Health, disease treatment and medication recommendatons

Generally when one thinks of skin parasites, they think of scabies and ring worm for which the medical profession is well equipped.

Unfortunately I contracted the types of skin parasites about which doctors know nothing. I was doing my yearly back yard Spring clean-up when it happened. As I pulled a strangulating vine from a tree I noticed a cloud of dust descending upon me. I disposed of the vine, decided to call it quits, and took a shower thinking no more of the dust cloud.

My profession is about managing stress and the use of hypnosis for eliminating unhealthy habits. Within a month my life changed to the point that I was on the brink of anxiety panic attack.

Two days later while visiting my mother; my lady friend, Fran, and I began itching all over our bodies. We immediately left for home and took hot baths which provided relief. But within hours we were both itching again. The next few days were horrendous and confusing as we used everything we could to get rid of them–anti itch creams, rid, Nix…

I deduced the source of the infection was that cloud of dust but that did little good. Soon we realized that our bedding was contaminated and we began laundering our bedding daily with bleach. We took scalding baths two-to-three times per day to control the itching and biting. And then we realized that the bugs were all over the house-on the furniture, in the rugs… Thinking it must be some kind of mite, I ordered diatomaceous earth and dusted it all over the house.

Realizing how prolific the mites were, I treated my front and rear yard and all the shrubs with an insecticide that kills jiggers.

Fran went to her doctor who found nothing and at her urging he prescribed Elimite. We both used it thinking life would soon be normal only to find that within four days all symptoms returned.

I went to a dermatologist who after observing all the bites and rashes, took a plug sample for analysis and prescribed antibiotics along with Diprolene. Again we had about four days of relative freedom and then all symptoms returned. My doctor called to inform me that the analysis of the plug sample showed nothing.

I tried everything I could think of–boric acid, sulfur… I mixed sulfur with Vaseline and applied it to my skin. I looked like I was jaundiced with liver disease; my silver hair was yellow. I noticed that my arms sparkled in sun light-maybe the eggs of the parasite.

After about three months of living in this hell. I experimented with approximately 30,000 mg of garlic and found that the symptoms stopped. After a few days I thought I was cured and stopped the garlic only to have the itching and biting return within days.

Fran moved away and got rid of her infestation with a product called Liquid Needles and ice baths. I could never bring myself to an ice bath and the Liquid Needles were like a band aid.

I relied heavily on garlic and eventually was at about 200,000 mg per day-I was popping those little round capsules like candy. I really didn’t notice any garlic odor about me so my body must have been using all the garlic or I was oozing it from my pores and was oblivious to it.

Ultimately I confided in a friend who suggested that I experiment with diet-an alternative to garlic. I began only eating eggs and within a day all symptoms of itching and biting had subsided. Life can get boring with only eggs so I began adding one new food at a time. I found that anything with wheat or oat flour caused symptoms to return. Rice was safe. Fruit was a big problem. The next couple years was about experimenting with various foods.

Eventually I found an old-timer doctor who was familiar with bird mites. He prescribed ORAP which along with the diet enabled me to eventually expand my diet to what I identify as Stage II of the diet. The ORAP was stopped after ten weeks and I remained on Stage II of the diet for nearly ten years during which time I got married, had normal intimate relations, and was free of being contagious as long as I remained on Stage II of the diet.

Over the years I helped dozens of other sufferers rid themselves of the symptoms with the diet. I also found that the itching and biting symptoms can be caused by several different organisms:

• Nematodes such as Strongyloides stercoralis

• Morgellons

• Collembola (spring tails)

• Fungi

• Mites

Suffering from genital warts is a condition that should not be ignored. Genital warts is one of the few sexually transmitted diseases that can turn into a terminal illness. Genital warts are caused by a virus called HPV or human papilloma virus. This virus comes in various strands which can lead to the development of cancer. The most common HPV or human papilloma virus which causes genital warts and opens a person’s body up to the possible growth of cancer are type 16, 18, 31, and 45. These types of human papilloma viruses create 80% of cancers.

It is the main cause of cervical cancer in women. Genital warts can easily turn into an annoying and embarrassing disease to a terminal one. Awareness of the dangers of untreated genital warts has been increasing in today’s society. The more you know about the importance of treating genital warts the more likely you are to protect yourself from allowing the disease to develop into something that can result in your death. Sexually transmitted diseases are not to be taken lightly. When it comes to genital warts it is important not to ignore the appearance of growths or warts. Taking the proper actions to treat genital warts is vital in the prevention of cancer.

