio burn fat?
Yes, 30 minutes of cardio exercise can burn fat and calories, focus on moderate-to-high-intensity cardio exercise for better outcomes5.
What are some cardio exercises that can be done at home?
There are certain exercises that can be done at home like jumping rope, burpees, running in place, climbing stairs, dancing and even some household work like mopping or vacuuming. If you have a treadmill at home, you can use it for walking, running, and jogging20,21.
Does cardio exercise lower blood pressure?
Yes, cardio exercise can lower blood pressure by improving the health of blood vessels, specifically by reducing vascular stiffness and enhancing endothelial function. There are lot of studies that says cardio exercise can help lower blood pressure22.
El-Ashker S, Al-Hariri M. The effect of moderate-intensity exercises on physical fitness, adiposity, and cardiovascular risk factors in Saudi males university students. J Med Life. 2023 May;16(5):675-681. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10375358/
Foster-Schubert KE, Alfano CM, Duggan CR, Xiao L, Campbell KL, Kong A, et al. Effect of Diet and Exercise, Alone or Combined, on Weight and Body Composition in Overweight-to-Obese Postmenopausal Women. Obesity [Internet]. 2011 Apr 14;20(8):1628–38. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406229/
Wen H, Wang L. Reducing effect of aerobic exercise on blood pressure of essential hypertensive patients: A meta-analysis. Medicine (Baltimore). 2017 Mar;96(11):e6150. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5369884/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
Baby Rash: Causes, Types, Home Remedies & Prevention
Introduction
Seeing a rash on your baby’s soft and delicate skin can be worrying for any parent. But it is important for parents to know that these rashes are one of the most common skin problems in infants. In fact, most babies develop a skin rash at some point during early childhood1.
Baby skin rash is a common problem because infants are born with an underdeveloped skin barrier that differs from adult skin. This barrier increases the vulnerability of skin to irritation and moisture loss, which makes babies more susceptible to skin rashes2.
However, the good news is that most rashes in infants are mild and resolve with simple care1,3. So, understanding the common causes, recognising different types of rashes, and knowing basic management and preventive strategies can help parents effectively support their baby’s skin health and comfort.
What Is a Baby Rash?
Baby skin rash refers to any noticeable change in the colour, appearance, or texture of a baby’s skin. It may appear suddenly or develop gradually and can vary in how it looks and feels.
A baby rash can be bumpy or flat, red, skin-coloured, or slightly lighter or darker than the surrounding skin. It may sometimes even appear dry, rough, or scaly1.
Note: Most baby rashes are harmless and temporary. In most cases, they reflect the sensitivity of an infant’s delicate skin and its response to irritation, moisture, allergens, or mild infections.
Baby Rash Causes
Baby rashes on the body occur primarily because an infant’s skin is delicate, sensitive, and still developing. Common causes include1:
Prolonged exposure to moisture
Friction
Blocked sweat glands
Hormonal influences
Infections
Allergies
Genetic predisposition
Note: Irritants such as urine, faeces, heat, soaps, or rough fabrics can easily disrupt the skin barrier, which leads to inflammation and visible rashes. In some cases, rashes may also result from fungal overgrowth, immune reactions, or underlying skin conditions.
Baby Rash Types
Baby skin rashes are common in early childhood and can appear in many different forms, ranging from mild and temporary skin changes to conditions that may require simple home care or medical baby skin rashes treatment. Most common types of baby rashes include:
1. Baby Acne (Neonatal Acne)
Baby acne appears as small red or white bumps on the skin. They are most commonly on the cheeks, nose, and forehead. Baby acne is generally caused by the baby’s exposure to maternal hormones before birth. This type of rash is harmless and usually clears on its own1,4. For management, gentle cleansing with water and using mild baby products are usually sufficient. Aapplying breast milk over acne might also be helpful. However, please note that acne treatments meant for adults should be avoided3.
2. Cradle Cap (Seborrheic Dermatitis)
Cradle cap presents as greasy, yellowish, scaly or crusty patches. It is mainly seen on the scalp, but it may also affect the face, ears, and neck. Cradle cap is a common and normal condition in babies and is not painful or itchy (if it is, then you should see a doctor). It often resolves without treatment. For management, regular washing with baby shampoo and gentle brushing may help4.
3. Eczema (Atopic Dermatitis)
Eczema causes dry, itchy, red, and sometimes cracked skin. In babies, it often appears on the face and scalp and may later affect the folds of the elbows and knees4. It is linked to a family history of eczema, asthma, or allergies1. For management, keeping the skin well moisturised and avoiding harsh soaps could help4. Sometimes mild steroid ointments (only after being prescribed by a doctor) can be used in severe cases1.
4. Erythema Toxicum
This harmless newborn rash appears as blotchy red patches, sometimes with small white bumps in the centre1. It commonly affects the face, body, arms, and thighs and usually develops within the first few days after birth1,4. No treatment is generally required, and the rash typically disappears within a few days1. Sometimes doctors may prescribe an antibiotic ointment in severe cases.
5. Heat Rash (Prickly Heat)
Heat rash appears as tiny red bumps or small blisters. It often occurs on the neck, chest, back, or skin folds. Heat rash is commonly caused by blocked sweat glands, especially in hot or humid conditions or when babies are overdressed1. For management, keeping the baby cool, dressing them in light clothing, and avoiding overheating usually helps.
6. Nappy (Diaper) Rash
Nappy rash causes red, irritated skin in the diaper area (including the buttocks and genital region). Most of the time, it is triggered by prolonged exposure to wet or soiled nappies1,3. For management, frequent nappy changes every 3 to 4 hrs, keeping the area clean and dry, and using barrier creams may help1. If the infection is caused by a yeast, you may need to see a doctor for antifungal treatment.
7. Hives (Urticaria)
Hives appear as raised, red, itchy welts. They can occur anywhere on the body and may change position over time. Hives are often triggered by an allergic reaction (usually to milk, eggs, nuts and seafood), although the exact cause is sometimes unclear. Mild cases usually settle on their own, but medical advice may be needed if symptoms persist4.
8. Impetigo
Impetigo is a contagious bacterial skin infection that causes sores and blisters, often with a crusted appearance. It can occur anywhere on the body. Impetigo requires medical attention1,4.
9. Milia
Milia are tiny white spots caused by blocked pores. They commonly appear on a baby’s face, particularly on the nose and cheeks. Milia are harmless and usually disappear on their own within a few weeks without needing treatment4.
10. Ringworm
Ringworm appears as a circular red rash and is caused by a fungal infection. It can affect various parts of the body, including the scalp and skin. For management, doctors usually prescribe an antifungal cream4.
Home Remedies for Baby Rash
Many mild baby rashes (especially diaper rash) can be cared for safely at home with simple, soothing measures that protect the skin and support healing. Some common home remedies for baby rash on the body include:
1. Aloe Vera Gel
Image Source: freepik.com
Aloe vera has natural soothing and anti-inflammatory properties that may help calm the irritated skin of the baby. Evidence from clinical studies indicates that the topical application of aloe vera gel has the potential to reduce the severity of diaper rash by relieving redness and discomfort5. This suggests that it supports skin healing by maintaining moisture and protecting the damaged skin barrier.
2. Calendula Ointment
Calendula is a medicinal herb traditionally used for its anti-inflammatory and wound-healing effects. Clinical evidence shows that calendula ointment is helpful in reducing the severity and extent of diaper rash in infants5. This makes it a gentle and effective home remedy for baby rashes, particularly diaper rash.
3. Hamamelis (Witch Hazel) Ointment
Hamamelis ointment has been shown to be an effective and well-tolerated option for managing mild skin conditions in children, including diaper rash and localised skin inflammation6. This means that it can be considered as a safe and effective home-care option for certain minor baby skin rashes.
4. Breast Milk
Breast milk contains bioactive and antimicrobial components that may help soothe inflamed skin and support healing. It has been observed that the topical application of breast milk on a rash can significantly improve skin condition and reduce skin damage over a few days7. Thus, it can be considered as a safe and accessible option for parents to use in cases of mild rashes in babies.
5. Coconut or Olive Oil
Coconut or Olive oil can be used as a simple and effective home remedy particularly for diaper rash due to its soothing and skin-protective properties8,9. Evidence from a study showed that applying olive oil to the affected diaper area helped reduce inflammation, redness, and blisters in infants with diaper rash, while another study showed that coconut oil helped reduce water loss from the skin of infants8,9. Thus, it may be considered as a practical option that parents can safely use at home for mild diaper rashes.
Note: These home remedies are intended only for mild rashes and should not be used as a substitute for medical treatment. If symptoms worsen or persist, it is very important to seek medical advice.
Preventing baby rashes begins with gentle daily skin-care practices that help protect the baby’s delicate skin barrier and reduce exposure to common irritants. Some tips include:
Limit bathing frequency to 2 to 3 times per week (unless the baby is visibly dirty) as daily bathing is usually unnecessary and may dry the skin2,9.
Use lukewarm water and keep bath time short (usually only up to 5 to 10 minutes) to reduce skin barrier disruption1,2.
Use soap-free, fragrance-free cleansers specifically formulated for infants to help preserve the natural skin pH and reduce irritation2.
Consider adding a non-allergenic bath oil to help maintain skin hydration during bathing9.
Apply a gentle, unscented moisturiser (at least once a day) to lock in moisture and protect the skin barrier2.
Change diapers frequently to reduce prolonged contact with moisture, urine, and faeces, which are common triggers for diaper rash2.
Choose soft, breathable clothing (like cotton) and avoid rough fabrics that may irritate sensitive baby skin2,9.
Avoid overheating, as excess sweating can increase the risk of heat rash. Instead, maintain a comfortable environment with moderate humidity and temperature to prevent skin dryness or excessive sweating2.
Protect infants from direct sunlight using shade, hats, and protective clothing. For babies older than 6 months, you may use a broad-spectrum sunscreen (SPF ≥30) on exposed skin2.
Behavioural changes, such as confusion, agitation, extreme drowsiness, or reduced responsiveness3
Breathing problems, including rapid breathing, breathlessness, grunting, or chest/tummy pulling in under the ribs3
Note: Medical evaluation helps ensure proper diagnosis and the start of baby skin rashes treatment, especially when symptoms suggest infection or when the rash does not improve as expected.
Baby rashes are common in infancy and are usually mild, temporary, and manageable with proper skin care and simple home remedies. Therefore, understanding the different types of baby rashes, their causes, and early signs can help parents and caregivers respond appropriately and prevent discomfort. Additionally, it is important to note that gentle cleansing, regular moisturisation, careful diaper care, as well as maintaining a suitable environment play a key role in keeping an infant’s skin healthy.
While most rashes resolve on their own, recognising warning signs and seeking medical attention when needed is essential to prevent complications. Parents and caregivers can effectively protect their baby’s delicate skin and promote overall comfort and well-being with informed care and timely intervention.
Frequently Asked Questions (FAQs)
How do I identify my baby’s rash?
You can identify your baby’s rash by looking at how it appears, where it is located, and whether it seems to bother your baby. Note the colour (red, pink, or darker), texture (flat, bumpy, scaly, or blistered), and location (diaper area, face, skin folds, or body). Also, observe if your baby is uncomfortable, itchy, or otherwise well1,4.
How many days do baby rashes last?
Most mild baby rashes last a few days to about one week and improve with gentle care. However, some rashes, like baby acne or eczema, may last longer but usually improve gradually1,4. If a rash does not improve after 3 days of home care, it is important that you see a doctor for medical advice1.
How to check if a rash is ok?
A rash is usually okay if your baby is feeding well, active, comfortable, and the rash is not spreading, oozing, blistering, or worsening1,3. Improvement in redness or irritation over a few days is a good sign. However, any signs of infection or distress should be checked by a doctor.
Why does my child have a rash without a fever?
Many baby rashes are caused by skin irritation, heat, moisture, allergies, or normal skin changes, not infections1. These types of rashes often occur without fever and are usually harmless1,3.
How to tell if a rash is serious?
A rash may be serious if it is accompanied by fever, breathing difficulty, poor feeding, extreme sleepiness, blisters, swelling, bruising like spots that do not fade when pressed, or rapid spreading1,3. Rashes in babies under 3 months should also be checked by a doctor1,4.
Is vaseline good for a baby’s bum rash?
Vaseline (petroleum jelly) might be helpful for mild diaper rash. It could act as a barrier and protect the skin from moisture and irritation10. However, if the rash worsens or does not improve, consult a doctor.
Panahi Y, Sharif MR, Sharif A, Beiraghdar F, Zahiri Z, Amirchoopani G, et al. A randomized comparative trial on the therapeutic efficacy of topical aloe vera and Calendula officinalis on diaper dermatitis in children. ScientificWorldJournal. 2012;2012:810234.Available from:https://pmc.ncbi.nlm.nih.gov/articles/PMC3346674/
Wolff HH, Kieser M. Hamamelis in children with skin disorders and skin injuries: results of an observational study. Eur J Pediatr. 2007 Sep;166(9):943-8. Available from:https://pubmed.ncbi.nlm.nih.gov/17177071/
Efrianty N, Sartika RCT, Sulardi S, Komalasi U. Application of olive oil to the degree of diaper rash in babies aged 0–12 months. Int J Health Sci. 2024;8(S1):690–695. Available from: https://doi.org/10.53730/ijhs.v8nS1.14891
Pupala SS, Rao S, Strunk T, Patole S. Topical application of coconut oil to the skin of preterm infants: a systematic review. Eur J Pediatr. 2019 Sep;178(9):1317-1324. Available from: https://pubmed.ncbi.nlm.nih.gov/31267223/
Czarnowicki T, Malajian D, Khattri S, Correa da Rosa J, Dutt R, Finney R, et al. Petrolatum: Barrier repair and antimicrobial responses underlying this “inert” moisturizer. J Allergy Clin Immunol. 2016 Apr;137(4):1091-1102.e7.Available from:https://pubmed.ncbi.nlm.nih.gov/26431582/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
Blood Test for Hair Loss: Who Should Get Tested, Types and Prevention
Introduction
Dealing with hair loss, or alopecia, is a major concern for anyone experiencing it. Alopecia simply means losing hair, either completely or just partially, it affects both sexes of any age group, and it usually develops slowly over time. While it’s natural to feel uneasy finding hair on your pillow, hairbrush, or in the shower drain, try not to panic because it’s completely normal to shed about 100 hair daily from the roughly 100,000 strands covering your head1. However, it is crucial to monitor the pattern if you notice abnormal hair fall, that is something more than usual or in a patchy distribution. Early observation is the best way to get a timely diagnosis and start effective treatment.
There are different types of alopecia, and the most common one is known as androgenetic alopecia. It can affect about 80% of males and 50% females and its incidence increases with age2.
Figuring out the cause is confusing right? This blog will guide through everything about hair loss, the main reasons why it happens (from your genes to high stress), the important tests doctors use to diagnose, the different treatments options available, and simple tips to help stop it before it starts.
What Causes Hair Loss?
There can be several causes that lead to hair loss. These include:
Genetic Factor: Althoughit’s common for our hair to get thinner as we age, hair loss can be influenced by our genes. One common example of hereditary conditions associated with hair loss is androgenetic alopecia (pattern baldness). It is hair loss that runs in the family and happens because your hair follicles are too sensitive to male hormones called androgens3. Pattern baldness is more common in men than women and can start in men right after puberty1.
