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Botox: I’m not angry …it’s just my wrinkles! What can I do?

Published by DR, M.D. Simone Van Horne in SKIN · 27/9/2015 19:25:00
Botox: I’m not angry …it’s just my wrinkles!  What can I do?

“I’m not an aging gracefully type.  But I do believe in aging with grace”. Danielle Steele.
I think I have to agree with Danielle. But to each his own.  Some people cringe at the discussion of doing any “work” on your self by injecting of any sort.  My take on that is, if you don’t agree with it, then don’t do it.
Some people have muscles so well developed on their face, people constantly ask them what is wrong.  It is just that they repeatedly make that facial expression, and now it is etched in whether they make the expression or not.
This week we will deal with botulinum toxin, which was branded ever so successfully by Botox, but there are other brands – Dysport and Xeomin, which do the same thing.  The subtle changes to the botulinum molecule gives additional benefits.  The injection of all these products use purified botulinum which reduces wrinkles and can also reduce excessive sweating.
Deep wrinkles are really secondary to muscles which have become strong by using them over the years.  When we go to the gym, if we want muscles to get big, we use the muscles that we want to get bigger to strengthen them and make them larger. The same effect occurs in the face.  So when we worry, or get angry or smile exuberantly, these are the facial equivalent of going to the gym.  Over the years, the muscles increase in size and the lines that the muscles make remain.  The lines get deeper the more that we use them. These are nice in biceps and triceps, but not too nice in your face.  Botulinum works by weakening selected facial muscles so that they cannot pull on the overlying skin, thereby reducing wrinkles.  So the deeper wrinkles are not a skin issue as much as it is a muscle issue.
Botulinum is most commonly used for  wrinkles on the upper half of the  face, mainly the forehead,  and wrinkles around the eyes)






When a smile shows too much teeth, we can use it in this instance as well.


Images of study subjects before, at left and after receiving Botox.  Aesthetic Surgery Journal.
We may also use it for the neck – the “turkey neck”



Botox is also indicated for migraines and for excessive sweating, that is not controlled by other medications.

Safety

There is no chance of allergic reaction, and there is minimal swelling or bruising from the procedure.  It has gotten a bad rap because of people trying to get it cheaply by using veterinarain equivalents, or from other coutries where it may be tainted.

“Are the injections painful?”
No. Most patients describe it feeling like a mosquito bite or “like squeezing a pimple.”

“What is recovery like after Botulinum injections?”
Typically there is minimal to no bruising or swelling .  The instructions I give to patients are to stay upright for about 4 hours so it stays where it should.  The major concern being the eyelid.  No gym, no lying flat on the face to sleep that night, no facials or manipulation of that area, no caps, or bandanas.

“How long will the results last?”
Most patients can expect 3 months from a procedure on the face.  For excessive sweating, this will last a year.  In some people, it may last longer and in others shorter depending on their metabolism.  Anecdotally, some of my patients have noticed that when they are at the gym more, it lasts for a shorter period of time.

“What unintended results could I get from the botulinum?”
There is a slight (2 – 5 %) chance of mild eyelid droop with each Botox treatment performed on the forehead region. Medication can be prescribed to treat this condition, although it resolves on it’s own within 4 to 6 weeks without treatment.

“Does botulinum work 100% of the time?”
In some individuals the botulinum does not always “take” on the first attempt which means you may need repeated treatments to achieve the desired results. Some individuals also have very strong muscles and may require a greater dosage.



Treating acne with Essential Oils?

Published by DR, M.D. Simone Van Horne in SKIN · 27/9/2015 19:23:00


Treating acne with Essential Oils?

“Glamour is feeling good in your own skin”. Zoe Saldana.

carmencitta-essential-oil-2-640x401.jpg.pagespeed.ce.ayH5PhJRhK

Acne is a horrible condition, and many with this issue feel uncomfortable in their own skin. A long accepted idea about acne is too much oil is produced, an patients dry the face out as much as possible. In doing so, they worsen things and cause a breakout. Not all oils are created equal, and studies have actually shown that acne patients have inadequate essential fatty acids in their skin. For this reason, oil free products is not always the way to go. We just need increased knowledge of what are the right ones.