There are various ways to treat genital warts. One of the most common genital warts treatments is topical solutions or creams. Topical solutions and creams are considered to be immune response modifier drugs. These creams work quickly to treat the infected and surrounding area of the skin tissue which has genital warts present. 5-Fluorouracil creams are often prescribed to treat genital warts. The most commonly used genital warts treatments that are topical solutions includes Aldara, Condylox, and 5-Fluorouracil creams.

Aldara cream is used to treat external and perianal warts. Aldara cream is considered to be one of the most effective and original treatments for genital warts. It aids the body in fighting the virus instead of simply getting rid of the warts. The method in which Aldara cream works is by treating the warts from the inside out. Condylox is another popular treatment for genital warts. Condylox was one of the first FDA approved solution in gel form to treat genital warts. Loaded with active ingredients that quickly combats genital warts. Condylox is an extremely effective genital warts treatment for external genital warts and perianal warts as well.

A number of products that block the histamine receptor (anti-histamines) have been developed to treat the allergies that trigger attacks in those suffering from atopic asthma attacks. These include hydroxyzine (Atarax, Vistaril) and its breakdown product cetirizine (Zyrtec). These medications cause sleepiness. Other side effects include dry mouth and urinary retention, and more rarely, confusion, nightmares, nervousness, and irritability. Chlorpheniramine (Chlor-trimeton), cyproheptadine (Periactin), and diphenhydramine (Benadryl) are other older antihistamines. They can be associated with anti-cholinergic side effects (dry mouth, confusion, urinary retention), in addition to the side effects of Atarax.

The so-called second-generation antihistamines supposedly cause less drowsiness than the older products, but this is more hype than hope. They claim to specifically block the H-1 antihistamine receptor, and include fexofenadine (Allegra), loratadine (Claratin), and azelastine (Astelin). Side effects are similar to the older antihistamines. Drowsiness with all of the antihistamines is dose dependent. It is best to start with a low dose and work up.

One of the best selling allergy medications on the market is desloratadine (Clarinex). Clarinex is a newer generation anti-histamine medication that is marketed as a magic bullet for allergies. However what most people don’t know is that Clarinex is merely an old drug, loratadine (Claritin), marketed by the drug company as new and improved. However Clarinex doesn’t add anything to Claritin (other than more money for the coffers of its manufacturer, since Clarinex is still on patent). Clarinex is merely a metabolite (breakdown product) of its precursor, Claritin. That means that 20 minutes after you take Claritin, you will be getting Clarinex, but you’ll be paying much less for it than if you took Clarinex. Folks have been getting Clarinex for years, even though they didn’t know it, every time they took Claritin. The company patented the metabolite of their original product, and then did a misleading study where they compared differing doses of the two medications, coming to the erroneous conclusion that Clarinex was less sedating than the old drug. This was misleading because if a drug causes sedation, then higher doses of the drug will cause more sedation, so if you are not comparing the same doses of the drug, you are not making a fair comparison. This allowed them to promote Clarinex, which costs much more than the old drug that went off patent, and which in 2004 was bringing in close to a billion dollars a year in sales. Claritin and Clarinex as far as you are concerned are the same drug; so take Claritin and save some money.

Over the counter (OTC) epinephrine inhalers such as Primatene Mist are commonly used for the treatment of mild asthma. Over 115 million Primatene Mist inhalers have been sold over the past 20 years. These inhalers, however, are not as benign as they appear. About 20% of patients using OTC inhalers have severe asthma that needs medical care. Unfortunately, many asthma patients delay professional medical treatment while they use their OTC inhalers, often due to a lack of health insurance, to the point where it may be too late. OTC inhalers can also increase heart rate, and should not be used in patients with heart or thyroid disease. Thirteen deaths, mostly cardiovascular, have been reported to be associated with the use of OTC inhalers over the last 20 years. If you have a history of chronic asthma or a history of hospitalization for asthma you should not use OTC inhalers. If asthma symptoms do not resolve in 20 minutes after using an OTC inhaler, you should seek emergency treatment. Delaying medical treatment when you are using OTC inhalers may contribute to the overall severity and chronic nature of the disease over the lifetime.

Prescription short acting bronchodilators (²-2 agonists) are inhaled and promote dilation of airways. The most commonly prescribed inhalers are albuterol (Proventil) and levalbuterol (Xopenex). Side effects include tremors, jitters, and nervousness. There are no known long-term side effects. These medications are designed for temporary relief. If you find yourself using them often or with increasing frequency that means your asthma is getting worse and you need further evaluation by a doctor.