Stress: Hair loss can be caused by emotional or physical stress also. You may lose large amounts of hair when distressed, but the loss usually stops on its own after 6 to 8 months. This condition is usually short-term, but it can be long-term or chronic under following conditions:
Any major infections in the body
After childbirth
Intense emotional distress
Diet that does not contain protein
Illness including severe blood loss or any major surgery
Medications such as retinoids, birth control pills, blood pressure drugs and certain antidepressants, and pain relievers like NSAIDs1.
Nutritional Deficiencies: Iron, zinc and certain vitamins like B12, biotin, D and C are essential nutrients whose deficiencies can cause hair loss4.
Hormonal Changes: Significant shifts in hormone levels can trigger temporary or permanent hair loss.
Thyroid Disorders: Both an overactive (hyperthyroidism) and underactive (hypothyroidism) thyroid can disrupt the balance needed for hair growth5.
Childbirth or Menopause: The fluctuation and subsequent drop in oestrogen levels after these events can cause excessive temporary shedding of hai1,5.
Medical Conditions
Autoimmune issues like alopecia areata (patchy baldness) or Lupus.
The test checks for Thyroxine (T4) Triiodothyronine (T3) and Thyroid stimulation hormone (TSH). Thyroid hormones are strongly linked to hair loss because they control the growth of body cells, including those in the skin. Thyroid Hormones are essential for growth and maintenance of hair follicle; hair loss can signal underlying thyroid dysfunction. Hair loss affects roughly 50% of people with hyperthyroidism and 33% of those with hypothyroidism. Thus, one of the most important tests that is linked to hair loss is Thyroid function test6,7.
2. Sex Hormone Test
As mentioned above hair follicle are sensitive to male sex hormones or androgens. Dehydroepiandrosterone sulphate (DHEAS) and Testosterone are types of androgens found in both male and female, high level of these 2 hormones can lead to hair loss. Thus, DHEAS and Testosterone testing is important8,9.
CBC test checks for different components like red blood cells, white blood cells, platelets, haemoglobin, haematocrit and MCV (Mean corpuscular volume). Here CBC is performed to rule out anaemia or infection. Unusual levels of red blood cells, haemoglobin, or haematocrit can signal conditions like anaemia or insufficient iron. High level of WBC (white blood cell) could be a sign of infection6,10.
High C-reactive protein (CRP) levels suggest inflammation, which can be a sign of autoimmune disease. An example for autoimmune condition is Alopecia areata (sudden unpredictable hair loss)11.
5. Iron and Ferritin level
Ferritin is a protein that stores iron. Low serum ferritin levels are significantly associated with alopecia specially in pre-menopausal women, making it crucial to test and manage ferritin levels during hair loss. Studies indicates that low iron stores are an independent factor contributing to this type of hair loss in women who haven’t reached menopause6,12.
6. Vitamin and Mineral test
Studies4 have shown a low level of vitamin in people with alopecia which means alopecia can be due to deficiency of vitamins. Thus, Vitamin B12, biotin, D, C and zinc test are some essential blood tests to rule out alopecia13.
Other Tests to Determine the Cause of Hair Loss
Medical History and Scalp Examination: This is the most basic step to rule out alopecia where a physician takes detailed history on how you take care of your hair and scalp, your diet pattern, level of stress, medical and family history. Scalp is examined to see texture of hair, pattern of hair loss and to see any signs of infection like redness or inflammation1.
Hair Pull Test: Hair pull test offers a rough assessment of active hair shedding. It is performed by gently pulling a small bundle of hair from three different areas of the scalp. If fewer than three hairs are extracted during the test, the result is considered negative (normal shedding) and if more than six strands of hair are extracted, it suggests excessive or active hair loss, resulting in a positive test14.
Scalp Biopsy: A scalp biopsy is a critical diagnostic tool for hair loss, to see the living tissue. It involves taking a small sample of the scalp to examine under a microscope, which helps the doctor identify the cause of alopecia. Biopsy gives clues about the patient’s prognosis specifically, if the hair loss is due to inflammation, it can be reversed or slowed down in some cases by proper treatment. To get the best result, the biopsy should typically be taken from the leading edge of the affected area, where hair loss is actively occurring. Area with complete, long-term baldness is usually avoided, as there is little active tissue left to study14.
Trichoscopy: Also known as scalp dermoscopy, it is a non-invasive method for evaluating hair loss. This technique uses magnification to visualize the hair shafts and scalp skin in detail using a handheld dermoscope or a videodermoscope15.
Hair Loss Treatment Options
Treating hair loss is highly personalized and depends on the specific cause. Treatment can range from non-invasive topical applications to surgical procedures. Commonly used options are:
1. For Management of Common Underlying Conditions
Antifungals: If hair fall is linked to ringworm of any fungus, it is usually treated by antifungal shampoos or oral medicine for the same1.
Corticosteroids: Topical corticosteroids are used for autoimmune conditions like alopecia areata16.
Vitamin and Mineral Supplements: Supplements are recommended if a specific deficiency is identified as contributing factor of hair loss e.g. deficient specific vitamins, biotin, zinc supplements)1
2. Alopecia Medications
Topical: These are applied directly on the scalp to stimulate hair growth. For example, Minoxidil. It is used to promote hair growth and slow the progression of balding, and it is effective mainly for recent hair loss in people younger than 40. It comes in the form of liquid which is applied directly on the scalp17.
Oral Medications: These include drugslike Finasteride that control male pattern hair loss by inhibiting the production (Testosterone to Dihydrotestosterone) of a specific male hormone in the scalp that is responsible for halting hair growth18. It comes in form of a tablet to take orally.
Hair Transplant: It is a surgical procedure that improves baldness by moving hair from areas of thick growth to the bald areas. This procedure cannot produce new hair; it can only transplant the hair you currently have to the areas of baldness19.
Low Level Laser Therapy (LLLT) and Platelet Rich Plasma therapy (PRP): It helps in promoting hair growth by stimulating the cells within the hair follicle. Platelet rich plasma encourages hair growth by utilizing patients own blood platelets. For an effective outcome combination of LLLT and PRP is given together20.
How to Prevent Hair Loss?
By focusing on certain factors, you can effectively minimize hair loss to some extent.
Focus on Diet: Nutrient deficiency is one major factor that can lead to hair loss. Focus on a diet rich in iron, protein, zinc, biotin, omega-3 fatty acids, and vitamin C, which are found in foods like eggs, green leafy vegetables, nuts, meat, salmon and citrus fruits4.
Avoid Chemicals and Excessive Heat: Chemicals used for straightening and colouring hairs can cause certain side effects like allergy, chemical burns on scalp, breakage of hair further leading to alopecia. Hair styling like curling and straightening also worsens the hair condition21.
Avoid Stress: Stress hormones damage the stem cell required for hair growth. You can effectively manage stress by practicing relaxation techniques like yoga and meditation22.
Choose a shampoo and conditioner that suits your hair type.
Use a scalp exfoliator to remove dead skin build-up.
Avoid sharing personal items like hairbrushes and combs.
Brush your hair often to prevent tangles.
By practicing these above steps, you can significantly minimize hair loss and promote healthier hair growth. If you still face hair fall even after taking all preventive measures, consult a doctor for regular blood tests to avoid issues that can lead to further hair loss.
Hair loss is a condition that is quite frustrating at the same time can often be managed effectively once the root cause is identified. Diagnostic tools, especially blood tests, play an indispensable role by finding out internal imbalances like thyroid issues, hormonal changes, or nutritional gaps. Early, accurate diagnosis guides the selection of the most effective treatment, whether it’s a simple dietary supplement, a topical medication, or a more evolved procedure. If you notice rapid or unusual changes in your hair volume, consulting a doctor for comprehensive testing is the most constructive step you can take to understand and properly manage your condition.
Frequently Asked Questions (FAQs)
Do dermatologists take blood tests for hair loss?
Yes, dermatologists routinely advice blood tests as these help in evaluating the main reason behind hair loss, or alopecia. This step is essential because effective treatment depends entirely on identifying the root cause of hair fall25.
How can I check what’s causing hair loss?
It is always better to take doctors opinion on what’s exactly causing your hair loss, there are several invasive and non-invasive procedure that is conducted by the doctor, which will tell the exact cause of your hair fall.
Can over supplementation of vitamins cause hair loss?
Yes, over supplementation of vitamins also known as hypervitaminosis specifically vitamin A and E can hamper your hair growth and further lead to hair loss. Thus, it is always important to check your vitamin levels to prevent from toxicity4,24.
Why is sharing comb or hairbrush risky?
It is always wise to keep your comb to yourself as a precaution. Since fungal infections on the scalp, like ringworm, are easily transferable, it is best not to share, especially with people you don’t know personally23.
Is it possible for my hair to regrow after experiencing hair loss?
Yes, in cases where hair loss is triggered by a temporary medical condition such as fever, chemotherapy or by a stress factors, the hair typically grows back once the underlying condition is resolved1.
Nestor MS, Ablon G, Gade A, Han H, Fischer DL. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. Journal of Cosmetic Dermatology. 2021 Nov 6;20(12). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9298335/
Guo EL, Katta R. Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatol Pract Concept [Internet]. 2017;7(1):1–10. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5315033/
Owecka B, Agata Tomaszewska, Dobrzeniecki K, Maciej Owecki. The Hormonal Background of Hair Loss in Non-Scarring Alopecias. Biomedicines. 2024 Feb 24;12(3):513–3. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10968111/
Ahmed Ibrahim AbdElneam, Mohammed Saleh Al‐Dhubaibi, Saleh Salem Bahaj, Ghada Farouk Mohammed, Ahmed Kaid Alantry, Lina Mohamed Atef. C‐reactive protein as a novel biomarker for vitamin D deficiency in alopecia areata. Skin research and technology. 2024 Mar 1;30(3). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10963905/
Aslam MF, Khalid M, Amad Aslam M. The Association of Serum Ferritin Levels With Non-scarring Alopecia in Women. Cureus. 2022 Dec 2; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9805541/
Nayak K, Garg A, Mithra P, Manjrekar P. Serum Vitamin D3 Levels and Diffuse Hair Fall among the Student Population in South India: A Case-Control Study. International journal of trichology [Internet]. 2016;8(4):160–4. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28442870
Lacarrubba F, Micali G, Tosti A. Scalp Dermoscopy or Trichoscopy. Alopecias – Practical Evaluation and Management. 2015;21–32. Available from: https://pubmed.ncbi.nlm.nih.gov/26370641/
Gregoire S, McIntosh B, Sanchez K, Biba U, Arash Mostaghimi. Local Corticosteroids for Alopecia Areata: A Narrative Review. Dermatology and Therapy. 2025 May 5; Available from: https://pubmed.ncbi.nlm.nih.gov/40323545/
Nayak BS, Ann CY, Azhar AB, Ling ECS, Yen WH, Aithal PA. A study on scalp hair health and hair care practices among Malaysian medical students. Int J Trichology [Internet]. 2017;9(2):58–62. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5551307/
Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The role of vitamins and minerals in hair loss: A review. Dermatol Ther (Heidelb) [Internet]. 2019;9(1):51–70. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6380979/#Sec10
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
Black Spots on Skin: Causes, Types, Treatment & Prevention
Introduction
Black spots (hyperpigmentation) on the skin is a very common issue1. A majority of individuals experience this at some point in their life. It could be a faint mark after a pimple or a more dark/persistent patch that gradually fades over time.
Pigmentary disorders are actually the third most common reason for dermatology consultations, accounting for about 8.5% of visits in our country. Their impact also varies by region. In places with warm climates and high year-round sun exposure, these concerns tend to be more noticeable and distressing2. Even some skin tones (particularly common in Asia and India) are more prone to developing pigmentation issues3.
Understanding why dark spots or dark dots on skin appear, their different types, and how they can be managed, can help achieve a clear and even skin tome that everyone longs for.
What are Black Spots on Skin?
Black spots (often referred to as dark spots, pigmentation marks, or hyperpigmented patches) are areas of skin where melanin (the pigment that gives skin its colour) is produced in excess4.
These black spots on skin may appear as flat, tan, brown, or black marks. They can even vary in size from tiny freckles to larger patches3,4. They typically develop on areas exposed to sunlight, such as the face, hands, arms, chest, and back, but can appear anywhere on the body2.
Causes of Black Spots on Skin
Black spots (or areas of increased pigmentation) can develop due to several internal and external factors. While they are usually harmless, understanding what causes them is key to choosing the right treatment and preventing them from worsening. The most common causes include:
Genetics: Your genes play a major role in how your skin produces pigment. More than 125 genes influence melanin production. This determines your natural skin tone and your tendency to develop pigmentation. Also, people with naturally darker skin tones have more active melanocytes, which makes them more prone to dark spots when exposed to the sun, inflammation, or injury5.
Sun Exposure: Of all causes, sun exposure is the most common trigger for black spots. When the skin is exposed to ultraviolet (UV) rays, it produces more melanin in an attempt to protect itself. Over time, repeated or prolonged sun exposure can lead to uneven pigment deposits, which are commonly seen as sunspots, tanning, freckles, or age spots5.
Skin Inflammation or Injury: Any skin injury (such as acne, eczema, cuts, burns, or even aggressive cosmetic procedures) can leave behind dark marks known as post-inflammatory hyperpigmentation (PIH). This is one of the most common causes of dark spots in darker skin tones6.
Hormonal Changes: Hormonal fluctuations (pregnancy, birth control pills, endocrine issues) can also trigger a patterned form of pigmentation often seen on the cheeks, forehead, and upper lip2.
Medications: Certain medications can trigger or worsen pigmentation by stimulating melanin production, while others cause the skin to react more strongly to sunlight5. Common medication-related triggers include:
Note: Anyone noticing new dark spots or black dots on skin after starting a medication should consult their doctor to understand whether the drug could be contributing.
Risk Factors
Some individuals may be at a higher risk of developing black spots. These include:
People With High Sun Exposure: UV rays stimulate excess melanin production. High sun exposure, especially without sunscreen, is one of the strongest risk factors3,5.
Indiviuals With Pre-existing Skin Conditions: Acne, eczema, insect bites, burns, or picking the skin can trigger PIH, particularly in darker skin tones3,6.
People With Darker Skin Tones: Skin of colour has more active melanocytes and is therefore more prone to PIH, melasma, uneven tone, and persistent dark marks3.
Women: Hormonal fluctuations as in pregnancy or use of oral contraceptives can trigger melasma or worsen pigmentation in women3.
Individuals With a Genetic Predisposition: A strong family history of melasma or pigmentation disorders increases susceptibility5.
Types of Black Spots on Skin
Black spots on skin can appear in different forms, each with its own cause, appearance, and pattern. In India, pigmentation issues are especially common due to diverse skin tones and high sun exposure. Studies show that over 80% of Indians have facial skin-tone irregularities, often due to dark spots, melasma, and patchy pigmentation3. Below are the most common types of black spots seen in the Indian population:
1. Melasma
Melasma is a common acquired pigmentation disorder that appears as brown to grey-brown patches, usually on the cheeks, forehead, upper lip, and nose.
Affects around 50% of Indian women, increasing with age.
Causes include genetics, skin thinning, vascular congestion, post-inflammatory pigmentation, and sun exposure.
The pigmentation may result from increased melanin or visible underlying blood vessels, causing a shadowed appearance.
It can appear as brown, bluish, or purple discolouration around the eyes.
Dark circles often result from a combination of factors rather than a single cause.
Home Remedies For Black Spots
Many plant-based products have been traditionally used to lighten pigmentation, and some have been studied scientifically for their effect on dark spots on skin. These natural ingredients can be applied on the skin by mixing with a gentle base ingredient (such as water) that does not irritate your skin to help lighten dark areas.
