Medical News Today: How do you treat an allergic reaction?

Allergies are a common cause of illness and can occur at any stage in someone’s life. Numerous different things cause allergies from pollen to food to medication, meaning it is not always easy to know the best treatments or home remedies.

According to the Centers for Disease Control (CDC), more than 50 million Americans experience an allergic reaction each year, and the best treatment will depend on the cause and severity of the reaction.

In this article, we take a close look at a range of treatments for allergic reactions, depending on a person’s symptoms and their severity, including anaphylaxis.

What is an allergic reaction?

Woman outdoors with common allergic reaction blowing her nose.
Many people have allergies, which may cause symptoms such as coughing and sneezing.

An allergic reaction occurs when cells in the immune system interpret a foreign substance or allergen as harmful.

The immune system overreacts to these allergens and produces histamine, which is a chemical that causes allergy symptoms, such as inflammation, sneezing, and coughing.

Mild allergic reactions can usually be treated with home remedies and over-the-counter (OTC) medications.

However, chronic allergies need treatment from a medical professional. Severe allergic reactions always require emergency medical care.


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Treating allergic reactions

Many mild to moderate allergic reactions can be treated at home or with OTC medications. The following treatments are commonly used to reduce the symptoms of an allergic reaction:

Antihistamines

Antihistamines can help to treat most minor allergic reactions regardless of the cause. These drugs reduce the body’s production of histamine, which reduces all symptoms, including sneezing, watering eyes, and skin reactions.

Second-generation antihistamines, including Claritin (loratadine) and Zyrtec (cetirizine), are less likely to cause drowsiness than first-generation antihistamines, such as Benadryl.

Antihistamines come in several forms, usually to help deliver the medication closer to the source of the reaction or make it easier to consume, such as:

  • oral pills
  • dissolvable tablets
  • nasal sprays
  • liquids
  • eye drops

Antihistamines in these forms are available from pharmacies, to buy online, or on prescription from a doctor.

Antihistamines can also be taken to prevent allergies. Many people with seasonal or pet allergies will begin taking antihistamines when they know they are going to be exposed to an allergen.

A person who is pregnant or has a liver disorder should consult their doctor before taking antihistamines.

Nasal decongestants

Nasal decongestant pills, liquids, and sprays can also help reduce stuffy, swollen sinuses and related symptoms, such as a sore throat or coughing.

However, decongestant medications should not be taken continuously for more than 72 hours.

Nasal decongestants are available over the counter and online.

Anti-inflammatory medication

Non-steroidal anti-inflammatory medications (NSAIDs) may also be used to help temporarily reduce pain, swelling, and cramping caused by allergies.

Avoid the allergen

The best way to treat and prevent allergic reactions is to know what triggers the reaction and stay away from it, especially food allergens.

When this is not possible or realistic, using antihistamines or decongestants when in contact with allergens can help to treat the symptoms.

Use a saline sinus rinse

A sinus rinse being used by man.
A saline sinus rinse may treat symptoms such as a runny or itchy nose.

When allergies cause sinus problems, the American Academy of Allergy, Asthma & Immunology (AAAAI) recommend a person rinse their sinuses with saline. This can remove allergens and clear the airways.

The AAAAI recommend the following saline recipe:

  • mix 3 teaspoons of salt (without iodide) with 1 teaspoon of baking soda
  • add 1 teaspoon of this mixture to 8 ounces of boiled water
  • dissolve the mixture in the water then use as a saline rinse

Sinus rinsing devices can be purchased online or from a pharmacy.

Treating environmental allergies

For airborne allergens, such as pollen, dust, and mold spores, additional treatment options include:

  • throat lozenges with soothing ingredients, such as menthol, honey, or ginger
  • shower and wash all clothing after being exposed to an allergen
  • exercise for a few minutes to help reduce nasal congestion

Treating allergies on the skin

For allergic reactions that cause skin symptoms, including those associated with allergens found in animal saliva, poisonous plants, drugs, chemicals and metals, additional treatment options include:

  • Topical corticosteroid creams or tablets. Corticosteroids contain steroids that reduce inflammation and itching. Mild forms of these creams can be found online, and a doctor can prescribe stronger versions.
  • Moisturizing creams. Emollient creams with soothing ingredients, such as calamine can treat skin reactions.
  • Bite or sting medication. Medication targeted to reduce allergic reactions to insect bites or stings have a similar effect to other allergy medications.
  • Ice pack. Applying an ice pack wrapped in cloth to the area for 10- to 15-minute intervals can reduce inflammation.