Asthma patients can also be treated with steroids in pill form for a short period of time. Corticosteroids can inhibit growth in children and decrease bone mineral density, although growth inhibition is reversible. Steroids suppress the immune response, increasing risk of infection, and decrease bone mineral density. Other side effects of steroids include low blood sugar, changes in consciousness, nauseas, seizures, or in rare cases death. You can also develop symptoms like Cushing’s Disease (an excess production of cortisol in the body). These include deposits of fat on the upper back and face, high blood pressure, diabetes, slow wound healing, osteoporosis, cataracts, acne, muscle weakness, ulcers, thinning of the skin, and mood changes. When patients are treated for a long period of time, deaths from adrenal insufficiency have occurred with transfer from oral to inhalation steroids, especially during stressors like surgery. You should not be on steroids for long periods of time.

Non-allergic asthma is a chronic problem, and needs to be treated somewhat differently than allergic asthma, which may come and go with avoidable triggers and seasonal changes. Chronic asthma sufferers are more at risk for fatalities if they are not treated.

Corticosteroids

Patients with chronic asthma should be treated with inhaled corticosteroids. These include fluticasone (Flonase, Flovent), beclomethasone (Qvar, Beconase, Vancenase), flunisolide (Aerobid), budesonide (Rhinocort, Pulmicort), and triamcinolone (Azmacort, Nasacort). Inhaled corticosteroids have the same side effects of systemic steroids, but to a much lesser degree. Corticosteroids can inhibit growth in children and decrease bone mineral density, although growth inhibition is reversible. Steroids suppress the immune response, increasing risk of infection, and decrease bone mineral density. Other side effects of steroids include low blood sugar, changes in consciousness, nauseas, seizures, or in rare cases death. You can also develop symptoms like Cushing’s Disease (an excess production of cortisol in the body). These include deposits of fat on the upper back and face, high blood pressure, diabetes, slow wound healing, osteoporosis, cataracts, acne, muscle weakness, ulcers, thinning of the skin, and mood changes. Studies have shown that inhaled corticosteroids (budesonide) can be used intermittently; there is no advantage to regular use of these medications.

Theophylline (theodur, slophyllin) and the related aminophylline drugs are xanthine derivatives related to caffeine that act to dilate the bronchi. Aminophylline can cause rash in some people. They can be given either orally or intravenously for asthma emergencies. Toxicity results in seizures, irregular heartbeats, and pounding heartbeat. It interacts with ciprofloxacine and the other fluoroquinolone antibiotics (i.e. those ending with -xacine) as well as caffeine. They are not used much any more due to safety concerns and side effects.

Long acting beta-2 agonists have been promoted as reducing the need for inhaled quick relief medication. Drugs on the market include salmeterol (Serevent) and formoterol (Foradil). Serevent, approved in 1994, dilates breathing passages by stimulating the beta-2 adrenergic receptor. At least 300,000 children take this drug.

Serevent was isolated as one of five dangerous drugs still on the market by Dr. David Graham of the FDA in testimony to congress in November of 2004. In that testimony he described Serevent users “dying while clutching their inhalers.”

In 1996, based on reports of paradoxical bronchospasm (a contraction of the breathing airway or bronchus that impairs breathing and can be fatal) with Serevent, the manufacturer undertook a large multi site randomized placebo controlled trial, the Salmeterol Multi-center Asthma Research Trial (SMART). This was a 28-week safety study comparing salmeterol (Serevent) and placebo in the treatment of asthma.115 In addition to their usual asthma therapy, patients received either Serevent or a placebo. The study was stopped in 2002 by the study’s Data Safety Monitoring Board because of an increase in asthma related deaths. Analysis of 26,355 patients showed statistically significantly higher rates of asthma related deaths (13 versus 3, relative risk greater than four fold) in patients on Serevent.

In African Americans, who made up 17% of the study population, the study showed a statistically significant greater number of respiratory related deaths and life threatening events. Many had to get intubated, or have a tube put down their throat to let them breath related to respiratory causes (20 versus 5 for placebo, a four fold increase). In addition, there was a more than four fold increase in asthma-related deaths and life threatening respiratory events in patients taking salmeterol compared to those taking placebo. Overall the risk of death from any cause or having a life-threatening event was doubled in African Americans, another finding that was statistically significant. The data suggested that the risks of Serevent were greater in African Americans than in whites. About half of the patients were also taking an inhaled corticosteroid. In those patients not taking an inhaled corticosteroid, there were significantly more asthma-related deaths in all patients taking salmeterol compared to those taking placebo.