So, if you are wondering how to remove dark spots on skin naturally, here are some options you may try:
1. Chickpea
It is traditionally considered a natural skin-lightener. Chickpea works by inhibiting tyrosinase (the enzyme responsible for melanin production) and reducing free radicals7. A study8 revealed chickpea and melon seed combination showed signification skin lightening, comparable to 4% hydroquinone (a medical topical treatment option) when used for a period of 12 weeks, suggesting it may be a gentle but effective option.
2. Aloe Vera
It may help lighten pigmentation through more than just its soothing effects. A study has shown that Aloe vera extract and its active ingredient aloin can cause melanin aggregation, a process that may contribute to lighter skin appearance. This suggests9 Aloe vera could act as a gentle, non-toxic melanin-reducing agent.
3. Parsley
It has long been used as a natural skin-lightening remedy. Studies7 show that parsley is comparable to hydroquinone in reducing hyperpigmentation. This effect may be due to its active components (vitamin C and flavonoids) that help lower melanin production10. This makes it a promising plant-based option for lightening dark spots on skin.
4. Liquorice
It is one of the most effective plant-based skin-lightening ingredients (mainly due to glabridin content). Research11 shows that liquorice’s key component (glabridin) inhibits tyrosinase, reduces UVB-induced pigmentation and redness, and has strong anti-inflammatory and antioxidant effects.
5. Tomato
Lycopene, a strong antioxidant from tomatoes, may help reduce pigmentation by neutralising oxidative stress. Tomato lycopene and wheat bran extract based cream has been shown to reduce melasma size significantly and with no recurrence12. This suggests lycopene is a safe and promising option for improving dark spots.
6. Turmeric
Curcumin, the active compound in turmeric, is a potent natural skin-lightening agent. Curcumin significantly reduces melanin production and inhibits tyrosinase activity, thereby contributing to skin lightening13. Thus, turmeric has strong potential as a natural agent for reducing pigmentation.
While these remedies may offer mild improvement, it is important to understand that they generally work more slowly and less effectively than medical treatments. These ingredients should not replace medical advice/treatments for persistent or severe pigmentation.
Note: Natural remedies may support skin-lightening, but results vary widely from person to person. Also, its important to always patch-test new products and consult a dermatologist, especially if you have sensitive skin, allergies, or underlying skin conditions.
Over-the-Counter Options to Manage Black Spots
To deal with dark spots on skin, an effective approach is to combine daily sun protection with some targeted over-the-counter ingredients. Commonly available options include:
Hydroquinone and Combination Creams:Hydroquinone is one of the most effective remedies for dark spots. It works by inhibiting tyrosinase, reducing melanin production, and promoting melanocyte damage1.
Vitamin C (Ascorbic Acid): It is a powerful antioxidant that brightens skin and reduces melanin formation5.
Vitamin B3 (Niacinamide): It reduces melanin formation in skin cells, leading to a more even tone5.
Vitamin A (Retinoids/Retinol/Retinaldehyde): It boosts cell turnover and reduces melanin buildup1. Retinol is one of the most researched ingredients for pigmentation, but it may cause mild irritation initially.
Azelaic Acid: A gentle multitasking ingredient that brightens and reduces inflammation on the skin1.
Kojic Acid: It works by inhibiting tyrosinase and is commonly found in creams and serums for skin brightening1,5.
Alpha Arbutin: It is a gentler derivative of hydroquinone that suppresses melanin production14.
Chemical Peels: Peels such as glycolic acid, salicylic acid, etc., lighten dark spots by controlled removal of superficial skin layers and increasing keratinocyte turnover, helping pigmented cells shed faster1.
Important: Creams or serums containing the above-mentioned ingredients are commonly available at all pharmacy stores.However, it is important to remember that, even though these are over-the-counter options, the right concentration and frequency of use should ideally be guided by a dermatologist, especially for sensitive skin, darker skin tones, or persistent pigmentation, as misuse may lead to irritation or worsening of dark spots.
Medical Treatments to Manage Black Spots
Professionally guided medical treatments and procedures may be recommended by your doctor when black spots are stubborn, widespread, or unresponsive to home remedies and other products. Common options include1:
Ablative Lasers (CO2): Remove upper skin layers but carry a high PIH risk, especially in darker skin. Therefore, it is generally not preferred.
Non-Ablative Fractional Lasers: Create controlled dermal injury with lower PIH risk and are effective when settings are carefully optimised.
Low-Fluence Q-Switched Lasers (LFQSL): Gently break down pigment and can outperform 2% hydroquinone. However, recurrence and risk of hypo/PIH remain.
Picosecond Lasers: Offer promising results with minimal thermal damage, but data in darker skin is limited. Thus, caution should be exercised.
Precaution: Laser treatments should be selected carefully based on skin type, pigment depth, and history of PIH. Dermatologist supervision is essential to minimise complications and recurrence.
How to Prevent Black Spots?
Avoiding black spots requires consistent skincare habits and proper photoprotection. The following steps can help protect you skin:
Daily Sun Protection: Sun exposure is the biggest trigger for pigmentation. Thus, use broad-spectrum SPF 30 to 50+ and reapply every 2 hours1.
Avoid Picking the Skin: Picking acne, rashes, or insect bites increases inflammation and leads to dark marks6.
Gentle Skincare Routine: Avoid harsh or irritating products. Use mild cleansers, moisturisers, and introduce active ingredients slowly to manage inflammation that can worsen pigmentation6.
Patient Education: Understanding sun protection, triggers, medication effects, and proper skincare greatly reduces risk. Many people with skin-of-colour receive less sunscreen counselling, making education especially important6.
Seek Dermatology Advice When Needed: A dermatologist can guide treatments (especially for melasma, PIH, or darker skin tones) and help reduce risks like hypopigmentation or worsening discolouration.
While the majority of dark spots are harmless, certain changes may require medical attention. You should consider seeing a dermatologist for15:
Skin discolouration that worries you or affects your quality of life
Dark spots that persist, worsen, or appear without a clear cause
Any spot, mole, or lesion that changes in shape, size, or colour (as this may indicate a more serious condition, including skin cancer)
These warning signs help differentiate benign pigmentation from more serious conditions like atypical moles or, rarely, skin cancer. Keep in mind that seeking professional advice in such cases will ensure proper diagnosis and timely treatment.
Black spots are common and often harmless, but can be persistent and distressing, especially in darker skin tones. A wide range of management options, from home remedies and over-the-counter products to medical procedures, can help, but the best results come from choosing options suited to your skin type and underlying cause.
Remember, consistent sun protection, gentle skincare, and early management of inflammation are key to avoiding dark spots. However, for stubborn or changing pigmentation, only a dermatologist can provide safe, effective guidance.
Vitamin B12 deficiency is most commonly linked to dark spots or hyperpigmentation16.
Can liver problems cause black spots on the skin?
Severe or chronic liver disease can sometimes lead to skin changes, but black spots are usually not a direct sign of liver problems17. Most dark spots are caused by sun exposure, ageing, or inflammation rather than liver dysfunction3.
Do black spots go away naturally?
Some black spots (especially those from acne or minor inflammation) may fade naturally over months18. However, deeper pigmentation (like melasma or sunspots) usually does not go away on its own and may require treatment and strict sun protection.
Are black spots on the skin cancerous?
Most black spots are harmless. However, a spot may be concerning if it changes in size, shape, or colour, or looks very different from your other spots15. In such cases, it should be evaluated by a dermatologist to rule out skin cancer.
References
Moolla S, Miller-Monthrope Y. Dermatology: how to manage facial hyperpigmentation in skin of colour. Drugs Context. 2022 May 31;11:2021-11-2. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9165630/
Nouveau S, Agrawal D, Kohli M, Bernerd F, Misra N, Nayak CS. Skin Hyperpigmentation in Indian Population: Insights and Best Practice. Indian J Dermatol. 2016 Sep-Oct;61(5):487-95. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5029232/
Thawabteh AM, Jibreen A, Karaman D, Thawabteh A, Karaman R. Skin Pigmentation Types, Causes and Treatment-A Review. Molecules. 2023 Jun 18;28(12):4839. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10304091/
Lawrence E, Syed HA, Al Aboud KM. Postinflammatory hyperpigmentation [Internet]. Treasure Island (FL): StatPearls Publishing; [cited 2025 Dec 03]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559150/
Parvizi MM, Hekmat M, Yousefi N, Javaheri R, Mehrzadeh A, Saki N. Clinical Trials Conducted on Herbal Remedies for the Treatment of Melasma: A Scoping Review. J Cosmet Dermatol. 2025 Feb;24(2):e16741. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11837239/
Mahjour M, Banihashemi M, Rakhshandeh H, Vakili V, Khoushabi A, Tavakkoli Kakhki M. A triple-blind, randomized trial of a traditional compound as compared to 4% hydroquinone in melasma. J Herb Med. 2020;19:100308. Available from: https://www.sciencedirect.com/science/article/abs/pii/S2210803319300557
Ali SA, Galgut JM, Choudhary RK. On the novel action of melanolysis by a leaf extract of Aloe vera and its active ingredient aloin, potent skin depigmenting agents. Planta Med. 2012 May;78(8):767-71. Available from: https://pubmed.ncbi.nlm.nih.gov/22495441/
Khosravan S, Alami A, Mohammadzadeh-Moghadam H, Ramezani V. The Effect of Topical Use of Petroselinum Crispum (Parsley) Versus That of Hydroquinone Cream on Reduction of Epidermal Melasma: A Randomized Clinical Trial. Holist Nurs Pract. 2017 Jan/Feb;31(1):16-20. Available from: https://pubmed.ncbi.nlm.nih.gov/27902522/
Yokota T, Nishio H, Kubota Y, Mizoguchi M. The inhibitory effect of glabridin from licorice extracts on melanogenesis and inflammation. Pigment Cell Res. 1998 Dec;11(6):355-61. Available from: https://pubmed.ncbi.nlm.nih.gov/9870547/
Bavarsad N, Mapar MA, Safaezadeh M, Latifi SM. A double-blind, placebo-controlled randomized trial of skin-lightening cream containing lycopene and wheat bran extract on melasma. J Cosmet Dermatol. 2021 Jun;20(6):1795-1800. Available from: https://pubmed.ncbi.nlm.nih.gov/33151615/
Tu CX, Lin M, Lu SS, Qi XY, Zhang RX, Zhang YY. Curcumin inhibits melanogenesis in human melanocytes. Phytother Res. 2012 Feb;26(2):174-9. Available from: https://pubmed.ncbi.nlm.nih.gov/21584871/
Boo YC. Arbutin as a Skin Depigmenting Agent with Antimelanogenic and Antioxidant Properties. Antioxidants (Basel). 2021 Jul 15;10(7):1129. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8301119/
Jangda A, Voloshyna D, Ramesh K, Bseiso A, Shaik TA, Al Barznji S, Usama M, Saleem F, Ghaffari MAZ. Hyperpigmentation as a Primary Symptom of Vitamin B12 Deficiency: A Case Report. Cureus. 2022 Sep 10;14(9):e29008. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9551622/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
Rickets in Children: Causes, Symptoms, Types & Treatment
Introduction
One of the most common nutritional deficiencies observed in otherwise healthy, growing children is vitamin D deficiency1. A multicentre study across six Indian states involving over 2,500 children (5 to 18 years) found that only 36.8% showed sufficient levels of vitamin D2. Despite India’s abundant sunlight, this deficiency remains highly prevalent and can significantly affect bone health and overall growth.
Vitamin D, along with calcium and phosphorus, plays a vital role in bone maturation and mineralisation. Thus, inadequate levels of these nutrients could impair proper bone formation, which may lead to conditions like rickets3.
Through this article, we aim to highlight the importance of addressing vitamin D deficiency and preventing rickets disease in the growing population.
What is Rickets?
Rickets is a bone disorder that causes the bones of growing children to become soft and weak4.
It occurs when the mineralisation (a process that makes bones strong and rigid) of the growing parts of bones, known as the epiphyseal plates, is defective. In simple terms, this means the bones do not harden properly as they grow.
Rickets can be inherited (genetic) or acquired (nutritional), with nutritional rickets being the most common form seen worldwide3.
The Role of Vitamin D in Rickets
Vitamin D plays a vital role in maintaining healthy bones by regulating the body’s levels of calcium and phosphorus, the two main minerals responsible for bone strength and structure. It helps the intestines and kidneys absorb calcium and phosphorus from food and urine and ensures that these minerals are properly deposited in growing bones.
When vitamin D levels are low, the body cannot absorb enough calcium and phosphorus. As a result, bones become soft, weak, and poorly mineralised, leading to rickets in children and osteomalacia in adults. The lack of vitamin D also triggers an increase in parathyroid hormone (PTH), which draws calcium out of bones to maintain normal blood levels, further weakening the skeleton4.
Therefore, ensuring sufficient vitamin D during growth years is crucial to prevent rickets disease, promote bone development, and support overall skeletal health.
Symptoms of Rickets
Rickets often develops gradually as bones weaken and can affect multiple parts of a child’s body. Common rickets symptoms include3,5:
Muscle cramps and general fatigue
Bone pain or tenderness in the arms, legs, pelvis, and spine
Muscle weakness and reduced muscle tone, which may worsen over time
Delayed growth and developmental milestones.
Frequent bone fractures, even after minor injuries
Dental problems, such as delayed tooth eruption, weak enamel, or increased cavities
Excessive irritability is also a feature of vitamin D deficiency.
Children with rickets disease may also develop skeletal deformities, such as5:
Bowed legs or knock knees
An abnormally shaped skull
Bumps along the rib cage (rachitic rosary)
A protruding breastbone (pigeon chest)
Spinal or pelvic deformities
Protruding abdomen
Chronic cough
Note: Children with rickets are often smaller for their age, and their teeth may appear later than usual6. Thus, early recognition of rickets symptoms is essential to prevent long-term bone deformities and complications.
A point to note here is that in exclusively breastfed infants, the very first sign of deficiency is often not bowed legs but hypocalcemic seizures (convulsions due to low calcium), which warrants immediate testing for Vitamin D levels and ionized calcium levels in blood even if the baby looks physically normal.
The most common cause of rickets is a deficiency of vitamin D, which is essential for calcium and phosphorus absorption and bone mineralisation. In some cases, low calcium or phosphorus intake may also lead to rickets.
Rickets disease may be nutritional (acquired) or genetic (inherited)3:
Nutritional rickets occurs due to inadequate vitamin D from the diet, limited sunlight exposure, or malabsorption (as seen in conditions like celiac disease).
Genetic rickets results from inherited defects that affect vitamin D production, activation, or action in the body.
Certain medications (like anticonvulsants), chronic liver or kidney diseases, and disorders affecting phosphate metabolism may also cause rickets.
Risk Factors
Rickets most often develops when the body does not get or use enough vitamin D, calcium, or phosphorus, leading to weak and poorly mineralised bones. Children are at a higher risk if they3,5:
Spend little time outdoors or have limited sun exposure
Have dark skin, which reduces vitamin D synthesis
Are exclusively breastfed without vitamin D supplementation
Live in polluted or high-latitude areas where sunlight exposure is low
Are born preterm or there was maternal deficieny of vitamin D during pregnancy
Suffer from mabsorption syndromes like celiac disease
Primarily have a vegan diet
In my routine OPD as a clinician, I have observed that parents often dismiss leg pain in children as growing pains, but a key clinical distinction is that rickets causes deep bone pain that worsens with weight-bearing activity, whereas growing pains almost exclusively occur at night.