Treating severe allergies

People should speak to a professional if they have or suspect that they have severe or chronic allergies.

A doctor or allergy specialist can prescribe medications that contain much stronger doses of the compounds found in OTC products.

Treatment options for chronic or severe allergies include:

  • Immunotherapy, or allergy shots. Immunotherapy can be between 90 and 98 percent effective at reducing allergic reactions to insect stings, for instance.
  • Prescription asthma medications, such as bronchodilators and inhaled corticosteroids.
  • Oral cromolyn can be taken for food allergies.
  • Drug desensitization therapy is used for specific allergens.

Natural remedies for allergic reactions

Many traditional medicine systems use herbal supplements and extracts to both treat and prevent allergic reactions, especially seasonal allergies.

Though there is little scientific evidence to support the use of most alternative or natural remedies, some people may find that some can provide relief from their symptoms.

The American Association of Naturopathic Physicians recommend the following natural treatments for allergies:

  • Dietary changes. A low-fat diet high in complex carbohydrates, such as beans, whole grains, and vegetables may reduce allergy reactions.
  • Bioflavonoids. These plant-based chemicals found in citrus fruits and blackcurrants may act as natural antihistamines. These can also be taken as supplements.
  • Supplements. Flaxseed oil, zinc, and vitamins A, C, and E are suggested to improve allergy symptoms.
  • Acupuncture. Acupuncture treatments may help some people to find relief from their symptoms.


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Identifying and treating anaphylaxis

Epi-pen on pack.
An EpiPen is designed to treat anaphylaxis, and should be used at the first sign of a severe allergc reaction.

A very severe allergic reaction can lead to a condition called anaphylaxis, or anaphylactic shock.

Anaphylaxis occurs when the body’s immune response to an allergen is so severe and sudden that the body goes into a state of shock.

Anaphylaxis can impact multiple organs and if left untreated lead to coma, organ failure, and death.

The early symptoms of anaphylaxis can be fairly mild and similar to those of minor to moderate allergic reactions, but they often rapidly worsen.

Symptoms unique to anaphylaxis include:

  • unexplained anxiety
  • tingling in the palms of the hand, soles of the feet, and lips
  • swollen tongue, throat, mouth, and face
  • difficulty breathing
  • rapid but weak pulse
  • low blood pressure
  • sense of dread or doom
  • vomiting or diarrhea
  • confusion or disorientation
  • loss of consciousness
  • very pale or blue skin
  • a heart attack

Anyone who suspects anaphylaxis should call 911 and seek emergency medical care.

If the person carries an EpiPen, which is a self-injectable dose of epinephrine that is designed to treat anaphylaxis, inject this into their thigh, as soon as possible.

First aid for anaphylaxis includes:

  • try to keep the person calm
  • the person may vomit, so turn them on their side and keep their mouth clear
  • try to get the person to lay flat on their back with their feet raised about a foot above the ground
  • make sure the person’s clothing is loose or remove constricting clothing
  • do not give them anything to drink or eat, even if they ask for it
  • if they are not breathing, practice CPR with around 100 firm chest compressions every minute until emergency services arrive

If a person does not have an EpiPen, a doctor or paramedic will give an injection of the hormone epinephrine, or adrenaline. This will immediately increase the output of the heart and blood flow throughout the body.

A person should seek medical care each time anaphylaxis occurs. Even if they start to feel better or their symptoms go away, a second severe allergic reaction can occur up to 12 hours after the initial response.

Allergy symptoms

The symptoms associated with an allergic response depend on the specific allergen, how severe the allergy is, and whether a person has touched, swallowed, or inhaled the allergen.

Not everyone responds the same way to each allergen. But there are similar sets of symptoms most people experience when exposed to specific allergens.

Common symptoms associated with different type of allergens include:


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Outlook

Many people experience allergic reactions when they are exposed to specific allergens, ranging from pet dander and pollen to compounds in foods, drinks, and personal hygiene products.