Sebum production

Wheat germ oil, borage seed oil, and grape seed oil are all a great source of linoleic acid which is present in omega 3 and omega 6 fatty acids. Patients with comedones have been shown in studies to have a decrease in the size and inflammation of these with linoleic acid. Less sebum is produced, and the follicles are less inflamed,

Controlling inflammation

Fish oil is well known even in heart disease to impact inflammation at the level of the blood vessels. Studies show that they do the same for the skin when taken orally as a supplement and in diet. The amount of anti-inflammatory properties, it requires for this effect is more than in one’s diet, and hence supplements are required.

Marigold flower oil is also quite potent in it’s ability to be anti-inflammatory and anti-bacterial.

Balancing Oil Production

If one over-dries the skin, the skin reacts by producing an excessive amount of sebum which will worsen the acne flare. Jojoba seed oil closely resembles the sebum that we produce, but when applied, decreases the amount of oils produced. This is important in its use as a cleanser in daily regimens, because the natural oils will be removed, the skin will produce less oil in the form of sebum and less breakouts will occur!

Antibacterial Oils

Tea tree leaf oil is well known to have astringent and anti-bacterial properties. It also helps to bring oxygen into the pores, which the bacteria hate. Eucalyptus (blue gum) leaf oil is also quite potent in this regard, and is not as drying. Grapefruit peel oil is an anti-septic and astringent – it will decrease the bacteria, but won’t kill them.

There are many other well-known treatments for acne, but this discussion was to simply highlight that oils are not necessarily bad for acne, and there are many natural oils which we can use on their own, or integrated in skin care products.

Remember, beauty is in the eye of the beholder, and that beholder is you.



Dark Circles Under Eyes

Published by DR, M.D. Simone Van Horne in SKIN · 27/9/2015 19:19:00

Dark Circles Under Eyes
“To make women look young. Then their outlook changes. They feel more joyous.” Coco Chanel.

Unknown

The eyes are a big issue in most women. Most people do not want to be told they look tired, especially when they don’t feel tired and feel great. Most people think that a lack of sleep causes circles. There are, however many more reasons. Here are some of the things that can alleviate this.

Fatigue or illness

A good night’s rest and consistent sleep habits. Sleeping 7-8 hour a night is best, and not sleep that add up to 7-8 hours. Reduce stress, drinking a lot of water and cessation of smoking go a long way. Exercise is always good for the circulation that it enhances everywhere.

Allergies, Congestion, Sinus problems:

Allergy medications, nasal sprays, rinsing out sinuses, eucalyptus oils

Hyperpigmentation

This refers to too much melanin around the eyes. In most instances, this is genetic. Sunscreen can be used to prevent them from getting darker. Skin lighteners – vitamin C, Kojic acid, retinoids, will help them to improve. The skin is very thin, so be careful not to be too aggressive. Boron Nitride is a naturally occurring mineral that reflects light away from the eye area, leaving dark circles and under-eye bags immediately brighter. Niacinamide, Fraxinus Excelsior Bark Extract and Silanetriol as a combination of ingredients reduces eye puffiness, dark circles and under-eye bags while providing antioxidant protection

Thin Skin

Retinoids can thicken skin. Retinoids really for anyone above the age of 40 is a must. Drinking water again is a must for this. Products with elastin and collagen help and IPL and other lasers close blood vessels which may be seen through the skin, especially when fair, or when a lot of weight is shed quickly. Citrus Aurantium Dulcis Callus Culture Extract (Orange Stem Cell Extract) – strengthens skin structure to maintain healthy and youthful-looking skin; it organizes and firms the skin to reduce the appearance of fine lines and wrinkles.

Anemia

Many women will realize that when they are menstruating their circles will become worse. Iron intake needs to be optimal with supplements, red meats, broccoli or liver.

Bruising

Do not rub eyes. Be gentle when removing contacts, or removing makeup. Put on eye cream with ring fingers

Common home remedies which can be used to alleviate all of the above:

  • Cold cucumber slices
  • Tea Bags
  • Cold spoons
  • Potato slices



Adrenal Fatigue and Restoring Balance

Published by DR, M.D. Simone Van Horne in Health · 27/9/2015 19:16:00


“It is health that is the real wealth and not pieces of gold and silver” Mahatma Ghandi.