If the deficiency becomes severe, low calcium levels can lead to3:
Muscle cramps or seizures
Heart and skeletal muscle weakness (myopathy)
If left untreated, these complications may progress and become life-threatening.
Diagnosis of Rickets
Diagnosis of rickets is based on clinical evaluation, biochemical investigations, and radiological findings. A detailed medical history and thorough physical examination are essential to identify underlying causes and assess disease severity.
Laboratory investigations help confirm the diagnosis. Basic tests include3,5:
Serum 25-hydroxyvitamin D
Parathyroid hormone (PTH)
Serum alkaline phosphatase (ALP)
Serum/Urine calcium and phosphate
ALP isoenzymes
Blood urea nitrogen (BUN) and creatinine
Liver enzymes
Radiological evaluation (especially X-rays) is also performed to confirm characteristic bone changes, particularly at rapidly growing sites such as the wrists, knees, and ribs.
Treatment and Management
Treatment depends on the cause, most commonly a vitamin D or calcium deficiency. The main goals are to correct the deficiency, strengthen bones, and prevent deformities.
Regular blood tests for vitamin D, calcium, phosphate, ALP, and PTH
Urine tests to monitor calcium loss
Note: Genetic forms of rickets are best managed under the care of a paediatric endocrinologist or a metabolic bone specialist.
Prevention of Rickets
Rickets is caused by vitamin D deficiency and is largely preventable through proper nutrition, sunlight exposure, and supplementation. Key preventive measures include:
Vitamin D and calcium intake: Ensure a diet rich in vitamin D (fortified milk, fish, eggs) and calcium (dairy products, leafy vegetables)3.
Sun exposure: Encourage regular, safe sunlight exposure for about 5 to 30 minutes, 2 times a week (more often for darker skin tones) after 6 months of age8.
Maternal supplementation: Pregnant women are advised to take vitamin D (under medical guidance) along with other essential nutrients to help prevent deficiency in their babies3.
Infant supplementation: Vitamin D drops are recommended for all infants in the first year, and after infancy, for children who are at a higher risk due to poor diet or previous rickets3.
Medical care: Kidney or digestive disorders should be treated promptly to improve vitamin D absorption5.
Genetic counselling: This is recommended for families with inherited forms of rickets9.
When to Seek Medical Help?
Early medical attention is important to prevent permanent bone damage and complications. Consult a doctor immediately if your child shows3:
Delayed growth or walking
Bone pain, tenderness, or deformities (bowed legs, thick wrists/ankles)
Frequent fractures or muscle weakness
Seizures or muscle spasms (possible severe calcium deficiency)
Rickets is a preventable and treatable condition that primarily results from vitamin D or calcium deficiency.
Early recognition through clinical evaluation, biochemical tests, and radiological findings is key to effective management. In addition to this, adequate nutrition, sunlight exposure, and timely supplementation during pregnancy and childhood play vital roles in preventing rickets in children. Therefore, parents should keep in mind that with prompt diagnosis and proper treatment, children with rickets can achieve normal growth, strong bones, and healthy development.
Frequently Asked Questions (FAQs)
Can rickets be corrected?
Yes, rickets can be corrected if detected early. A guided treatment with vitamin D, calcium supplements, and adequate sunlight exposure helps strengthen bones and correct deformities over time3.
Is rickets genetic?
Most cases are due to vitamin D or calcium deficiency (nutritional rickets), but some rare forms are genetic, caused by inherited problems in vitamin D metabolism or phosphate handling3.
What are anti-rickets?
Anti-rickets refers to nutrients or treatments that prevent or cure rickets10. These are mainly vitamin D, calcium, and phosphorus. They help maintain strong and healthy bones.
Are bow legs rickets?
Bow legs can be a symptom of rickets, especially in children with soft or weak bones. However, not all bow legs are due to rickets; sometimes, they occur as a normal stage of growth11.
Can you reverse rickets?
In most cases, rickets is reversible with early treatment using vitamin D and calcium. However, long-standing or severe deformities may need braces or surgery for correction3.
Khadilkar A, Kajale N, Oza C, Oke R, Gondhalekar K, Patwardhan V, et al. Vitamin D status and determinants in Indian children and adolescents: a multicentre study. Sci Rep. 2022 Oct 6;12(1):16790. Available from:https://pubmed.ncbi.nlm.nih.gov/36202910/
Lerch C, Meissner T. Interventions for the prevention of nutritional rickets in term born children. Cochrane Database Syst Rev. 2007 Oct 17;2007(4):CD006164. Available from:https://pmc.ncbi.nlm.nih.gov/articles/PMC8990776/
Makishima M. [Rickets/Osteomalacia. The function and mechanism of vitamin D action.]. Clin Calcium. 2018;28(10):1319-1326. Japanese. Available from:https://pubmed.ncbi.nlm.nih.gov/30269113/
Vagha K, Jameel PZ, Vagha J, Varma A, Murhekar S, Reddy P, Madirala S. Not all the bowlegs is rickets! (a case report). Pan Afr Med J. 2022 Jun 29;42:161. Available from:https://pmc.ncbi.nlm.nih.gov/articles/PMC9482215/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
Nasal Drops for Babies and Kids: Types, Uses, and Safety Guide
Introduction
The nasal airway plays a vital role in both breathing and smell. In addition to allowing respiration, the nose and sinuses (air-filled spaces around the nose) help condition inhaled air by humidifying and filtering it, while also trapping harmful particles1.
This natural defence system is especially important in newborns, who rely mainly on nasal breathing during their first few months of life. Any obstruction of the nasal passages at this stage can therefore lead to significant issues, including breathing difficulty, sleep disturbances, feeding problems, and a higher risk of conditions such as obstructive apnoea1.
In infants and children, nasal obstruction and a runny nose are most commonly caused by viral upper respiratory tract infections (URTIs), allergic reactions, or neonatal rhinitis. Since babies cannot blow their noses effectively, the accumulation of mucus can worsen discomfort and respiratory distress1,2.
To relieve this, nasal drops or sprays are commonly recommended1,2.They are safe, gentle, and effective in easing congestion, but their correct and careful use is essential. Therefore, through this guide, we aim to help parents understand the different types of nasal drops available for babies, their uses, and important safety tips.
What Are Nasal Drops and Sprays?
Nasal drops or sprays are liquid formulations designed to be placed directly into the nasal cavity to help relieve a blocked or stuffy nose. They are usually water-based (aqueous) solutions or suspensions and may contain active ingredients or simple saline1,3.
Nasal Drops vs. Nasal Sprays
Both nasal drops and sprays are used to relieve nasal congestion, dryness, or allergies but the difference lies in how they are delivered3:
Nasal drops: liquid is instilled directly into the nostrils.
Nasal sprays: a fine mist is sprayed to coat the nasal passages.
Saline nasal drops in particular are gentle, drug-free, and safe, making them a preferred choice for babies. They help loosen mucus, clear nasal passages, and improve breathing, which supports more comfortable feeding and sleeping1,2.
Types of Nasal Drops for Babies and Kids
Nasal drops or sprays are packaged in single-use or multi-use containers. They are often equipped with droppers or nozzles to ensure safe and accurate dosing3.
Nasal drops for kids can be either simple saline or medicated formulations, depending on the purpose:
Saline Nasal Drops
The most commonly used type is for babies and young children2,4.
They are drug-free, which means they are made of just salt (sodium chloride) and sterile (purified)water5.
Helps loosen mucus, clear blocked noses, and ease breathing2.
Medicated Nasal Drops (doctor-prescribed only)
They are used for specific conditions such as severe allergies or nasal infections6.
They may contain decongestants (like xylometazoline) or other active ingredients7.
Not safe for self-use; must always be prescribed by a doctor. Also, usually not prescribed for babies.
Another option is nasal sprays; however, these are generally used in older children.
Saline Nasal Spray
They are drug-free, just salt and sterile water.
Used to moisturise nasal passages, loosen mucus, and ease congestion3.
Medicated Nasal Sprays(doctor-prescribed only)
They may contain active ingredients (like decongestants).
Prescribed by doctors for conditions such as allergies3,8.
Disclaimer: Always consult your paediatrician before using medicated nasal drops or sprays for children. Even with saline drops or sprays, it is best to check with your doctor, especially for newborns and infants, to ensure proper use and safety.
When Are Nasal Drops Needed?
Doctors may recommend nasal drops for babies and nasal sprays for kids in the following situations:
To loosen mucus and make suctioning easier in infants10
Note: Saline nasal drops for babies do not cure the underlying illness, but they help relieve congestion and make breathing, feeding, and sleeping more comfortable.
How to Use Nasal Drops for Babies and Kids
Using nasal drops correctly helps ensure they work safely and effectively. Follow these steps when using a nasal drop/spray for your child10,12:
Wash your hands thoroughly with soap and water.
Position your child with care:
For infants: Lay the baby on their back and gently tilt the head back.
For older kids: Ask them to sit on your lap (facing away from you) and tilt their head slightly backwards.
Open the bottle and hold it above one nostril.
Gently squeeze the recommended number of drops/spray, being careful not to touch the inside of the nose with the dropper (to avoid contamination).
Keep your child’s head tilted for 1 to 2 minutes to let the solution spread inside the nasal passages. This step is also essential if suctioning is advised for your baby.
Repeat for the other nostril if advised.
Wipe the dropper tip with a clean tissue and replace the cap securely.
Note: Always be gentle with newborns and infants. Avoid forcing the head back or inserting the dropper deep into the nostril.
A critical hygiene mistake to avoid is releasing the squeeze on the dropper bulb while it is still inside the nostril because this creates a vacuum that sucks infected mucus back into the sterile bottle. To prevent contaminating the solution and re-infecting your child it is recommended to always withdraw the dropper completely from the nose before releasing your grip18.
Safety and Dosage Guidelines on Using Nasal Drops for Infants
The safe use of nasal drops in newborns, infants, and children depends on following the correct dosage and frequency. Moreover, every child is different, and the right amount may vary depending on age, weight, and medical condition.
Therefore, even if the recommended saline nasal drops dosage for babies is mentioned on the product packaging, parents should always follow their paediatrician’s instructions rather than relying on general guidance.
For saline nasal drops or sprays: These are generally considered safe and may be used a few times a day (usually 2 to 3 times and can be used up to 6 times) as needed to relieve congestion or dryness13. Since saline is drug-free, the risk of side effects is minimal, but it is still important not to overuse it unnecessarily.
For medicated nasal drops or sprays: Strict medical supervision is essential. Overuse or prolonged use of medicated drops can lead to serious side effects7. Therefore, these formulations should never be given without a doctor’s prescription and should only be used for the recommended duration.
Key point: Always consult your paediatrician for the correct type, dosage, and frequency of nasal drops or sprays for your child. Remember, safe handling and proper use are just as important as the medicine itself.
In my experience, a common mistake parents make is frequent or aggressive suctioning after using nasal drops. It is usually advised to limit mechanical suctioning via nasal suction bulb to maximum 2–3 times a day preferably before feeds and before sleep, as overuse causes trauma and swelling of the delicate nasal mucosa, which paradoxically worsens the congestion17.
Here are some tips to help you use nasal drops and sprays safely for your baby:
Follow instructions carefully: Always use the recommended dosage and frequency on the packaging or as advised by your paediatrician.
Choose the right type: Use saline drops for newborns and infants (from reputed brands only); reserve medicated drops or sprays for older children and only under a doctor’s guidance.
Check ingredients for allergies: Always read the label to ensure your child is not allergic to any component of the drops or sprays.
Avoid homemade saline for newborns: Do not prepare saline solutions at home for infants unless specifically prescribed by a doctor.
Maintain hygiene: Wash hands before use and keep the dropper or nozzle clean. Do not share bottles between children11,12.
Store properly: Keep drops tightly closed, stored as directed, and never use expired or discoloured products11.
Monitor for side effects: Watch for irritation, stinging, bleeding, or unusual symptoms, and stop use if these occur11.
Avoid overuse: Do not exceed the recommended duration (especially for medicated drops) to prevent rebound congestion or other complications11,15.
Seek medical advice promptly: Contact your paediatrician if congestion lasts longer than 10 days, if fever develops, or if breathing problems worsen.
Saline nasal drops and sprays are a safe, gentle, and effective way to relieve nasal congestion in babies and children. They help loosen and clear mucus, ease nasal blockage, and make breathing more comfortable (especially during colds, allergies, or dryness).
When used correctly, nasal drops are highly safe and well-tolerated. However, it is important for parents to follow the right dosage, handling, and frequency, and to seek medical advice before using medicated drops or sprays.
Remember, with proper use and guidance from your paediatrician, nasal drops can provide valuable relief, support restful sleep and feeding, and help little ones recover more comfortably and quickly.
It is possible, but not always practical. For safety and effectiveness, it is usually easier when the baby is slightly upright or lying down with the head gently tilted back. This position helps the drops spread properly and reduces the risk of choking or discomfort11,12.
How many times a day can I give saline drops to my baby?
Saline drops are usually safe and can be used 2 to 3 times a day, which can be increased up to 6 times or as directed on the packaging. Always follow your paediatrician’s advice and avoid overuse13.
Are nasal sprays safe for toddlers?
Yes, saline nasal sprays are generally safe for toddlers (usually above 2 years). However, medicated sprays should only be used if prescribed by a doctor16.
Can saline nasal drops cause side effects?
Saline drops are drug-free and rarely cause side effects. In some cases, babies may briefly sneeze or feel mild irritation, but this usually passes quickly11.
Do nasal drops cure a cold?
No, nasal drops do not cure a cold. They help relieve congestion, clear mucus, and make breathing easier, but the cold itself will resolve naturally over time1,2.
References
Chirico G, Beccagutti F. Nasal obstruction in neonates and infants. Minerva Pediatr. 2010 Oct;62(5):499-505. Available from:https://pubmed.ncbi.nlm.nih.gov/20940683/
Chirico G, Quartarone G, Mallefet P. Nasal congestion in infants and children: a literature review on efficacy and safety of non-pharmacological treatments. Minerva Pediatr. 2014 Dec;66(6):549-57. Available from: https://pubmed.ncbi.nlm.nih.gov/25336097/
U.S. Food and Drug Administration. Nasal Spray and Inhalation Solution, Suspension, and Spray Drug Products—Chemistry, Manufacturing, and Controls Documentation: Guidance for Industry[Internet]. U.S. Department of Health and Human Services; [cited 2025 Sep 10]. Available from: https://www.fda.gov/media/70857/download
Cabaillot A, Vorilhon P, Roca M, Boussageon R, Eschalier B, Pereirad B. Saline nasal irrigation for acute upper respiratory tract infections in infants and children: A systematic review and meta-analysis. Paediatr Respir Rev. 2020 Nov;36:151-158. Available from: https://pubmed.ncbi.nlm.nih.gov/32312677/
Deve L, Poduval J. Effectiveness of Over-The-Counter Intranasal Preparations: A Randomized Trial. Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):1923-1928. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6848630/
van Stralen KJ, van Tol JE, de Wildt SN, Becker ML, van Houten MA. Use of xylometazoline in hospitalised infants: is it safe? A retrospective cohort study. Arch Dis Child. 2023 Jan;108(1):62-66. Available from: https://pubmed.ncbi.nlm.nih.gov/36171065/
Kim KT, Kerwin E, Landwehr L, Bernstein JA, Bruner D, Harris D, Drda K, Wanger J, Wood CC; Pediatric Atrovent Nasal Spray Study Group. Use of 0.06% ipratropium bromide nasal spray in children aged 2 to 5 years with rhinorrhea due to a common cold or allergies. Ann Allergy Asthma Immunol. 2005 Jan;94(1):73-9. Available from: https://pubmed.ncbi.nlm.nih.gov/15702820/
World Health Organization. Pocket book of hospital care for children: guidelines for the management of common childhood illnesses [Internet]. WHO; [cited 2025 Sep 29]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK154448/
Ramalingam S, Graham C, Oatey K, Rayson P, Stoddart A, Sheikh A, Cunningham S; ELVIS Kids Trial Investigators. Study protocol of the Edinburgh and Lothian Virus Intervention Study in Kids: a randomised controlled trial of hypertonic saline nose drops in children with upper respiratory tract infections (ELVIS Kids). BMJ Open. 2021 May 5;11(5):e049964. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8103393/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
Breast Cancer: What It Is, Types, Early Signs, Treatment & Prevention
Introduction
Breast cancer is a disease where the cells and tissues in the breast change and grow out of control1.This extra growth can form a lump called a tumour. If the tumour keeps growing, it can spread to nearby breast tissue, reach the lymph nodes, and move to other parts of the body2. Breast cancer is the second most common cancer in women, after skin cancer3.