The best way to treat an allergic reaction depends on the cause, though most minor cases can be treated with OTC antihistamine and anti-itch products.

A person should seek immediate medical attention for chronic or severe allergic reactions, especially those that involve swelling of the throat or changes in heart rate. Anaphylaxis should always be treated as a medical emergency.

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Medical News Today: Why does my urine smell like coffee?

A person’s urine can indicate a lot about their health. Changes in the smell of urine most often reflect a person’s diet, but medications, pregnancy, and some medical conditions can also affect the odor and color of urine.

The kidneys produce urine, and the urinary system helps the body to remove waste and regulate the volume and composition of blood. The waste that comes out in urine can affect its color and odor.

The most common reason for a person’s urine to smell like coffee is that they have simply drunk too much coffee.

In this article, we look at why this occurs. We also describe other possible causes of urine that smells like coffee and several ways to get rid of the odor.

Causes

Too much coffee can make urine smell like coffee
If someone drinks a lot of coffee, their urine may contain enough chemical compounds to make it smell like coffee.

Urine is mostly water, so healthy urine should be pale and usually odorless. Waste products give urine its color, smell, and appearance. These products may include:

  • digested, or metabolized, material from food and drinks
  • toxins or allergens that a person has breathed in
  • hormones and other bodily chemicals
  • drugs or medications

Below are some reasons that urine may smell like coffee:

Drinking too much coffee

Coffee contains more than 1,000 chemical compounds that contribute to its flavor, smell, and appearance. Antioxidants called polyphenols are primarily responsible for the smell of coffee.

The polyphenols in coffee are absorbed by the digestive tract and put to use, then broken down and excreted in urine. So, if someone drinks a lot of coffee, their urine may contain a high enough concentration of polyphenols and other coffee compounds. This will make it smell like coffee.

Coffee also contains a stimulant, caffeine, which increases the rate of urination and can lead to dehydration. When a person is dehydrated their urine is more concentrated, so it contains less water and more waste products than usual.

It is possible to overdose on caffeine, though this is rare. The following symptoms may indicate that a person has overdosed and should seek medical advice:

  • vomiting
  • confusion or disorientation
  • chronic insomnia
  • chronic headaches
  • chest pains
  • an irregular or fast heartbeat
  • difficulty breathing
  • convulsions
  • hallucinations

Dehydration

When the body is dehydrated, urine becomes more concentrated. It will smell stronger and appear darker than healthy urine, which is pale or clear.

If someone becomes dehydrated after drinking too much coffee, or if they drink coffee while otherwise dehydrated, their urine will often smell like coffee.

Certain foods and drinks

Several foods and beverages cause the urine to have an unusual smell or appearance. These odors can have varied characteristics, and conditions like the common cold and pregnancy can affect a person’s sense of smell.

Foods that change the smell of urine include:

  • asparagus
  • garlic
  • leafy greens, especially kale
  • salmon
  • teas
  • alcohol
  • puffed wheat
  • spicy foods that contain capsaicin, an active compound in chili peppers

Other conditions

No potentially severe health conditions, except dehydration, are associated with urine that smells like coffee.

However, people interpret smells differently. It may be easy to mistake a smell that indicates a problem for the smell of coffee, which is often more familiar.

The following medical conditions can cause changes in the odor of urine, or an altered sense of smell:

  • nasal congestion
  • a burnt tongue or mouthinflammation or infection of the bladder or urinary tract can cause urine to smell strong or foul
  • metabolic and liver disorders are associated with musty-smelling urine
  • kidney failure and disease are associated with dark, stronger-smelling urine
  • uncontrolled or untreated type 2 diabetes is associated with sweet-smelling or pungent urine
  • maple syrup urine disease causes urine to smell very sweet, similar to burnt caramel
  • bladder fistulas are associated with urine that smells like feces or gas


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Urine odor and pregnancy

Urine smells differently during pregnancy
A woman’s urine can smell different during pregnancy, and this is often caused by urinary tract infections (UTIs).

Women often report that their urine smells differently at various stages of pregnancy. This may be caused by frequent urinary tract infections (UTIs), hormonal changes, or dehydration.

Below is more information on why urine can smell different during pregnancy:

UTIs

Many pregnant women develop infections in the bladder or urinary tract during pregnancy, and these can lead to strong- or foul-smelling urine.