The manufacturers of Serevent initially showed data to the FDA that included the results from the 28-week trial plus a 6 month follow up period. The results for this time period were better than the initial 28 weeks alone. However the initial study protocol was for a 28 week trial, and the FDA appropriately requested the 28 week outcomes, which they posted on their web site in 2005. However the potential risks of long-acting beta agonists have long been known.116 A long acting beta agonist drug marketed in New Zealand was associated with an increase in asthma related deaths and was pulled from the market there in 1976. A recent meta analysis (where data from all published studies were combined) looking at trials from the past 20 years involving a total of 33,826 asthma patients treated with long acting beta agonists showed that all drugs in this class are dangerous.116 Overall there was a statistically significant increase in a number of parameters, including an increase in asthma exacerbations requiring hospitalizations by 2.6 fold, increased life threatening exacerbations of asthma by 1.8, and increased risk of asthma related death by 3.5 fold.

Based on these findings, I do not recommend use of a long-acting beta-2-agonist.

Advair, which contains Serevent and a steroid, also carries the same black box warning about increased asthma related deaths. This hasn’t stopped it from running up 2 billion dollars in sales per year. Based on the SMART study we cannot conclude that long acting beta agonists when administered with steroids are safe; in studies where 75% of patients were taking a steroid there was still a 2-fold increased risk of asthma related death.

Montelukast (Singulair) and zafirlukast (Accolate) are part of a new generation of asthma medications that are leukotriene antagonists. These medications work by inhibiting the cysteinyl leukotriene CysLT-1 receptor, which is involved in the inflammatory response. In rare cases they may be associated with Churg-Strauss syndrome, which involves inflammation of the blood vessels. Zileuton (Zyflo) can cause lupus and liver toxicity and requires blood to be checked every six months. They are expensive and have not been shown to be more effective than steroids and antihistamines.

Other new drugs are the mast cell stabilizers like nedocromil (Tilade) and omalizumab (Xolair). Xolair is given by injection every 2-4 weeks. These meds have only recently been approved by the FDA, and so we have to adopt a wait and see attitude.

Eczema, also known as atopic dermatitis, is characterized by a red itchy rash that is scaly and is oozing in some cases. The condition can appear on the arms and legs, cheeks, forehead, and in body parts such as knees and elbows where there are creases. In some cases, skin will have a leathery feel and even crack or blister. Some people also experience a thickening of the skin, red patches and even a slight color change when they have eczema.

1. Skin Conditions

This refers to the skin’s inflammation, while atopic means an allergic, and usually genetic or inherited, tendency. The condition is common for infants, although eczema is typically outgrown. The child’s condition could be chronic, or recur with regularity, if the problem persists beyond the second birthday, when eczema usually disappears. Eczema can worsen during winter, when dryness pervades the house, and summer, when temperatures could rise to extremes.

2. Treatment

The rashes are easy to eliminate, although they return sometimes even with proper treatment. To prevent eczema, bubble baths, exposure to extreme heat, strong soaps and other triggers must be avoided. In cases where these triggers are sometimes hard to avoid or identify, moisturizers may be the most important weapon one can use to prevent any flare-up of the condition. Since atopic dermatitis can accompany dry skin, individuals with this skin type will benefit from taking a daily bath - of about 5-10 minutes - with lukewarm water and using only a mild soap with moisturizing properties. This helps locks the moisture into the skin, limiting the likelihood of eczema development. Some people benefit from having topical medications as the first layer of treatment, with moisturizers or lubricants applied on top as the second layer, following a bath. This two-pronged approach should be enough to maintain healthy and hydrated skin.

3. Ointments & Creams

Greasy ointments are one of several moisturizers available in the market. Aquaphor and Vaseline are probably the more popular choices, although consumers should also consider other brands and similar products to determine which one works best for their skin. For more extreme eczema break-outs, individuals may need to turn to topical steroids and Protopic and other non-steroidal treatments. Hydrocortisone creams are among the very mild over-the-counter topical steroids one can use, even on facial eczema. Drug stores will already ask for a prescription for Dermatop, 0.1% Triamcinolone, Cutivate, Elocon and other more potent topicals. These stronger products are generally not advisable for children, as they could have adverse effects.

4. Medications

Protopic, Elidel and other non-steroidal medications, or immunodulators, are preferred for children with eczema. These milder topicals can be used twice daily, and even on the face and other more sensitive areas. However, steroid-free medications take a longer time before producing results compared to topical steroids. Some doctors recommend antihistamines as part of eczema treatment.  Atarax, Benadryl and other antihistamines with a sedative effect are particularly effective in cases when itching is already hampering sleep. Other solutions that can also help are cold compresses, wet dressings, ultraviolet light therapy, oral steroids and cylcosporin and other immunosuppressive drugs.