Getting diagnosed early often leads to more effective treatment. In most cases, screening tests like mammograms can detect breast cancer even before a lump forms. Around 99 in 100 women survive 5 years or more when breast cancer is caught early. Survival drops to about 87 in 100 if it spreads nearby, and to about 33 in 100 if it spreads further4,5.After diagnosis, doctors choose treatment by looking at how advanced the cancer is, what signals the cancer cells show (like hormones or HER2), and the person’s overall health. Treatment may include surgery, radiation, or medicines2.
In this blog, we will see what breast cancer is, its types, early signs, and how to lower the risk or manage it.
What Is Breast Cancer?
The breast is an organ in the front of the chest that makes milk after childbirth. It is more developed in women, while in men it stays smaller6.
Breast cancer happens when cells in the breast grow out of control. It usually begins in the milk ducts (tiny tubes that carry milk) or in the lobules (glands that make milk). Sometimes the cancer stays in place, but if it spreads into nearby tissue, it can grow and move to other parts of the body. If the cancer cells stay inside the duct, it is called ductal carcinoma in situ. If they break through the duct wall and spread into nearby tissue, it is called invasive ductal carcinoma. Sometimes, cancer can also begin in the lobules. When it spreads from the lobules into nearby tissue, it is called invasive lobular carcinoma7,9.
Breast cancer is one of the most common cancers worldwide, affecting about 2.3 million women each year. In India, it accounts for about 1 in 8 cancer cases, with around 1.6 lakh women diagnosed in 2020. Breast cancer survival rates depend on how early it is found and treated; about 66 out of 100 women in India live at least five years after diagnosis10,12.
Causes & Risk Factors of Breast Cancer
The reasons for breast cancer could be due to hereditary or lifestyle-related factors.
Hereditary (Genetic factors): BRCA1 and BRCA2 are tumour suppressor genes (genes that repair damaged DNA and keep cells healthy). When these genes undergo changes called mutations, they don’t work properly, leading to breast cancer. This mutated gene is inherited from your parents, and those who have this gene have an 85% risk of getting breast cancer early.
Other causes of breast cancer are:
Age: As you get older, risk increases, mainly after age 50. Most cancers are diagnosed after this age.
If you attain puberty at 12 and menopause after 55: This leads to a longer reproductive span with a longer exposure to hormones like oestrogen. When tissues are exposed to these hormones for a longer period, the risk of cancer can increase.
Breast density: Dense breasts (breasts with more firm tissue and less fat) makes tumour detection difficult during scans or mammograms, so breast cancer can be missed.
History: If you had breast cancer earlier or any other breast diseases in the ducts or lobules, your cancer risk increases. In addition, having a close family member with breast cancer can increase your risk of developing the disease, as genetics also play an important role.
The modifiable risk factors of breast cancer are:
Physical inactivity increases risk, especially if you are obese.
Taking oral contraceptive pills for several years or hormone medicine during menopause may slightly increase the risk of breast cancer. This risk gradually decreases once the pills are stopped.
Those who get pregnant after 30, do not breastfeed, or do not have a full-term pregnancy are at increased risk.
Alcohol consumed in larger quantity increases the risk of breast cancer12,13.
Types of Breast Cancer
There are different types of breast cancer and they vary in tumour behaviour, grade, and treatment response.
1. Non-invasive breast cancer
Ductal carcinoma in situ is an early, non-invasive cancer that stays inside the milk ducts. It is found more often now due to better screening and shows as tiny spots on mammograms. It is considered “stage 0” cancer and, if untreated, can grow into invasive cancer.
Lobular carcinoma in situ occurs when abnormal cells are found inside the lobules of the breast. It is not cancer, but it does mean a higher chance of developing invasive breast cancer later in some women. Regular check-ups and close monitoring are usually recommended14.
2. Invasive breast cancer
Invasive ductal carcinoma is the most common type (70-80%) of breast cancer. It starts in the ducts and can spread to other parts of the body. Symptoms include a lump or nipple changes. It usually responds well to chemotherapy.
Invasive lobular carcinoma accounts for about 10-15% of all breast cancers. It grows in the lobules and can be harder to detect. It often responds well to hormone therapy but less to chemotherapy and may return years later7,15.
Breast cancer is also divided into different subtypes depending on certain proteins called receptors. These include oestrogen and progesterone receptors and another called HER2. Some breast cancers use these proteins to grow faster.
Triple-negative breast cancer: This type doesn’t have oestrogen, progesterone, or HER2 receptors. Its growth and spread tends to be faster than other types.
HER2-positive breast cancer has too much of the HER2 protein, which helps the cancer grow quickly. Targeted medicines like trastuzumab and pertuzumab can now block HER2 and yield much better outcomes than before.
Most breast cancers called luminal types have hormone receptors. Luminal A type grows slowly, can be treated with hormone medicine, and usually has a good outcome, while luminal B type grows faster, may need hormone medicines plus chemotherapy, and has a slightly higher risk16.
Breast Cancer Stages
Breast cancer is divided into 5 stages based on how much the cancer has grown and its spread to other parts.
Stage 0 means cancer cells are only in one place and haven’t spread outside the ducts, not including lobular carcinoma in situ.
Stage 1 means the tumour is small (≤2 cm) and may have spread to the nearby lymph nodes, but not to other organs.
Stage 2 includes a larger tumour (≤5 cm) and/or more nearby lymph nodes, but still no distant spread.
Stage 3 means the cancer has spread more in the breast, nearby lymph nodes, or to the chest wall/skin.
Stage 4 means the cancer has spread to other parts of the body (metastatic disease) and is not curable but treatment can control the symptoms and help patients live longer17,18.
Doctors use the TNM system to decide the cancer stage. T stands for the size of the tumour, N shows if lymph nodes have cancer, and M indicates whether the cancer has spread to distant parts.
The higher the stage, the more advanced the cancer is. Staging the cancer helps to formulate the best treatment plan and predict how likely it is that the patient will recover. It also helps track how the cancer changes over time during breast cancer treatment and predict the outcomes18.
Early Signs & Symptoms
Many individuals who have breast cancer don’t show symptoms in the early stage, so how to identify breast cancer? You can check for lumps in the breasts yourself or get them checked during regular checkups or screening from a doctor. Symptoms may be seen only when the cancer grows or spreads.
The common signs and symptoms of early and advanced breast cancer are:
Early Signs of Breast Cancer: The breast early cancer findings are a small lump or thick area in the breast or underarm. Other signs include skin puckering, nipple changes like pulling in, unusual fluid discharge, or uneven size of the breasts8,19.
Advanced Signs: When cancer grows, more serious symptoms appear like swollen lymph nodes in the armpit or ongoing pain in the breast area and general symptoms like losing weight without reason, feeling tired, or sharp pain. The cancer can also spread to the bones, lungs, liver, or brain, causing other symptoms.
The table below gives more clarity on breast cancer symptoms in early and advanced stages19,20.
Symptoms
Early Stage
Advanced Stage
Lump or thickening in breast
Yes
Yes
Skin changes (redness, dimpling)
Yes
Yes
Nipple changes (pain, discharge)
Yes
Yes
Swollen lymph nodes
No
Yes
Breast pain
Rare
Yes
Bone pain or aches
No
Yes (bone involvement)
Weight loss or tiredness
No
Yes (liver involvement)
Shortness of breath or cough
No
Yes (lung involvement)
Headache or vision changes
No
Yes (brain involvement)
I would suggest that any nipple discharge should be followed by self examination. Women can learn proper self examination technique from a general surgery doctor at the OPD basis. In case of doubt one should undergo mammography. Note that there are breast cancers which are hormone dependent and hence can be managed well with proper care.
Breast cancer can be checked by different methods. You can check your breasts for changes yourself, or a doctor can do a breast examination to feel for any lumps or unusual signs.
1. Checking Your Breasts for Changes
Stand in front of a mirror and relax with your arms by your side. Look closely if there are any changes in the size, shape, or skin texture of the breasts. Raise your arms and check again for changes.
While lying down or taking a bath, use the pads of your fingers and gently feel your entire breast and underarm area in a circular motion. Use light, medium, and firm pressure while checking for any thickness or lumps in those areas.
Check the nipple for any lump or discharge other than milk or any other changes21,22.
If you notice any changes in these areas, see a doctor promptly so that even small changes can be checked thoroughly.
2. Clinical Breast Examination
This is done by a doctor who will gently feel and check the breasts and underarms for any lumps or unusual signs. They carefully look for anything different in the breast like changes in size, shape, or texture23.
There are certain screening tests available to check for breast cancer, as below:
3. Imaging Tests
Besides exams done by you or your doctor, there are imaging tests that can give a clearer picture of breast cancer.
Mammogram is an x-ray image of your breast. It helps find breast cancer early, even before you can feel any lumps.
Breast MRI uses magnets and radio waves to create detailed images of the breast. 21
Ultrasound tests use sound waves to get pictures of the inside of the breast. They are used for people with dense breasts or those at higher risk of getting breast cancer.
Biopsy: A small piece of breast tissue is taken and examined under a microscope to check for cancer cells23.
The type of screening required for breast cancer depends on your medical condition and risks, as the doctor advises. It is recommended that women aged 40 to 74 years with average breast cancer risk get a mammogram every 2 years. Those who have risks like BRCA1 and BRCA2 gene mutation, or have had chest radiation at a young age, need more frequent screening as advised by the doctor21,23.
Self examination of breast is very important in detecting early breast cancer. Usually doctors don’t examine breast for all the patients and hence it can be missed on diagnosis. Self examination is thus crucial and should be done every 5-7 months after menustration or on a fixed date every month after menopause to check for any lumps or growth in the breasts.
The treatment of breast cancer depends on the stage of breast cancer. No two patients are exactly the same, and treatment and responses to treatment can vary a lot.
Around the world, about 92 out of 100 women live at least 5 years after being diagnosed with breast cancer.In India, the numbers are lower because many women find out late or don’t get full treatment.
If breast cancer is found early and before it spreads to other parts, the survival rate increases. Therefore, regular checks and timely screening for women at increased risk can help find cancer early. In India, many women do not get routine mammograms, so doctors mainly use careful breast exams and special imaging tests to detect cancer early and make it easier to treat24,26.
Breast Cancer Treatment Options
There are various treatment options for breast cancer, the choice of which depends on the type of breast cancer and its stage, as follows:
Surgery: This is often the first step for breast cancer. However, not all patients have surgery first; sometimes chemotherapy or hormone therapy is given before surgery to shrink the tumour (neoadjuvant treatment). Lumpectomy removes only the tumour and some nearby tissue and is done in early stages. Mastectomy, which removes the whole breast, is mostly done when cancer is of significant size, but the decision also depends on tumour location, number of tumours, patient choice, and gene changes.
Radiation: Radiation uses strong rays to kill cancer cells after surgery. It helps stop cancer from coming back in the breast or nearby areas. Radiation may be given after lumpectomy or sometimes after mastectomy.
Chemotherapy: Chemotherapy medicines are given to kill cancer cells in the body. It is used for higher-risk hormone-positive cancers and also when cancer is very aggressive, like triple-negative or HER2-positive breast cancer. Common chemotherapy medicines include cyclophosphamide, methotrexate, doxorubicin (Adriamycin), epirubicin, and docetaxel.
Hormone therapy: Hormone therapy blocks certain hormones that help the breast cancer grow. Medicines like tamoxifen, exemestane, and letrozole block or lower these hormones. Tamoxifen can be used in both younger and older women. Letrozole and exemestane are usually used in older women, especially after menopause, however, they can also be used in younger women if their ovaries are temporarily shut down (ovarian suppression).
Targeted Therapy: Some breast cancers are associated with a protein called HER2 that makes the cancer cells grow faster. Medicines like trastuzumab and pertuzumab block this protein to stop cancer growth. HER2-positive cancers are usually treated with chemotherapy and targeted medicines, but the amount and type of chemotherapy can vary depending on the patient. Other drugs like PARP inhibitors (e.g., olaparib and talazoparib) help people who have BRCA gene changes. CDK4/6 inhibitors such as palbociclib slow down cancer cells in breast cancer associated with hormones.
Immunotherapy: For some difficult or advanced breast cancers, new medicines help the body’s immune system fight cancer better. These include medicines that help the body’s own immune system find and attack cancer cells. For example, pembrolizumab is one such drug used in some cases of triple-negative breast cancer that test positive for a marker called PD-L1.
Some patients may receive a combination of therapies to improve their chances of recovery. When breast cancer is diagnosed early, treatment can be planned to get the best outcome and help prevent cancer from coming back2,8.
How to Prevent Breast Cancer
Breast cancer cannot be completely prevented, but healthy lifestyle choices and certain measures may help lower the risk. These include:
Keep your weight within a healthy range.
Regular physical activity.
Avoid or limit alcohol use.
Breastfeed your children if possible.
Get a mammogram every two years for women aged 50 to 74, or sooner if risk is higher27,28.
Take preventive medicines like tamoxifen orraloxifene (if prescribed by the doctor) in women at high risk of breast cancer.
Consider medicines such as anastrozole or letrozole after menopause, as they lower oestrogen levels and help in breast cancer prevention.
Discuss preventive surgery with your doctor if you are at very high risk.
Ask about genetic testing for BRCA1 and BRCA2 if you have a family history; if results are positive, your doctor will guide you on next steps29,30.
When to See a Doctor?
You must see a doctor if you have any of these signs, which could possibly indicate breast cancer:
Breast cancer can be managed well if found in the early stages. Knowing the early signs and acting promptly helps early detection and treatment initiation. Many types of breast cancer respond well to advanced medicines, especially when diagnosed early, leading to better outcomes and improved recovery.
Most people don’t show any early signs of breast cancer. As the cancer grows, you might feel a lump in the breast. Other signs include changes in breast size or shape, nipple redness or sores, skin dimpling, swelling in the armpit, or persistent breast pain not related to periods8,27.
How is breast cancer diagnosed?
Breast cancer is diagnosed by checking the breast for lumps or changes, getting imaging tests like mammograms, and confirming with a biopsy27.
Is breast cancer hereditary?