UTIs are especially common in weeks 6 to 24 of pregnancy.

Many women with UTIs also notice:

  • cloudy urine
  • more frequent urination
  • pain or cramps in the lower abdomen
  • pain and burning when urinating

The bacteria involved in UTIs can spread to the kidneys and other pelvic organs if left untreated. Pregnant women who experience lower back pain, nausea, vomiting, chills, or a fever should seek medical attention and treatment.

Human chorionic gonadotrophin (hCG)

During the first few weeks of pregnancy, the levels of the hormone hCG in a person’s blood rise rapidly. Many people report that this changes the smell of their urine.

Heightened sense of smell

Some research has shown that people tend to have a heightened sense of smell during their first trimester of pregnancy. A person may notice the smell of waste products in their urine, including byproducts of coffee, more than usual.

Increased urination

The kidneys and bladder also change during pregnancy. The kidneys work 50 percent harder, and this causes a person to urinate more often, making it easier for them to become dehydrated.

Many pregnant people also experience altered kidney function. This involves an increased number of nutrients and electrolytes being excreted in the urine, which can alter the smell.


Treatment

The best way to eliminate the smell of coffee in urine depends on the cause. Often the most effective way to do so is to reduce coffee consumption.

People who drink more than 4 cups of coffee a day are more likely to excrete the compounds in the drink without absorbing them. For these people it is a good idea to drink more water, to balance the intake of caffeine.

If other foods or drinks are affecting the smell of urine, it is a good idea to avoid or limit consumption.

If an underlying medical condition may be causing the smell, seek medical treatment.


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Outlook

It is not uncommon for urine to smell like coffee if a person has drunk too much coffee or had any while dehydrated.

Some conditions, such as uncontrolled type 2 diabetes and bladder infections, can give urine an odor that may be mistaken for coffee.

Consult a doctor if urine that smells like coffee is accompanied by:

  • pain, burning, or discharge when urinating
  • an increase in the urge to urinate
  • a reduced rate of urination
  • swelling and pain in the lower abdomen
  • pain in the lower back
  • nausea, vomiting, and diarrhea
  • fever or chills
  • flu-like symptoms that last longer than two weeks

If a person suspects that their diet is not responsible for foul- or very strong-smelling urine, it is a good idea to speak with a doctor.

While rare, it is possible to overdose on caffeine. Too much caffeine can make a person shaky, restless, and anxious. Seek medical attention for symptoms of severe caffeine overdoses.

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Medical News Today: Personalized vaccine fights off cancer in clinical trial

In the latest foray into personalized medicine, scientists design tumor vaccines specific to each patient’s tumor. Although the technology is in its infancy and the trial is small-scale, the findings are incredibly promising.
Scientist in a lab
Scientists recently designed a new, personalized tumor vaccine.

Over recent years, there have been various attempts to produce anti-cancer vaccines.

Most of these efforts have focused on designing a vaccine that recognizes a generic target on a tumor.

This method ensured that the vaccine would be able to attack most tumors, but it also meant that it lacked specificity — every tumor is different.

Recently, researchers set out to design a vaccine that is much more patient-specific. They attempted to tailor a vaccine to specifically match the patient’s individual disease.

The research took place across a range of institutions, including the University of Pennsylvania in Philadelphia and the Lausanne Branch of the Ludwig Institute for Cancer Research in Switzerland.

The team concentrated on people with advanced ovarian cancer, a particularly difficult cancer to manage; treatment normally involves surgery followed by chemotherapy and, although there is often a good response initially, patients tend to relapse and become resistant to treatment.

Though the study only set out to determine whether such a personalized treatment was possible and safe, the results were positive and the authors believe that the technology has enormous potential.

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Creating a personalized tumor vaccine

Each tumor has its own set of mutations, making it unique. The vaccine designed by the team was a so-called whole-tumor vaccine. This means that rather than targeting just one region of the tumor, it attacks hundreds, or even thousands, of sites.

Lead study author Dr. Janos L. Tanyi explains, “The idea is to mobilize an immune response that will target the tumor very broadly, hitting a variety of markers including some that would be found only on that particular tumor.”