5. Other Factors

Some individuals may find that the condition is common within the family. One who is genetically disposed to having sensitive skin could easily trigger bouts of eczema due to an allergy, stress or other specific environmental factor. Asthma, allergic rhinitis and other similar disorders tend to accompany eczema in these individuals. When this happens, the allergen or source of the allergy must be identified first and properly addressed. These sources could include shrimp and other seafood, strawberries, nuts, cow’s milk, eggs and other types of food. Pollen, dust mites and other airborne agents are also possible triggers. Eczema can also be driven by irritation to specific substances such as detergents, products containing chlorine, earrings and jewelry containing silver or nickel, woolen fabrics, synthetic materials, latex rubber, and formaldehyde and similar chemicals.

6. Treatment Tips

Eczema may not require continuous treatment, as most people generally outgrow the condition as they become older. However, antibiotics may have to be used when infections set in and hamper treatment of the flares. A dermatologist, allergologist or other specialist should be consulted after reasonable time and treatment fails to eliminate eczema or improve skin condition. Consultation should be immediate particularly if the affected individual develops fluid- or pus-filled blisters, which are symptomatic of eczema herpeticum - a rare complication attributed to the herpes simplex virus.

A number of people across the world suffer from different sort of pain such as chronic pain, acute or severe pain. Each one of you may have realized pain in one form or the other. Sometimes you face back pain or migraine after a whole day stressful work; others may be having joint pains due to arthritis or pain due to undergoing surgery.

Most of the times, these pain become a part of one’s routine life and health largely. It hinders the growth and living of a person and therefore it becomes necessary to cope up with such pains. Several approved medicines provide relief from day to day pain whether acute or severe.

• Butalbital - Butalbital belongs to the group of medicines known as Barbiturates and has a composition that relieves pain and acts as a relaxant. It is commonly used for the treatment of migraine headaches.

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• Ultram - Ultram is the brand name for tramadol hat is being used as a pain reliever for moderate to severe pain caused after any surgery or other types of pain.

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• Ultracet - UltraCet is the brand name for the combination of two drugs, tramadol (Ultram) and acetaminophen (Tylenol). It is an analgesic used for patients to relieve them of any sort of acute, moderate, or severe pain caused by any surgery or other types of pain.

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In addition to these, other medicines are also available but one should contact their medical practitioner before carrying out any of the treatment because their might be certain side effects associated to these medicines in some circumstances.

These medicines serve purposes such as relieving pain and inflammation, increasing the quality of life, reduces the progress of the disease, controls co-morbidity, and minimizes the risks of therapy.

What is psoriasis?

Over 7.5 million Americans have psoriasis, and they spend between $1.6 billion and $3.2 billion each year to treat the disease of autoimmunity, according to the National Psoriasis Foundation. Between 150,000 and 260,000 new cases are diagnosed each year, including 20,000 in children younger than 10. Though seldom disabling, the red welts, pustules, and scaling skin that mark the disease can be painful and extremely embarrassing.

A chronic, non-contagious disease, psoriasis [pronounced sore-EYE-ah-sis] varies in its severity and how it responds to treatment. It results from inappropriate responses of the body’s immune system to essentially attack the body itself and can occur on any part of the body that’s covered by skin. The resulting inflammation can be as mild as something resembling dandruff or as radical as a body covered with thick, crusted plaques. Less than 10 percent of sufferers have an extreme form of the disease; it is a mild form in 65 percent of cases. Everything else is in between mild and serious.

Though it usually doesn’t get any worse over time, about 10 percent to 30 percent of people with psoriasis also develop psoriatic arthritis, which causes pain, stiffness and swelling in and around the joints.

Psoriasis is a disease which takes different forms, including scalp, genital and facial psoriasis.

Scalp psoriasis

At least half of all people who have psoriasis have it on their scalp. As with psoriasis elsewhere on the body, skin cells grow too quickly and cause red lesions covered with scale. In severe cases of thick, crusted plaques covering the entire scalp, the hair may fall out. The affected area can extend beyond the hairline onto the forehead, the back of the neck and around the ears. Treatments, as with any type of psoriasis, are often combined and rotated because it can become resistant to medications after repeated use. Many treatment options can help control scalp psoriasis and its symptoms:

• Tar products and salicylic acid are generally sufficient for treating very mild scalp psoriasis.
• Ultraviolet (UV) light treatments.
• Systemic (oral or injected) treatments may be tried if psoriasis is present elsewhere on the body and/or the psoriasis is severe.
• Topical medications (applied to the skin).