Some types of breast cancer are hereditary. The BRCA1 and BRCA2 genes, which control cell growth, can undergo mutations causing cancer. The child can get cancer if it is passed from parents, but not everyone with this gene will develop cancer12.
How to reduce breast cancer risk?
You cannot completely prevent breast cancer, but healthy eating, exercise, and limiting alcohol use can lower the risk. High-risk individuals can talk to a doctor about hormone therapy or surgery to reduce cancer risk27.
Łukasiewicz S, Czeczelewski M, Forma A, Baj J, Sitarz R, Stanislawek A. Breast cancer—epidemiology, Risk factors, classification, Prognostic markers, and Current Treatment Strategies—an Updated Review. Cancers [Internet]. 2021;13(17):4287. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8428369/
Mehrotra R, Yadav K. Breast cancer in India: Present scenario and the challenges ahead. World Journal of Clinical Oncology [Internet]. 2022 Mar 24;13(3):209–18. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8966510/
Pillai RN, Alex A, Narassima M.S, Verma V, Ajil Shaji, Keechilat Pavithran, et al. Economic burden of breast cancer in India, 2000–2021 and forecast to 2030. Scientific Reports [Internet]. 2025 Jan 8;15(1). Available from: https://www.nature.com/articles/s41598-024-83896-1#Sec13
Udaya Kumar D. Issue 3 www.jetir.org(ISSN-2349-5162). JETIR2403572 Journal of Emerging Technologies and Innovative Research [Internet]. 2024 [cited 2025 Aug 11];11. Available from: https://www.jetir.org/papers/JETIR2403572.pdf
Yang C, Lei C, Zhang Y, Zhang J, Ji F, Pan W, et al. Comparison of Overall Survival Between Invasive Lobular Breast Carcinoma and Invasive Ductal Breast Carcinoma: A Propensity Score Matching Study Based on SEER Database. Frontiers in Oncology [Internet]. 2020 Dec 22;10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783385/
Yersal O, Barutca S. Biological Subtypes of Breast cancer: Prognostic and Therapeutic Implications. World Journal of Clinical Oncology. 2014;5(3):412. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4127612/
Teichgraeber DC, Guirguis MS, Whitman GJ. Breast Cancer Staging: Updates in the AJCC Cancer Staging Manual 8th Edition and Current Challenges for Radiologists, From the AJR Special Series on Cancer Staging. American Journal of Roentgenology. 2021 Feb 17;217(2). Available from: https://www.ajronline.org/doi/10.2214/AJR.20.25223
Mehrotra R, Yadav K. Breast cancer in India: Present scenario and the challenges ahead. World Journal of Clinical Oncology [Internet]. 2022 Mar 24;13(3):209–18. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8966510/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
Did you know that leukaemia (a type of blood cancer) is the most common cancer diagnosed in children? It accounts for approximately 30.8% of all cancer cases in this age group1.
Blood cancer, also referred to as haematological cancer is defined as cancer originating in the blood-forming tissues such as the bone marrow, lymph nodes and other parts of the lymphatic system1,2. Common types of blood cancer include leukaemia (cancer of the blood cells and bone marrow, characterised by uncontrolled proliferation of abnormal or immature white blood cells), lymphoma (cancer of the lymphatic system), myeloma (cancer of plasma cells in the bone marrow), and rare types of blood cancers such as myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPNs)3,4.
Early recognition of symptoms and diagnosis can help to improve your treatment outcomes and increase your chances of long-term survival5.
What Are the Types of Blood Cancer?
Blood cancers can be classified into different types depending on the cells of the blood, bone marrow or lymphatic system affected. The blood cancer types include:
1. Leukaemia
Leukaemia is a cancer that affects your blood cells. It begins in the bone marrow and affects the white blood cells, red blood cells, and platelets. In this condition, your bone marrow produces a large number of abnormal cells, especially white blood cells. Leukaemia can be classified into four types – acute lymphocytic leukaemia (ALL), acute myeloid leukaemia (AML), chronic lymphocytic leukaemia (CLL), and chronic myeloid leukaemia (CML). Broadly, based on how quickly it develops, leukaemias can be classified into two types6:
Acute leukaemia: This type of leukaemia develops and progresses rapidly. Hence, prompt treatment is needed.
Chronic leukaemia: This type of leukaemia progresses slowly and the individual’s condition worsens over a longer period of time, if not treated.
Based on the type of cells affected, leukaemia blood cancer types include6:
Myeloid leukaemia: The myeloid cells (immature cells that develop into granulocytes, monocytes, red blood cells or platelets) are affected.
Lymphoid leukaemia: Lymphocytes, a type of white blood cell, are affected.
2. Lymphoma
Lymphomas are cancers of the immune system that account for approximately 5% of all cancers. Lymphomas occur due to the abnormal growth and multiplication of lymphocytes at different stages of their maturation. Lymphomas can be classified as Hodgkin’s and non-Hodgkin’s lymphomas7.
Hodgkin’s Lymphoma: Defined by the presence of abnormal cells known as Reed Sternberg cells. In most cases, no causative agent has been detected, however, studies have shown many a link between Epstein Barr Virus and Hodgkin’s lymphoma (especially mixed cellularity subset and in immunosuppressed individuals).
Non Hodgkin’s Lymphoma: This is a heterogeneous group with several subtypes where there are no Reed Sternberg cells present. Each of these subtypes differ greatly in prognosis and treatment.
3. Multiple Myeloma
Multiple myeloma is a cancer that causes the abnormal proliferation of plasma cells in your bone marrow. These plasma cells are responsible for forming some of the proteins found in your blood. If not treated, the cancer can damage organs such as bones, kidneys, blood (anaemia), and immune system in your body. This can be summarised by CRAB criteria (high calcium levels [hypercalcaemia], renal [kidney] problems, anaemia [low red blood cell count], and bone pain)8.
Rare Types of Blood Cancer
These include:
Myelodysplastic syndrome (MDS): This is a condition where the bone marrow doesn’t produce enough healthy blood cells. Often seen in older adults (above 65 years of age), this condition can cause symptoms like fatigue, frequent infections, and easy bruising or bleeding. In some cases, MDS can progress to AML9.
Myeloproliferative neoplasms (MPNs): Stem cells in the bone marrow can potentially develop into many types of blood cells. Sometimes, the body overproduces certain cells, causing disorders like MPNs. The four classical types of MPNs include essential thrombocythemia, CML, primary myelofibrosis, and polycythemia vera (PV)10.
A lump or swelling in the lymph tissues due to the abnormal proliferation of lymphocytes, causing swollen lymph nodes. This can be commonly noticed in your armpit, neck, or groin region.
Profuse night sweats that can soak clothes and sheets.
Infections that are persistent, severe and recur frequently.
Fatigue or tiredness that does not improve after sleeping or resting.
Persistent or recurrent fever. Some blood cancers, such as lymphomas, may present with low-grade fevers or intermittent fever referred to as B symptoms7.
Itchiness is more common in Hodgkin’s lymphoma and certain leukaemias. While rashes may appear in leukaemias, they are not a universal sign12.
Pain in the bones, abdomen or joints.
If you are facing any of these signs and symptoms, it is recommended that you speak to your doctor and seek prompt medical care.
What Causes Blood Cancer?
Blood cancer is believed to be caused due to damage to the DNA of a single haematopoietic stem (blood-forming cell) or progenitor cell. While this is sometimes triggered by one key event, it may also develop gradually through several genetic changes over time. These abnormal cells multiply and eventually collect in the bone marrow, blood, or lymphatic system. This process interferes with the normal production and functioning of the normal healthy cells leading to anaemia, increased bleeding risk due to thrombocytopenia (low platelets) and an inability to fight infections1.
Although the exact causes of blood cancer remain unclear, many genetic and environmental risk factors are identified, which include13,14:
Previous exposure to cancer treatments (chemotherapy)
Exposure to intense radiation
Exposure to certain chemicals, such as benzene
Family history of leukaemia
Exposure to certain viral infections, for example, Epstein Barr virus is linked to some lymphomas, while human T-cell leukaemia virus type 1 (HTLV-1) is associated with adult T-cell leukaemia and certain subtypes of ALL7,13,14.
Age and gender
Syndromes that have a genetic origin, such as Down syndrome and Fanconi syndrome.
Understanding these risks is essential for the early detection of blood cancers.
As per my experience, any persistant bony swelling in individuals aged above 60 years which doesn’t get relieved with pain killers or physiotherapy rather worsens with it and restricts movement, should be evaluated for blood cancers like Multiple Myeloma etc.
Although most blood cancers are not curable, some can be cured based on the stage and type of blood cancer15.
Acute lymphoblastic leukaemia: Children with ALL show high cure rates, though certain individuals may present with a high risk of relapse16.
Chronic myeloid leukaemia: Treatment of CML with tyrosine kinase inhibitors (TKIs) may help to keep the condition under control for many years and is associated with a high survival rate. Advances with modern TKIs have made it possible for some patients to reach a deep level of remission, making it possible to stop treatment while still staying in long-term remission without medication17.
Non-Hodgkin’s lymphoma: Aggressive forms of Non-Hodgkin’s lymphoma can be cured in more than 50% of cases with intensive chemotherapy. Diffuse large B-cell lymphoma often responds well to R-CHOP (chemotherapy regimen), but cure rates depend on the type and the patient’s overall health. Although slower-growing forms of the lymphoma respond well to treatment, (especially in the early stages), advanced stages may relapse despite good long-term survival. Studies18 have shown that modern therapy has improved 5-year survival rates to over 60%.
Multiple myeloma: Although multiple myeloma is considered an incurable disease, treatment with high-dose therapy followed by autologous stem cell support ensures that 3-10% of individuals with multiple myeloma remain free of active disease for more than 10 years after treatment19.
Your treatment outcomes can vary depending on the stage of the disease, your age, your health conditions, and the response of cancer to treatment.
Blood Cancer Stages and Classification
Staging is incorporated to help in the classification based on how much cancer is present in your body. The blood cancer stages include20:
Leukaemias: Leukaemias usually do not use a defined staging method and most leukaemias are classified based on the disease subtype, severity and its effect on your body. However, ALL and AML use risk stratification systems (grouping patients by their risk level). CML uses a staging system (Rai, Binet, and CLL-IPI systems). These systems provide the staging based on lymph node involvement, organ enlargement, anaemia, and platelet levels20.
Lymphomas: Both Hodgkin and most Non-Hodgkin lymphomas use the Ann Arbor staging system. It describes how far the cancer has spread ranging from stage I (single node region) to stage IV (widespread organ involvement), with A indicating the absence or B indicating presence of symptoms like persistent fevers, unexplained weight loss, and night sweats21,22.
Multiple myeloma: Uses the International Staging System (ISS), and the Revised ISS (R-ISS), which relies on blood levels of β2-microglobulin, albumin, serum lactate dehydrogenase and high-risk cytogenetics23.
Understanding staging and grading of blood cancers helps in the treatment planning and determining your prognosis.
How Is Blood Cancer Diagnosed?
After a careful assessment of your symptoms, family history, and a physical examination, your doctor may suggest certain tests which will help in making an accurate diagnosis24:
Blood Tests: These include:
Complete blood count: This test helps to count the number of red blood cells, white blood cells and platelets in your blood.
Blood differential test: This test helps to check the amount of each type of white blood cell (lymphocytes, neutrophils, monocytes, eosinophils, and basophils) present in your blood25.
Biopsy: This is a definitive method of diagnosing blood cancer. Your doctor may suggest bone marrow biopsy or lymph node biopsy to accurately diagnose the type of cancer you have:
Lymph node biopsy: If you present with swollen lymph nodes, your doctor may remove a part of the affected lymph tissue for examination. This method can be used to diagnose certain lymphomas without marrow involvement26.
Bone marrow biopsy: Involves the removal of a sample of bone marrow to check for blood cancer. Can be used to diagnose many leukaemias and myelomas14.
Peripheral blood flow cytometry: This test can help diagnose certain leukaemias, such as CLL, if many cancer cells are present in the blood.
Tumour marker tests: These tests help to check and measure the substances that are produced by the body in response to cancer, for example, LDH can be used for lymphoma prognosis. These tests have a limited role in blood cancers7.
Imaging Tests: These tests are mainly done to assess the extent of your disease. They include:
Nuclear scan: Uses a small amount of radioactive material or tracer to indicate how organs or tissues are functioning.
PET-CT scan: Preferred imaging tool for lymphomas. It helps in the initial staging, assessing treatment response, and detecting potential recurrence27.
Ultrasound: Uses high-frequency sound waves to create real-time images of organs and tissues without radiation.
X-rays: Uses low-dose radiation to capture quick, simple images of bones and certain body structures.
MRI: Rarely used. Uses a strong magnet and radio waves to produce detailed cross-sectional images that are sometimes enhanced with a contrast agent, for example, in cases of central nervous system involvement or spinal cord compression.
Bone scan: Rarely used. This is a nuclear scan that detects any abnormal bone changes.
Immunophenotyping: Mainly done on blood or bone marrow samples, this test uses antibodies to identify cells based on the antigens or markers that are present on its surface. This test can be used for the identification and staging of leukaemias, lymphomas, myelodysplastic syndromes, and myeloproliferative disorders.
Cytogenetic Analysis (Karyotyping, FISH): Helps to detect chromosomal abnormalities, such as translocations and deletions, that are crucial for diagnosis. It also guides risk stratification (understanding a person’s risk level) and influences treatment decisions, such as eligibility for targeted therapies28.
Molecular Testing (e.g., PCR for BCR-ABL and JAK2): Identifies specific gene mutations that confirm the diagnosis and enable targeted therapy selection29.
There are many subtypes of blood cancers, each requiring different treatment. The correct identification can directly impact your prognosis, treatment choice, and expected outcomes.
In my opinion, regular 6 monthly or annual blood check ups should include not just CBC but also peripheral smear. Peripheral smear is the first thing which may reveal early signs of blood cancer (Leukemia).In my opinion, regular 6 monthly or annual blood check ups should include not just CBC but also peripheral smear. Peripheral smear is the first thing which may reveal early signs of blood cancer (Leukemia).
Blood cancer treatment depends on the type of blood cancer, its extent, and other factors such as the individual’s age and overall health. Treatment options typically include chemotherapy (medicine given through a vein to kill the cancer cells or slow their growth), radiation therapy (uses radiation to damage cancer cells to prevent their multiplication), targeted therapies (medications that are designed to act more specifically on cancer cells, though some may also affect healthy cells), immunotherapy (medications that boost your immunity so that your body can fight the cancer), and stem cell or bone marrow transplantation (involves placement of healthy stem cells after chemotherapy)14.
Leukemias (ALL, AML, CLL, CML) are often managed with combinations of chemotherapy, targeted therapies, and sometimes bone marrow transplantation14.
Lymphomas frequently use chemotherapy combined with immunotherapy7.
Multiple myeloma is treated with targeted drugs, immunomodulators, and, in eligible patients, transplant8.
Newer blood cancer treatments include CAR-T cell therapy (indicated for cancers such as ALL, non-Hodgkin lymphomas, advanced B cell malignancies and relapsed or refractory leukaemias), antibody–drug conjugates (such as Gemtuzumab ozogamicin for AML), and menin inhibitors (mainly used for AML subtypes with specific genetic abnormalities), offering better treatment results for patients with resistant or relapsed disease30,31.
Can Cancer Spread From One Person to Another Through Blood?