Naturally, T cells mount an immune response against tumors, but this vaccine heightens their attack and helps them to overcome the cancer’s robust defenses. The team’s results were published this week in the journal Science Translational Medicine.

To create these vaccines, Dr. Tanyi and team pored over the immune cells present in the patients’ blood. They were on the lookout for precursor cells that they could extract and grow in the laboratory. From these, they developed a population of dendritic cells.

Dendritic cells are messengers, of sorts, in that they consume antigen material (in this case, parts of a tumor) and present it to T cells to spark a response.

The dendritic cells were taken from the patients’ blood and then introduced to extracts of their tumors and activated with interferon gamma, which is a chemical that is critical in the immune response. Finally, they were injected into the patients’ lymph nodes.

This procedure was carried out on 25 patients. Each participant received a dose of the carefully harvested dendritic cells every 3 weeks. Some participants continued this regimen for 2 years.

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Promising results warrant further work

Approximately half of the patients who could be evaluated experienced a significant increase in the number of T cells reactive to the tumor material. These “responders” tended to survive longer with no tumor progression, when compared with non-responders.

The 2-year overall survival rate of these responder patients was 100 percent, whereas the rate for non-responders was just 25 percent.”

Dr. Janos L. Tanyi

One participant — a 46-year-old — had already received five courses of chemotherapy for ovarian cancer before the pilot study began. At the start of the trial, her cancer was classed as stage 4. Ovarian cancer is notoriously difficult to treat, and at stage 4, the 5-year survival rate is just 17 percent.

In this study, the patient received 28 doses of personalized vaccine, spread over 24 months. She remained cancer-free for 5 years.

The results are impressive, given the type and severity of cancer being treated, but it is important to remember that this is a pilot study and much more research will be needed.

“This vaccine,” explains Dr. Tanyi, “appears to be safe for patients, and elicits a broad anti-tumor immunity — we think it warrants further testing in larger clinical trials.”

There is a great deal of ongoing research that is looking at the body’s immune response to cancer and how it might be enhanced. To date, though, these efforts have had mixed results because tumors have an impressive suite of defensive techniques.

Dr. Tanyi believes that this vaccine might be particularly successful if it is paired with other drugs that weaken the tumor’s ability to fight the immune system.

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Medical News Today: Seven causes of a green tongue

It is common to have a green tongue after eating or drinking something with green food coloring, but an unexplained color change can be a sign of an underlying issue.

An infection or overgrowth of certain germs is often the cause of a green tongue, though there are other causes as well. Symptoms of a green tongue will usually go away after treating the underlying condition.

In this article, we look at conditions that cause a green tongue, treatment options, and when to see a doctor.

Causes

Several conditions may cause a green tongue, including:

1. Oral thrush

Woman with green tongue being inspected by dentist or doctor.
Oral thrush may cause discoloration of the tongue.

In some cases, a buildup of germs or poor oral hygiene may lead to a Candida infection.

Candida albicans is a naturally-occurring yeast that is usually balanced by other bacteria. Oral thrush occurs when this yeast grows uncontrolled in the mouth and on the tongue.

Oral thrush usually gives the tongue a whitish or off-white appearance, but that may change to green over time, depending on how the infection develops. Oral thrush also causes:

  • bumps or changes in texture on the tongue or tonsils
  • pain in the mouth
  • difficulty or pain while swallowing
  • bleeding from the bumps if scraped by food, teeth, or a toothbrush

Oral thrush commonly occurs in infants who are breast-feeding. It can cause a similarly discolored tongue, as well as symptoms including irritability and difficulty feeding.

2. Leukoplakia

Leukoplakia causes a white patch in the mouth or on the tongue, which may become green or discolored over time. Leukoplakia is often linked to alcohol or tobacco use.

Leukoplakia is typically painless and harmless. Doctors will still want to monitor it regularly as leukoplakia may turn cancerous in some cases.

3. Hairy tongue

Hairy tongue is a harmless condition that causes the tongue’s texture and appearance to change. It occurs because of a buildup of keratin cells, which are the proteins that also make up human hair. This buildup can give the tongue a rough, hairy texture.

This rough surface also provides an excellent area for bacteria and fungi to multiply, which could also cause a green tongue.