Genital psoriasis

Although it usually responds well to various treatments, the sensitive nature of the skin around the genitals requires a cautious approach to genital psoriasis:

• Ultraviolet (UV) light. Overexposure to UV light can burn the skin, especially the thinner skin around the genitals, so it is therefore used only in special circumstances and in very low doses.
• Protopic and Elidel. Both of these drugs reduce skin inflammation much as topical steroids do, but they do not cause thinning of the skin. They may cause some irritation when they are first used, but they do not promote yeast or bacterial growth, which may further help with inflammation and itching.

Psoriasis in the pubic area may respond well to UV light treatment if the pubic hair is cut short or shaved. Men should wear briefs or athletic supporters to protect their genitals while receiving UV light treatment on other parts of the body.

• Dovonex. Though this synthetic form of vitamin D3 has the potential for irritation, it does not have any of the drawbacks of topical steroids, and mixing it with petroleum jelly may minimize irritation.

  Tazorac. Because of its potential for irritation, some doctors alternate its use with a low-strength topical steroid.

• Over-the-counter (OTC) moisturizers. The skin in affected genital areas should be continuously moisturized, but choose wisely: moisturizers with fragrance and perfumes may irritate.
• Steroids. Prolonged use of topical steroids can permanently thin the skin and cause stretch marks. Furthermore, psoriasis may become resistant to clearing with continuous long-term use of steroids.

Facial psoriasis

Areas of the face most often affected are the eyebrows, the skin between the nose and upper lip, the upper forehead, and the hairline. Because other skin diseases resemble the symptoms of psoriasis on the face, a biopsy may be needed to positively identify it.

Psoriasis scaling can also block the ear canal and produce temporary hearing loss; it should be removed by a doctor. Psoriasis in and around the mouth or on the lips causes discomfort and may present difficulty in chewing and swallowing food. Improving hygiene and rinsing frequently with a saline solution can help relieve oral discomfort, and there are effective topical steroids that have been designed to treat moist areas.

Rashes may also appear on the eyelids, around the ears, mouth, and on the nose. Treating eyelid inflammation may involve washing the edges of the eyelids and eyelashes with a solution of water and baby shampoo. An over-the-counter product, Ocusoft, can help with removing scales on the lids and eye margins. But a doctor must carefully supervise the treatment because eyelid skin can be easily damaged, and the use of topical steroids there can lead to glaucoma and/or cataracts.

In addition to Dovonex, Tazorac, and ultraviolet light, Protopic may be used in treating facial psoriasis. This and Elidel, both drugs used to treat eczema, have also been found effective in treating psoriasis. Topical steroids may be used, but prolonged use of them may cause enlarged capillaries (spider veins) on the face.

Psoriasis lesions, usually white or gray, may also appear on the gums, the tongue, inside the cheek, or inside the nose.

Facial hair growth in women is something that many of us find concerning. Assuming that you are not genetically inclined to facial air (Mediterranean, Jewish and Eastern European ancestry) or have a family history of facial hair growth in women), it could be a number of things.

One of the most common is hormonal imbalance. Women have both estrogens and androgens (male hormones). As we age, the levels of both hormones naturally decline. However, the ratio between the differences declines and it can look as if we suddenly have more of the male hormones, and therefore stray hairs. In addition, there are some medications that can stimulate the growth of stray, darker, coarser hair such as phenytoin, cyclosporine, anabolic steroids, combination medications with testosterone such as estratest, and minoxidil (used for high blood pressure as well as baldness in men).

Sometimes though, excessive facial/body hair can be a result of physical and medical issues. For example, polycystic ovarian syndrome and obesity (adipose tissue can produce androgens). Occasionally it can be related to adrenal tumors. In these cases one will see more than just the occasional stray hair on the face. If this is happening to you, see your health care provider.

So what can do you about it? Women have been looking for ways to permanently remove hair for years. There does not seem to be an easy fool-proof permanent way to deal with facial hair.

Treatments include:

• Makeup Radio frequency
• Hormones (estrogen and progesterone)
• Shaving
• Waxing
• Laser
• Electrolysis
• Medications: Vaniqua - a prescription cream

According to many dermatologists, electrolysis seems to be the only method for permanent removal. Vaniqua medication, which is relatively new in the past few years does not seem to work for all women. The long term effectiveness is unknown at this time.

As with most things, there does not seem to be a one-size-fits-all solution to the problem of the stray facial hair. You will most likely need to try various treatments and see what works for you. However, keep in mind if the hair seems excessive or you have concerns, please speak with your health care provider for further evaluation.