Blood cancer cannot be transmitted from one person to another. In other words, blood cancers are not contagious. They cannot spread by sharing needles, meals, or close contact. Even if cancer cells enter your body, your immune system recognises these cells and destroys them as you have a healthy immune system, although in rare cases, they can evade detection. Transmission of cancer is also unlikely because cancer cells are fragile and do not survive well outside the body32,33. While blood contact and sharing needles can lead to an increased risk of infectious diseases such as HIV and hepatitis, cancer cannot be transmitted from one person to another in this way32,34.
When to See a Doctor
You should see a doctor if your symptoms, such as unexplained fever, fatigue, night sweats, or swelling, persist for more than a few weeks. If routine tests show abnormal blood counts, or if you experience sudden weight loss, unexplained bleeding, or frequent infections, it is best to consult your doctor for prompt medical treatment11,13.
Blood cancers include leukaemia, lymphoma, myeloma, and rarer forms, each with distinct signs such as fatigue, swollen lymph nodes, night sweats, and unexplained bleeding. Early detection allows timely initiation of appropriate treatment like chemotherapy, targeted therapy, immunotherapy, and stem cell transplant, improving cancer control and survival. Always consult your doctor for accurate diagnosis and prompt medical care.
Frequently Asked Questions (FAQs)
How fast does blood cancer progress?
The progression of blood cancer varies depending on the type of blood cancer. Acute blood cancers can worsen within days or weeks, while chronic forms may develop slowly over months or years6.
Can diet or lifestyle help cure blood cancer?
Diet and lifestyle cannot cure blood cancer, but eating nutritious foods, staying active, and avoiding smoking or excessive alcohol can support your overall health and recovery during treatment35.
Is blood cancer contagious?
No, blood cancer is not contagious and cannot spread from person to person. It develops from changes in a person’s own blood-forming cells, not from contact or sharing bodily fluids with a person who has cancer32,33.
What’s the survival rate of blood cancer?
Survival rates for blood cancer vary widely by type, stage, and your body’s response to the treatment. For example, children with AML often respond well to treatment and can achieve high survival rates compared to individuals with more aggressive, advanced cancers15.
Is blood cancer hereditary?
Most cases of blood cancer are not directly inherited, but certain genetic syndromes and family history can increase their risk12,13.
What are the cancer screening tests that help find cancer early?
Cancer screening tests that may help early detection of cancer and improve the chances of survival include mammograms for breast cancer; HPV tests and Pap smears for cervical cancer; colonoscopy, sigmoidoscopy, and stool tests for colorectal (bowel) cancer; and low-dose CT scans for lung cancer5.
Chennamadhavuni A, Lyengar V, Mukkamalla SKR, Shimanovsky A. Leukemia [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560490/
Howell DA, McCaughan D, Smith AG, Patmore R, Roman E. Incurable but treatable: Understanding, uncertainty and impact in chronic blood cancers—A qualitative study from the UK’s Haematological Malignancy Research Network. Soundy A, editor. PLOS ONE [Internet]. 2022 Feb 10;17(2):e0263672. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8830712/
Bhojwani D, Howard SC, Pui CH. High-Risk Childhood Acute Lymphoblastic Leukemia. Clinical Lymphoma and Myeloma [Internet]. 2009 Sep;9:S222–30. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2814411/
Osman AEG, Deininger MW. Chronic Myeloid Leukemia: Modern therapies, current challenges and future directions. Blood Reviews [Internet]. 2021 Mar;49:100825. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8563059/
National Library of Medicine. Adult Non-Hodgkin Lymphoma Treatment (PDQ®): Health Professional Version [Internet]. PubMed. Bethesda (MD): National Cancer Institute (US); 2002. Available from: https://www.ncbi.nlm.nih.gov/books/NBK66057/
Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, Rosinol L, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. Journal of Clinical Oncology [Internet]. 2015 Sep 10;33(26):2863–9. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4846284/
Kaur H, Palot Manzil FF. Nuclear Medicine PET/CT Lymphomas Assessment, Protocols, and Interpretation [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585116/
Ozkan E, Lacerda MP. Genetics, Cytogenetic Testing And Conventional Karyotype [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563293/
Barcelos MM, Santos-Silva MC. Molecular approach to diagnose BCR/ABL negative chronic myeloproliferative neoplasms. Revista Brasileira de Hematologia e Hemoterapia [Internet]. 201;33(4):290–6. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3415756/
An ZY, Zhang XH. Menin inhibitors for acute myeloid leukemia: latest updates from the 2023 ASH Annual Meeting. Journal of Hematology & Oncology [Internet]. 2024 Jul 19;17(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11264855/
Vishwasrao P, Li G, Boucher JC, Smith DL, Hui SK. Emerging CAR T Cell Strategies for the Treatment of AML. Cancers [Internet]. 2022 Feb 27;14(5):1241. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8909045/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Typhoid Vaccine: What is It, Types, When to Be Taken & Side Effects
Introduction
Typhoid fever is a serious (and potentially life-threatening) illness caused by the bacterium Salmonella Typhi that spreads primarily through contaminated food and water. Once inside the body, the bacteria rapidly multiply in the intestinal lymphoid tissue known as Peyer’s patches, and eventually enter the bloodstream, leading to infection (bacteraemia)1,2.
With increasing urbanisation, poor sanitation, and the growing threat of antibiotic-resistant strains, the global risk of typhoid is rising, especially in communities lacking clean water and proper hygiene1,2.
Given the public health threat posed by typhoid fever, vaccination plays a crucial role in prevention. This article explores the typhoid vaccine, what it is, the types available, when it should be administered, and its possible side effects, helping you make informed decisions about protection against this preventable disease.
What is the Typhoid Vaccine?
The typhoid vaccine is a preventive vaccine that provides immunity against the Salmonella Typhi bacterium, which is responsible for causing typhoid fever2,3.
The vaccine consists of either weakened live bacteria or inactive (killed) bacteria (alone or attached to a carrier protein). When the body is exposed to the bacteria or its antigens, it helps in developing long-lasting protection by stimulating the immune system to recognise and fight the bacteria if exposed in the future. While the vaccine does not treat active infection, it plays a critical role in preventing illness and reducing its spread3.
It is important to note that while the vaccine lowers the chances of getting sick, it doesn’t fully stop the bacteria from spreading (especially in people who carry it for a long time). So, while it helps reduce transmission, it doesn’t completely prevent it.
Not suitable for children <6years, people with compromised immune systems or certain medical conditions5.
Why Is the Typhoid Vaccine Important?
As of 2019, an estimated 9 million people contract typhoid each year, and approximately 110,000 die from the infection1. The disease disproportionately affects low- and middle-income countries, where access to clean water, proper sanitation, and healthcare may be limited2.
Vaccination plays a key role in reducing the risk of infection and preventing its transmission, which is especially crucial in areas with frequent outbreaks, improper sanitation, and rising antibiotic resistance. Moreover, by stimulating the body’s immune system to recognise and fight Salmonella Typhi, the vaccine lowers the chances of severe illness, complications, and death. It also helps protect vulnerable populations, making it an essential tool in the global fight against typhoid fever3.
Typhoid vaccine can help prevent typhoid infection, which is very common in a country like India. Outside food, contaminated and uncovered food, are all sources of typhoid, and eating street food is a common cause of infection. Thus, if one eats outside regularly, they should definitely take the typhoid vaccine.
The typhoid fever vaccine is recommended for individuals who are at a higher risk of exposure. These groups include:
Travelers to Endemic Areas: People visiting countries where typhoid fever is common (particularly parts of South Asia, Africa, and Latin America) should get vaccinated 1 to 2 weeks before travel2.
People Handling the Bacteria: Professionals who work in labs and may handle Salmonella Typhi bacteria as part of their research or diagnostic work are advised to receive the vaccine as a safety measure.
People Living in or Near Outbreak Zones: Individuals residing in communities where typhoid outbreaks have occurred, or where sanitation and water supply are poor, may also be advised to get vaccinated to help control the spread of the disease1,3.
Who Should Not Get the Vaccine?
While the typhoid fever vaccine is generally safe and effective, it may not be suitable for everyone. Individuals who should avoid or delay vaccination include:
People with Severe Allergic Reactions: Anyone who has had a severe allergic reaction (anaphylaxis) to a previous typhoid vaccine dose or any of its components should not receive it3.
Young Children: Age recommendations in young children may vary depending on the specific vaccine used. The oral typhoid vaccine is typically not recommended for children under 6 years of age, while the injectable vaccine is usually avoided in children under 2 years. The typhoid conjugate vaccine is however safe to be given from 6 months of age and is suitable for routine childhood immunization3.
Immunocompromised Individuals: People with weakened immune systems (such as those undergoing chemotherapy or taking immunosuppressive medications) should consult their doctor before taking the live oral vaccine. It is usually not recommended in these cases due to the risk of infection, especially the live oral typhoid vaccine3,4.
People with Certain Medical Conditions: Individuals with acute illness, gastrointestinal issues (for oral vaccine), or fever should postpone vaccination until they recover3,5.
Typhoid Vaccination During Pregnancy and in People with Weakened Immunity
Special consideration may be needed before receiving a typhoid vaccine during pregnancy or if you have a weakened immune system.
During Pregnancy
The typhoid vaccine is not routinely recommended during pregnancy but may be considered if the risk of exposure is high, such as when travelling to areas where typhoid is common.
If vaccination is considered necessary, injectable typhoid vaccines (Typhoid Conjugate Vaccine and Vi polysaccharide vaccine) are generally preferred after discussion with a healthcare professional16. The potential benefits and risks should be assessed on an individual basis.
The oral Ty21a vaccine is usually avoided during pregnancy because it contains a weakened form of the bacteria16.
People with Weakened Immunity
Individuals with weakened immunity due to medical conditions or treatments should consult their doctor before vaccination.
Injectable typhoid vaccines can generally be given safely, but the decision should be based on the person’s medical condition and treatment status17.
The oral Ty21a vaccine is usually not recommended because it contains live and weakened bacteria17.
Your doctor can help to determine the most suitable vaccine based on your health status and risk of exposure.
How is the Vaccine Given
The administration and preparation for all the typhoid fever vaccine types differ in certain aspects:
1. Typhoid Conjugate Vaccine
Method: Given as a single intramuscular injection3.
Currently typhoid vaccine is not part of NIS. The typhoid conjugate vaccine is available in India in the private sector and is being recommended to be included in India’s Universal immunization programme (UIP) in view of disease burden14.
Timing: Usually, a single typhoid vaccine dose; recommended to be taken at least 2 to 3 weeks before potential exposure (e.g., travel)5,6.
Booster: Currently, no routine booster is recommended, but guidelines may vary by country. However, for some types (like PedaTyph), a booster dose is recommended after 24 to 30 months6.
Approx. cost in India: ₹1,300 – ₹2,500 per dose
Where to get it: Available at hospitals and vaccination centres, including PharmEasy-partnered clinics
Timing: A 4-dose typhoid vaccine schedule, with one capsule taken on days 1, 3, 5, and 7. The last typhoid vaccine dose should be completed at least 1 week before exposure3,5.
Booster: Every 5 years for those at ongoing risk3.
Approx. cost in India: ₹2,000 – ₹3,500 for full course
Where to get it: Available at hospitals and vaccination centres, including PharmEasy-partnered clinics.
Note: Currently, IAP (ACVIP) immunisation guidance in India recommends Typhoid Conjugate Vaccines as the preferred option for routine prevention of typhoid fever15.
Effectiveness and Safety of the Typhoid Vaccine
Typhoid vaccines are generally effective and safe in preventing typhoid fever. They offer moderate protection, with an efficacy ranging from 50% to 85%, depending on the type of vaccine used7.
While they are not 100% protective, they significantly reduce the risk of infection, especially when combined with good hygiene and safe food and water practices.
Typhoid Conjugate Vaccine: Around 81 to 84% efficacy8
Vi Polysaccharide Vaccine: Around 55 to 65% efficacy9,10
Oral Ty21a Vaccine: Around 53 to 67% efficacy11,12
Vaccine protection may decline over time, particularly for the Vi polysaccharide and Ty21a vaccines, which may require booster doses for continued protection.
Possible Side Effects of Typhoid Vaccines
Most side effects of typhoid fever vaccines are mild and temporary. Common side effects include5:
For injectable vaccines:
Pain, redness, or swelling at the injection site
Low-grade fever
For oral vaccines:
Headache or tiredness
Diarrhoea
Nausea
Vomiting
Abdominal discomfort
Note: Allergic reactions like rash, itching, and swelling may rarely occur in all types of vaccines.
It’s important to seek medical advice at certain points related to typhoid vaccination and potential infection:
Before Travel: Consult a doctor at least 3 to 4 weeks (depending on the vaccine type as discussed above) before travelling to regions where typhoid is common5. This allows enough time to receive the appropriate vaccine and ensure protection. Along with vaccination, follow safe food and water practices while travelling. Prefer freshly cooked hot meals, avoid raw or cut fruits from outside, drink sealed bottled or boiled water, and maintain good hand hygiene.
After Vaccination: While side effects from typhoid vaccines are usually mild, you should see a doctor if you experience5:
Severe allergic reaction (difficulty breathing, swelling, rash)
High fever
Persistent gastrointestinal issues (especially after oral vaccine)
If Symptoms Appear Despite Vaccination: No vaccine offers 100% protection. If you develop symptoms like prolonged high fever, abdominal pain, fatigue, headache, constipation or diarrhoea, especially after travel to an endemic area, consult a doctor immediately2.
Note: Antibiotic-resistant typhoid is a growing concern, especially in South Asia, so prompt diagnosis and blood culture testing are crucial to ensure the right treatment13.
Typhoid vaccination is a simple yet powerful tool in preventing a potentially serious and life-threatening illness. It offers protection against Salmonella Typhi, the bacterium responsible for typhoid fever, which continues to affect millions of people globally each year.
Vaccines are especially important for travellers to high-risk regions, individuals living in or near outbreak areas, and those working in environments where exposure is more likely. While no vaccine provides complete immunity, typhoid vaccines significantly reduce the risk of infection and severe complications.
By getting vaccinated, you not only protect yourself but also help limit the spread of disease within communities, making typhoid prevention a shared responsibility and a vital part of public health.
What typhoid conjugate vaccines are available in India?
India currently offers two WHO-prequalified typhoid conjugate vaccines3: -Typbar-TCV® by Bharat Biotech -TyphiBev™ by Biological E Ltd
Can pregnant or breastfeeding women receive the typhoid vaccine?
Safety data is limited, but Vi polysaccharide vaccines and typhoid conjugate vaccines are considered to pose minimal risk and can be given if needed. However, the live oral Ty21a vaccine is not recommended during pregnancy due to potential risks3.
Besides vaccination, what other measures help prevent typhoid fever?
In addition to vaccination, safe food and water practices are crucial, such as eating thoroughly cooked food, peeling fruits before eating, and drinking only boiled, disinfected, or sealed bottled water. Handwashing before meals is also essential. In prevention of typhoid, WASH (Water, Sanitation, and Hygiene) interventions remain equally important to vaccination, especially in high-risk areas3.
Can the typhoid vaccine be given with other vaccines?
Yes, the typhoid vaccine can be safely administered alongside other routine vaccines3.
Should I inform my doctor about any medications before getting the typhoid vaccine?
Yes, it’s important to tell your vaccine provider if you are currently taking or have recently taken antibiotics or anti-malarial medications5.
What if I get typhoid symptoms even after vaccination?