Hairy tongue is more common in older people than other people, though it can occur at any age. Hairy tongue may cause other symptoms, including:

  • an odd taste on the tongue
  • a tickling or gagging sensation that may get worse when swallowing
  • bad breath
  • difficulty tasting food or changes in the taste buds

Factors that contribute to hair tongue include poor oral hygiene, the use of certain medications, such as antibiotics, or tobacco and caffeine.

4. Geographic tongue

geographic tongue pattern image credit martanopue 2012
Geographic tongue may cause unusual patterns and colors on the tongue.
Image credit: Martanopue, 2012

Geographic tongue is a harmless condition that causes irregular blotches to appear on the tongue. These blotches often appear as a dark red spot with a raised white border at first, but they may change color over time.

These lesions may also change shape or location over time and can disappear and reappear often.

Geographic tongue may cause other symptoms, such as a burning sensation in the mouth or discomfort while eating, especially when eating spicy or acidic foods.

The tongue may also become very sensitive to chemicals in oral products and tobacco smoke.

5. Lichen planus

Lichen planus is a disorder of the immune system that can cause a rash on and discoloration of the tongue. The tongue typically turns whitish but may develop a green tint if bacteria or fungi start to grow. Some oral products, foods, and beverages may also be responsible for the color change.

Lichen planus may also cause white lesions in the mouth, which can change color depending on what foods a person has eaten and whether bacteria start to multiply. These lesions may be painful and often cause a burning sensation in the mouth.

6. Syphilis

Syphilis is a bacterial infection that can be sexually transmitted or passed on from a mother to child during pregnancy.

If a person contracts syphilis from oral sex, they may develop a sore on the tongue that may change color over time. If left untreated, multiple sores may appear in the mouth. Doctors usually prescribe penicillin to treat syphilis.

7. Oral cancer

Although it is much rarer than an oral infection, oral cancer may also cause similar symptoms. One sign of oral cancer is an open sore or lesion on the tongue that does not heal.

This sore may change color depending on the oral products a person uses and the foods and beverages they consume, or if bacteria start to collect.

Oral cancer often causes other symptoms as well, including:

  • a growth or uneven area on the tongue
  • persistent tongue pain
  • bleeding on the tongue or gums with no known cause
  • loose teeth
  • unexplained weight loss
  • colored patches on the tongue that may be green, white, or pinkish
  • numbness or tingling sensation in the lips, chin, or neck
  • a persistent sore throat or jaw pain

Other causes

Other possible causes for a green tongue include:

  • poor dental hygiene
  • antibiotics
  • throat or upper respiratory infection that spreads to the tongue
  • discharge from an infected tongue piercing
  • illicit drug use
  • temporary color changes caused by food coloring in candy, sweets, or oral hygiene products
  • temporary color changes caused by supplements or foods containing chlorophyll


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Diagnosis

Sometimes, a doctor can diagnose causes of a green tongue with a simple visual examination. A doctor will also ask a person about their symptoms and may look for other signs of an infection.

A biopsy is often only necessary if a doctor suspects that there is a chance of cancer somewhere on the tongue. They may also use one or more imaging tests to see if cancer cells have spread.

Treatment

Medication in packets in pharmacy
Treatment for green tongue usually involves taking prescribed medication.

Treatment for a green tongue will vary depending on the underlying cause. Doctors may recommend antibiotics if they are confident the green tongue is caused by bacteria.

If a doctor suspects a fungal infection, they may recommend antifungal medications, such as nystatin, fluconazole, or clotrimazole.

Oral leukoplakia may be treated with vitamin A or retinoids, but treatment does not always resolve symptoms.

Antihistamines or corticosteroids can help treat inflammation in the tongue or mouth. Over-the-counter pain relievers, such as ibuprofen (Advil) or acetaminophen (Tylenol), may also provide some relief, depending on a person’s symptoms.

Treatment for oral cancer treatment varies between individuals and may include nutritional changes, chemotherapy, and surgery.

In all cases of green tongue, proper oral hygiene is essential to support treatment efforts. Steps a person can take to encourage healing include:

  • brushing teeth and tongue regularly
  • flossing daily to reduce bacteria in the mouthbrushing and flossing gently to avoid causing any cuts in the mouth
  • avoiding mouthwashes that contain harsh chemicals or high alcohol levels
  • rinsing the mouth regularly with saltwater
  • drinking plenty of water

Some doctors may also recommend eating probiotic foods or supplements to increase the number of good bacteria in the body.