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May 8, 2008 (San Diego) — If your face looks younger than your years but your hands aren’t keeping up, there’s help.

If you’ve got the funds, plastic surgeons have a host of solutions to make your hands look young again — or at least be a closer match to your face.

“The best place to guess someone’s age is their hands,” says Danny Vleggaar, MD, a physician at Clinique Vert Pre in Geneva, Switzerland, and part of a panel of plastic surgeons discussing new options for rejuvenating aging hands at the annual meeting of the American Society for Aesthetic Plastic Surgery in San Diego.

Pigment changes, age spots, texture changes, loss of fat, contour changes, and prominent veins all contribute to make the hands look older, Vleggaar and his colleagues say.

To turn back the clock, plastic surgeons are offering topical treatments, lasers, and soft tissue fillers, the same ones that refresh the face.

Topical and Laser Treatments for the Aging Hand

Topical treatments include tretinoin, says Barry E. DiBernardo, MD, a plastic surgeon in Montclair, N.J., and another panel member. Chemical peels can also improve the appearance of the skin on the hands, he and others say.

Laser treatment can also improve the hand’s appearance. “Feathering” the effect of the laser near the wrist can help prevent a “line of demarcation,” says DiBernardo, who works as a consultant for filler and laser manufacturers.

Filler Treatments for the Aging Hand

Fillers approved for use in the face are being used to restore the lost volume in the hands that often accompanies aging.

DiBernardo mixes the filler Radiesse with lidocaine, an anesthetic, and injects it to help restore a more youthful contour. Once injected, he massages the hand to distribute the filler evenly.

“It will take one or two syringes [of filler] per hand if there is significant contour to improve,” he says.

If patients are happy with the fillers, DiBernardo says he sometimes switches to autologous fat injections (fat collected from your own body) the next time if the patient agrees. The fat is typically longer lasting, he says.

Another filler, Sculptra, may last longer than other fillers, up to two or three years, says Vleggaar, who has presented studies about the filler at professional meetings and works as a consultant for Sculptra’s manufacturer and other companies.

Treating the Veins in Aging Hands

Another alternative is laser removal of unwanted hand veins, a technique favored by Roxanne Guy, MD, a plastic surgeon in Melbourne, Fla., and another speaker.

In her study of the technique, called laser ablation, she and a colleague performed the treatment on 28 women and 54 hands in all, reporting the results in Plastic & Reconstructive Surgery. A laser is placed on the tip of a wire, which is threaded into the vein. As the wire is slowly pulled out, the laser energy heats the veins and damages the vessel wall’s inner lining. Over the next few weeks, the vein dies.

The patients, aged 41 to 68, were followed for up to 31 months. “Patient satisfaction was high,” Guy says. Post-procedure swelling, which was expected, usually resolved within two weeks, she says. On average, most patients had four veins per hand treated. One woman had a skin burn where the laser exited. Even so, all 28 said they were satisfied with the results, Guy says.

Aging Hand: Caveats

Not everyone is a candidate to rejuvenate their hands, Vleggaar says. Among the conditions that may disqualify a patient, he says, are osteoarthritis, rheumatoid arthritis, hand tremors, or Parkinson’s disease.

Not everyone thinks the dermal fillers should be used in the hands. On its web site, the Physicians Coalition for Injectable Safety states that dermal fillers shouldn’t be used in the hands. Fat injections in the hands, however, are viewed as acceptable by the American Society for Aesthetic Plastic Surgery.

What Price for Pretty Hands?

“It can get quite costly, between lasers and injectables, to treat a hand,” DiBernardo says. “Overall, the cost could be $3,000-$5,000, if you did everything.”

For patients on a budget, DiBernardo suggests they “set up a treatment protocol according to the problem you would like to tackle.”

Or if you want the most return for just one treatment, he suggests correcting the contour with filler. “It’s a very dramatic result and you can see it right away.” Most patients who have their pigment problems treated seem happy too, he says.

While the fillers are temporary, Guy says she believes her vein removal procedure is permanent, “but we have only followed these people for a couple years.”

Second Opinion: Aging Hands

Skin treatments with lasers or a technique known as intense pulsed light (IPL) therapy may be the best bets for hand rejuvenation, says Jack Friedland, MD, a Scottsdale, Ariz., plastic surgeon not involved in the panel discussion.

Lasers or IPL ”that treat brown pigmented spots for removal work,” he tells WebMD.

He says he is not convinced that the fillers used in the hand give a completely natural look.