While the vaccine greatly reduces the risk, no vaccine offers 100% protection. If you develop symptoms of typhoid fever after vaccination, it’s important to seek medical care immediately.
Bhandari J, Thada PK, Hashmi MF, et al. Typhoid Fever [Internet]. StatPearls Publishing; 2025 Jan; [updated 2024 Apr 19; cited 2025 Jun 17]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557513/
Van Camp RO, Shorman M. Typhoid Vaccine [Internet]. StatPearls Publishing; 2025 Jan; [updated 2024 Jul 1; cited 2025 Jun 17]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470571/
Tanrıöver MD, Akar S, Türkçapar N, Karadağ Ö, Ertenli İ, Kiraz S. Vaccination recommendations for adult patients with rheumatic diseases. Eur J Rheumatol. 2016 Mar;3(1):29-35. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5042271/
Patel PD, Patel P, Liang Y, Meiring JE, Misiri T, Mwakiseghile F, Tracy JK, Masesa C, Msuku H, Banda D, Mbewe M, Henrion M, Adetunji F, Simiyu K, Rotrosen E, Birkhold M, Nampota N, Nyirenda OM, Kotloff K, Gmeiner M, Dube Q, Kawalazira G, Laurens MB, Heyderman RS, Gordon MA, Neuzil KM; TyVAC Malawi Team. Safety and Efficacy of a Typhoid Conjugate Vaccine in Malawian Children. N Engl J Med. 2021 Sep 16;385(12):1104-1115. Available from: https://pubmed.ncbi.nlm.nih.gov/34525285/
Klugman KP, Koornhof HJ, Robbins JB, Le Cam NN. Immunogenicity, efficacy and serological correlate of protection of Salmonella typhi Vi capsular polysaccharide vaccine three years after immunization. Vaccine. 1996 Apr;14(5):435-8. Available from: https://pubmed.ncbi.nlm.nih.gov/8735556/
Klugman KP, Gilbertson IT, Koornhof HJ, Robbins JB, Schneerson R, Schulz D, Cadoz M, Armand J. Protective activity of Vi capsular polysaccharide vaccine against typhoid fever. Lancet. 1987 Nov 21;2(8569):1165-9. Available from: https://pubmed.ncbi.nlm.nih.gov/2890805/
Simanjuntak CH, Paleologo FP, Punjabi NH, Darmowigoto R, Soeprawoto, Totosudirjo H, Haryanto P, Suprijanto E, Witham ND, Hoffman SL. Oral immunisation against typhoid fever in Indonesia with Ty21a vaccine. Lancet. 1991 Oct 26;338(8774):1055-9. Available from: https://pubmed.ncbi.nlm.nih.gov/1681365/
Levine MM, Ferreccio C, Black RE, Germanier R. Large-scale field trial of Ty21a live oral typhoid vaccine in enteric-coated capsule formulation. Lancet. 1987 May 9;1(8541):1049-52. Available from: https://pubmed.ncbi.nlm.nih.gov/2883393/
Parry CM, Ribeiro I, Walia K, Rupali P, Baker S, Basnyat B. Multidrug resistant enteric fever in South Asia: unmet medical needs and opportunities. BMJ. 2019 Jan 22;364:k5322. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6340381/
Mogasale VV, Sinha A, John J, Farooqui HH, Ray A, Chantler T, Mogasale V, Dhoubhadel BG, Edmunds WJ, Clark A, Abbas K. Typhoid conjugate vaccine implementation in India: A review of supportive evidence. Vaccine X. 2024;17:100568. doi:10.1016/j.jvacx.2024.100568. Available from: https://www.sciencedirect.com/science/article/pii/S2590136224001414#:~:text=Abstract,Results
IAP Advisory Committee on Vaccines & Immunisation Practices. Typhoid fever [Internet]. Navi Mumbai (India): Indian Academy of Paediatrics; updated 2020 Jan 10 [cited 2026 Jun 18]. Available from: https://acvip.org/parents/columns/typhoid.php
Touchan F, Hall JD, Lee RV. Typhoid fever during pregnancy: case report and review. Obstet Med. 2009;2(4):161-163. doi:10.1258/om.2009.090020. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4989662/
Sztein MB, Salerno-Goncalves R, McArthur MA. Complex adaptive immunity to enteric fevers in humans: lessons learned and the path forward. Front Immunol. 2014;5:516. doi:10.3389/fimmu.2014.00516. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4209864/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
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1
Pneumococcal Vaccine: Types, Side Effects, and Who Needs It
Introduction
Pneumonia is a broad term that refers to lung infections caused by various organisms, including bacteria, viruses, and fungi1. Normally, the lungs contain tiny air sacs called alveoli that fill with air during breathing. In pneumonia, these alveoli become inflamed and filled with pus and fluid. This makes breathing difficult and reduces oxygen intake2.
The infection typically spreads when a person breathes in respiratory droplets or accidentally inhales secretions from the mouth or throat (when an infected person coughs or sneezes)2. Pneumonia can range from mild to life-threatening, with the highest risk seen in infants, older adults, individuals with weakened immune systems, patients with chronic illness (such as diabetes), smokers, and patients on ventilators1,3.
Fortunately, pneumonia (when caused by bacteria) can be prevented with vaccines. In this article, we will explore what pneumococcal vaccines are, how they work, and who should receive them.
What Is Pneumococcal Vaccine?
As mentioned, pneumonia is a respiratory infection caused by bacteria, fungi or viruses. More commonly, it occurs due to infection with the bacteria Streptococcus pneumoniae (also known as pneumococcus). Infection with this organism can lead to serious illnesses such as pneumonia, sinusitis, ear infections (otitis media), and meningitis. These infections remain a significant cause of illness and death, even in high-income countries4.
More than 90 distinct pneumococcal serotypes have been identified, and while many are capable of causing illness, only a subset is responsible for the majority of severe and invasive pneumococcal diseases5.
Pneumococcal vaccines help prevent these infections in the body by developing immunity against them. These vaccines contain parts of the bacteria (specifically capsular polysaccharides) either alone or linked to a carrier protein, which trigger the immune cells to produce antibodies that fight against specific pneumococci strains. Let us discuss about this in detail in the next section.
How Do Pneumococcal Vaccines Work?
Pneumonia or Pneumococcal vaccines help the body develop active immunity by training the immune system to recognise and combat certain serotypes of Streptococcus pneumoniae bacteria. There are two types of pneumococcal vaccines currently in use, which include:
Conjugated vaccines (PCV): These use a carrier protein to attach to the bacterial capsular polysaccharides and enable the body to produce both B-cell and T-cell immune responses. This results in longer-lasting immunity.PCV can help reduce bacteria in the nose and throat (nasopharyngeal carriage), which lowers the risk of spreading the infection (polysaccharide vaccines (PPSV) does not have this effect)6,7.
Unconjugated or Polysaccharide vaccine (PPSV): This consists of the polysaccharide alone and produces a weaker and shorter-lasting immune response than PCVs because it triggers B-cell responses without the help of T-cells, which means it doesn’t create long-term immune memory. As a result, PCVs provide stronger and more lasting protection. However, PPSV covers more serotypes than PC vaccines6.
After vaccination, the immune system generates targeted antibodies against the specific pneumococcal serotypes present in the vaccine, helping to protect the body from future infections caused by those strains.
Types of Pneumococcal Vaccines
Pneumococcal vaccines are available in two main formulations: PCV and PPSV. Let us see how they differ in covering different serotypes.
Covers 23 serotypes, such as 1, 2, 4, 3, 5, 6B, 7F, 8, 9N and 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19A and 19F, 20, 22F, 23F, and 33F.
Often administered after a conjugate vaccine (with PCV 13 or 15) to enhance coverage and boost memory immunity which is not possible with PPSV23 alone3,8.
Note:
PCVs are routinely given to children under 5 and to older children or adults with certain health conditions, including all adults ≥65 years8.
PPSV23 is recommended for children aged 2 to 18 with specific medical risks and for adults as a follow-up to PCV15 or based on prior vaccination status8.
As per recent Centers for Disease Control and Prevention/Advisory Committee on Immunization Practices (CDC/ACIP) guidelines:
Adults ≥65 years and those 19 to 64 with certain risk factors (e.g., immunocompromised) should receive either:
PCV20 alone (no PPSV23 needed), or
PCV15 followed by PPSV23
1 year later in healthy (immunocompetent) individuals
8 weeks later in high-risk/immunocompromised individuals
PPSV23 may also be given in previously vaccinated individuals to address timing or coverage gaps3.
It’s best to consult a doctor to determine the appropriate vaccine and schedule based on age, health status, and medical history.
Accoding to the new regime, PCV20 are recommended for adults also: Above 50 years: 1 dose of PCV20 only, At-risk: 1 dose of PCV20 only, High-risk: 1 dose of PCV20 only13.
Clinical studies have demonstrated strong immune responses and significant protection against vaccine-covered serotypes9,10. Top pneumococcal vaccine uses include:
Reducing the risk of severe pneumonia and invasive pneumococcal diseases (bacterial origin)3. This may lead to reduced hospitalisations and deaths.
PCVs reduce bacterial carriage in the nasopharynx, which helps lower transmission rates within communities11.These vaccines induce robust and long-lasting immune responses due to T-cell involvement.
PPSV23 offers broad coverage against numerous serotypes and effectively prevents serious infections in adults (although short lived)3,6.
Overall, widespread vaccination has led to a marked decline in pneumococcal infections globally and continues to be a critical tool in preventing pneumonia and its complications.
Adults aged 19 to 64 years should only get vaccinated if they have specific health risks (such as chronic illnesses, immunocompromised status, or lifestyle factors)3,12.
Who Shouldn’t Get the Pneumococcal Vaccine?
Some individuals may need to avoid pneumococcal vaccination or should first consult their doctor. The CDC recommends avoiding or delaying vaccination in the following conditions.
For PCV15, PCV20, or PCV21:
History of a life-threatening allergic reaction to any PCV.
Severe allergy to any vaccine containing diphtheria toxoid (e.g., DTaP).
Known severe allergy to any other component of the PCV vaccines8.
For PPSV23:
Children younger than 2 years old.
History of a life-threatening allergic reaction to PPSV23 (a previous dose).
Known severe allergy to any ingredient in PPSV238.
Tip: Always talk to a doctor about your vaccination history, allergies, and medical conditions before getting vaccinated.
More patients above age of 50 years are becoming aware of pneumococcal vaccination, and recent trends in India show a steady rise in both interest and uptake, though there’s still a big need for continued awareness and counselling. Myths like those for COVID vaccines (that they cause heart attacks) should not be considered for pneumococcal vaccines.
Most pneumococcal vaccine side effects are mild and temporary. They may vary slightly by vaccine type and age group3:
Injection Site Reactions: Pain, redness, swelling, tenderness, or hardness at the site of injection (commonly reported across all age groups for PCV13, PCV15, PCV20, and PPSV23).
General Symptoms: Fatigue, headache, muscle pain (myalgia), joint pain (arthralgia), and low-grade fever may occur.
Less Common Reactions: Vomiting, chills, rash, and limited arm movement may occasionally occur, especially in adults after PCV13.
These side effects typically resolve on their own. If severe or persistent symptoms occur, it’s important to consult a healthcare provider.
The pneumococcal vaccine plays a vital role in protecting individuals (especially young children, older adults, and those with certain health conditions) from serious and potentially life-threatening infections caused by Streptococcus pneumoniae. Pneumococcal vaccine uses conjugate and polysaccharide formulations to build immunity against multiple strains of the bacteria, significantly reducing the risk of severe pneumonia, hospitalisations, and complications such as meningitis and bloodstream infections.
Widespread vaccination not only safeguards individual health but also helps reduce the spread of pneumococcal disease within communities, making it an essential part of public health protection!
Is pneumococcal vaccination safe during pregnancy?
Safety data on PCV15 and PCV20 during pregnancy is limited. However, PPSV23 is recommended for pregnant patients with certain health conditions like diabetes and heart disease3.
Where can I get the pneumococcal vaccine?
For children, pneumococcal vaccines are available at paediatric or family doctor offices, community clinics, and public health departments. Adults can get vaccinated at a doctor’s office, pharmacies, federally funded health centres, or local health departments12.
How long does immunity from pneumococcal vaccines last?
Immunity develops about 2 to 3 weeks after vaccination and generally lasts around 5 years, but children and older adults may need re-immunisation sooner3.
How are pneumococcal vaccines administered?
PCV13, PCV15, and PCV20 are given as intramuscular (IM) injections, usually in the upper arm muscle for adults and older children, and the thigh muscle for infants; PPSV23 can be given IM or subcutaneously3.
References
Jain V, Vashisht R, Yilmaz G, Das S. Pneumonia Pathology [Internet]. StatPearls Publishing; 2025 Jan; [updated 2023 Jul 31; cited 2025 Jun 6]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526116/
Tereziu S, Minter DA. Pneumococcal Vaccine [Internet]. StatPearls Publishing; 2025 Jan; [updated 2023 Mar 20; cited 2025 Jun 6]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507794/
Pletz MW, Maus U, Krug N, Welte T, Lode H. Pneumococcal vaccines: mechanism of action, impact on epidemiology and adaption of the species. Int J Antimicrob Agents. 2008 Sep;32(3):199-206. Available from: https://pubmed.ncbi.nlm.nih.gov/18378430/
Wantuch PL, Avci FY. Current status and future directions of invasive pneumococcal diseases and prophylactic approaches to control them. Hum Vaccin Immunother. 2018;14(9):2303-2309. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6183136/
Golos M, Eliakim‐Raz N, Stern A, et al. Conjugated pneumococcal vaccine versus polysaccharide pneumococcal vaccine for prevention of pneumonia and invasive pneumococcal disease in immunocompetent and immunocompromised adults and children. Cochrane Database Syst Rev. 2019 Feb 20;2019(2)S:CD012306. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6381862/
Kim YK, LaFon D, Nahm MH. Indirect Effects of Pneumococcal Conjugate Vaccines in National Immunization Programs for Children on Adult Pneumococcal Disease. Infect Chemother. 2016 Dec;48(4):257-266. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5204004/
Centers for Disease Control and Prevention. Types of Pneumococcal Vaccines [Internet]. Centers for Disease Control and Prevention; [cited 2025 Jun 6]. Available from: https://www.cdc.gov/pneumococcal/vaccines/types.html
Nakafero G, Grainge MJ, Card T, et al. Effectiveness of pneumococcal vaccination in adults with common immune-mediated inflammatory diseases in the UK: a case-control study. Lancet Rheumatol. 2024 Sep;6(9):e615-e624. Available from: https://pubmed.ncbi.nlm.nih.gov/39067457/
Dunne EM, Cilloniz C, von Mollendorf C, et al. Pneumococcal Vaccination in Adults: What Can We Learn From Observational Studies That Evaluated PCV13 and PPV23 Effectiveness in the Same Population? Arch Bronconeumol. 2023 Mar;59(3):157-164. English, Spanish. Available from: https://pubmed.ncbi.nlm.nih.gov/36681604/
Kahn R, Moiane B, Lessa FC, et al. Nasopharyngeal carriage of Streptococcus pneumoniae among children and their household members in southern Mozambique five years after PCV10 introduction. Vaccine. 2025 Feb 15;47:126691. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11797556/
Centers for Disease Control and Prevention. Pneumococcal Vaccination [Internet]. Centers for Disease Control and Prevention; [cited 2025 Jun 6]. Available from: https://www.cdc.gov/pneumococcal/vaccines/index.html
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