Tongue scraping

Tongue scraping may also help reduce the number of germs on the tongue and in the mouth that contribute to oral issues.

Tongue scraping is not a cure for a green tongue but may help support a doctor-recommended medication or treatment plan.

Tongue scraping may work best when added to a daily oral hygiene routine, along with brushing and flossing.

It is best to ask a doctor or dentist about tongue scraping before starting, as it may not be helpful in every case.


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When to see a doctor

When not caused by temporary staining from food coloring, green tongue is often a sign of an overgrowth of harmful germs in the mouth.

Whether this is a yeast overgrowth or another type of infection, it is essential to see a doctor for treatment if the discoloration does not resolve in a few days or goes away and comes back.

Many cases of green tongue require medical treatment. Following the treatment plan set out by the doctor is the best way to resolve the underlying issue.

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Medical News Today: Can a vegan diet help you lose weight?

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Medical News Today: Blocking melanoma’s ‘escape route’

In order to escape treatment, melanoma sometimes reverts to a previous stage of cell differentiation. New research investigates this process more closely and finds a potential way to block this skin cancer’s escape route.
doctor examining melanoma
Melanoma is an aggresive form of skin cancer that often manages to evade treatment.

Although rare, melanoma is a very aggressive form of skin cancer that can prove fatal.

Of all skin cancers, melanoma has the highest mortality rate and the highest potential to spread.

It is particularly difficult to treat when it mutates and can therefore become treatment-resistant.

Though the latest advances in immunotherapy have drastically improved survival rates and outcomes for people with this mutant form of melanoma, there are still those who do not respond as well to these treatments, or whose cancer returns.

Now, researchers at the University of California, Los Angeles (UCLA) — led by Thomas Graeber, a professor of molecular and medical pharmacology — set out to investigate in more detail how this cancer changes in order to evade treatment.

The scientists examined the process of dedifferentiation — that is, the process in which melanoma cells regress to an earlier stage of embryonic development — and found that, depending on the stage that they’re in, melanomas can be broken down into four different subtypes.

Of these subtypes, the researchers found, some are vulnerable to a type of cell death.

Importantly, this type of cell death can be induced with certain drugs, and, as the new research reveals, using these drugs in combination with existing anticancer therapies could block melanoma’s escape.

The findings were published in the journal Cancer Cell.

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Finding four subtypes of melanoma

Melanoma emerges from the skin’s pigment-producing cells, or melanocytes. Prof. Graeber and colleagues carried out a gene expression analysis of melanoma cells, and, using stem cell technology, they also created melanocytes.

Then, the researchers compared the genetic expression of melanoma cells — as obtained from public genetic databases — with that of melanocytes.

The analysis revealed that melanoma cells can be divided into four subgroups, according to the genes that are activated and deactivated in each differentiation stage.

“This refined characterization improves our understanding of the progressive changes that occur in melanoma cells during dedifferentiation, which can help develop better strategies to target this form of therapy resistance,” says first study author Jennifer Tsoi, a UCLA researcher.

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Ferroptosis may block melanoma’s escape

Prof. Graeber and team also analyzed the various levels of drug sensitivity that corresponded with differentiation stages. The scientists searched for drugs that could be used either separately or in combination to target the different stages of melanoma dedifferentiation.

The researchers discovered “a heightened sensitivity to ferroptosis induction with the degree of differentiation.” Ferroptosis is a form of cell death that can be triggered and is different from the naturally occurring apoptosis — that is, the normal cell death that takes place as a result of an organism’s evolution.

Finding this vulnerability to ferroptosis has important therapeutic implications, explain the authors, as “ferroptosis-inducing drugs” are a good “therapeutic approach to target the differentiation plasticity of melanoma cells to increase the efficacy of targeted and immune therapies.”

Immune therapies are more successful when used against differentiated cells than non-differentiated ones, explain the authors.

Furthermore, these standard-of-care therapies can induce dedifferentiation, and thus in a co-treatment setting, ferroptosis induction can potentially block melanoma cells attempting to take this escape route.”

Prof. Thomas Graeber

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