Aging Hands: The Jewelry Alternative

Another alternative for younger-looking hands? Wear jewelry.

In a survey, published in Plastic & Reconstructive Surgery and cited by Guy, hands with jewelry were rated as younger looking by observers than those without, although the differences weren’t significant.

SOURCES: Roxanne J. Guy, MD, plastic surgeon, Melbourne, Fla. Jack A. Friedland, MD, plastic surgeon, Scottsdale, Ariz. Danny Vleggaar, MD, physician, Clinique Vert Pre, Geneva, Switzerland. Barry E. DiBernardo, MD, plastic surgeon, Montclair, N.J.; clinical associate professor of plastic surgery, University of Medicine & Dentistry of New Jersey. Bains, R. Plastic & Reconstructive Surgery, June 2006; vol 117: pp 2212-2218. Guy, R. Shamma, A. Plastic and Reconstructive Surgery, December 2007; vol 120: pp 2017-2024. Physicians Coalition for Injectable Safety. American Society for Aesthetic Plastic Surgery. American Society for Aesthetic Plastic Surgery Annual Meeting, San Diego, May 2-6, 2008.

© 2008 WebMD Inc. All rights reserved.

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Eli Lilly said Monday that its antidepressant Cymbalta (duloxetine) has been approved by the U.S. Food and Drug Administration to treat fibromyalgia, a chronic disorder with symptoms including widespread muscle pain and tenderness.

The condition affects about 2 percent of the American population, or about 5 million people, mostly women. While its cause is unknown and there is no known cure, it’s believed it may be related to a combination of changes in brain and spinal cord chemistry, genetic factors, and stress, the company said in a statement.

Cymbalta affects production of two naturally occurring brain substances, serotonin and norepinephrine. In addition to affecting mood, it’s believed these substances are part of the body’s natural pain-surpressing system, Lilly said.

In a pair of three-month trials involving 874 people with fibromyalgia, Cymbalta significantly reduced pain levels, compared with a non-medicinal placebo, the company said. Common adverse reactions included nausea, dry mouth, constipation, decreased appetite, and sleepiness.

Cymbalta also is approved to treat major depressive disorder and generalized anxiety disorder, and a form of nerve pain in diabetics, all in adults 18 and older.

— Scott Roberts

Copyright © 2008 ScoutNews, LLC. All rights reserved.

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The use of biologics is the focus of new guidelines for the management of mild to severe psoriasis and psoriatic arthritis released by the American Academy of Dermatology (ADA).

Biologics — given by injection or infusion — are systemic medications that pinpoint immune responses involved with psoriasis and psoriatic arthritis.

About 6 million to 7 million Americans have psoriasis, and between 300,000 and 750,000 have psoriatic arthritis. The new guidelines, based on an analysis of scientific studies of the conditions, were published in the May issue of the Journal of the American Academy of Dermatology.

“As a result of the impartial analysis of the most current research, physicians now have evidence-based guidelines which will help enhance the quality of care for patients and ultimately their safety,” ADA President Dr. C. William Hanke said in a prepared statement.

“The guidelines for psoriasis and psoriatic arthritis, which focus on the use of biologics, are the first phase of the academy’s efforts. The academy is currently working on the second phase of these guidelines, which will provide evidence-based advice for the management of psoriasis with topical therapies, ultraviolet light therapy, and systemic non-biologic therapies for psoriasis.”

The new guidelines advise that topical treatments are appropriate for patients who are good candidates for localized therapy. But, in many cases, topical treatments should not be used exclusively to treat psoriasis if patients would benefit from a combination of systemic and/or phototherapy treatments.

Currently, five biologics are approved by the U.S. Food and Drug Administration for treatment of psoriasis, and three of those five are approved for psoriatic arthritis.

Because biologics target the immune system, it’s important to use all approaches, including vaccination, to prevent infection, the guidelines state. However, once biologic therapy has started, patients should avoid vaccinations with live vaccines and consult their dermatologist before receiving vaccination of any kind.

Patients undergoing biologic therapy need to have periodic re-evaluations by their dermatologist to check for the development of new symptoms, including infections and potential cancers.

“Regardless of the therapy that is used to treat psoriasis or psoriatic arthritis, patients need to be in constant contact with their dermatologists to report any unusual side effects or fluctuations in their condition that may require an adjustment in their medications or indicate the onset of psoriatic arthritis or another secondary medical condition,” Hanke said. “These guidelines should help further the understanding of the current psoriasis therapies and help enhance the overall health and quality of life of patients.”

— Robert Preidt

SOURCE: American Academy of Dermatology, news releaes, May 21, 2008

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