Once one realizes within themselves that something is wrong, pay attention to your body. Do not ignore extreme tiredness and attention issues. Even if blood testing is normal, there are more tests that can be done to investigate the pathways in the adrenal gland to see if this is what is indeed going on. When your physician takes the history what you are feeling, and the times of day you are feeling these symptoms, will give a hint.

Salivary testing checks the variation of the hormones. It is absolutely ESSENTIAL to check the cortisol before replacing it. The saliva is tested in the morning (this is when cortisol is at its peak). It is then tested before lunch and dinner to see what happens during the day. It should gradually decline as the day progresses. We also check this before bedtime. In a healthy person, this should continue to decline.

The plan to treat the fatigue has steps

First one must rebuild the cortisol levels if low.

  • If the individual is flat-lined from cortisol depletion, then bio-identical cortisol in the form of hydrocortisone is administered. This is a very small tablet, and supports the adrenal rather than suppresses it. A prescription is usually required for this.
  • Vitamin Support – the following vitamins at the right doses need to be increased during stressful times because they are all used to make cortisol and the steroid hormones. If stress is increased, these should also be increased, and at very high doses, more than a regular diet can provide.
  • B-complex
  • Vitamin C
  • Magnesium
  • Biotin

Adrenal Fatigue with low cortisol – Panax Ginseng and Licorice extract are very beneficial

Adrenal Fatigue with high cortisol –

  • Rhodiola – this helps memory and concentration.
  • Licorice extract
  • Cordyceps
  • This has been shown in Indian studies to be highly effective in fighting the fatigue and supports the thyroid quite nicely
  • Panax Ginseng. This also helps DHEA.
  • Elutherococcus
  • Magnolia Bark
  • Melatonin this improves sleep cycles and sublingual administration is preferred. This is contraindicated in autoimmune diseases, leukemia, or Hodgkin’s diseases.
  • L-Theanine (Green Tea). Theanine is often lot in the decaffeination process and this is the component of green tea needed to decrease the anxiety and increase alertness.
  • Phosphatadylserine – this is very good for sleep support

Blood tests and saliva testing of the hormones which are affected will alter during treatment and this is easily followed by the physician. These hormones are testosterone, DHEA, progesterone, cortisol. The thyroid should always be checked as many of the symptoms of adrenal insufficiency overlap with hypothyroidism.

For thyroid support, the following are very beneficial:

  • Ashwagandha
  • Rosemary
  • Zinc
  • Selenium



I Don’t Like these Ugly Veins…!

Published by DR, M.D. Simone Van Horne in Health · 27/9/2015 19:12:00
I Don’t Like these Ugly Veins…!

“Darling, the legs aren’t so beautiful. I just know what to do with them.” Marlene Dietrich

Sclerotherapy is a procedure used to treat varicose veins. It has been around since the 1930’s. We have all heard the saying, “I have a circulation problem.” All “circulation problems are not the same, and clearly, a medical professional is needed to evaluate what is required. Varicose veins, which are more superficial can be treated with sclerotherapy and or laser therapy. For the purpose of this article, we will discuss sclerotherapy.

veins 1

Sclerotherapy are not for veins that look like this. This requires surgery.

Sclerotherapy can be used for legs that look like this.




Both, however are caused by the inability of blood to return from the legs, back up to the heart because the valves are not functioning. As a result, the blood collects and the bulging, or distension of the veins causes a back pressure and all the veins that are connected, in turn get bigger. They can be painful, but even worse, they are not so cute!

Sclerotherapy involves injecting a solution directly into the culprit vein. The solution irritates the lining of the vein, causing it to swell and stick together. Over time, the vessel turns into scar tissue that fades from view. The results, however, if successful are instantaneous.



Foggy Mind? …. Adrenal Insufficiency?

Published by DR, MD Simone Van Horne in Health · 27/9/2015 18:55:00
Tags: AdrenalMind

Foggy Mind? …. Adrenal Insufficiency?


People look around and feel that the conventional system does not measure up, and that something deeper about their well-being is notbeing addressed at all”
Dr. Linda Barnes, Boston University School of Medicine
To this end, people look to Suzanne Somers and Oprah for their medical advice, and trust them more than they do medical professionals.
Why? There are indeed a group of people who are not well, don’t have the disease per say that is “textbook”, and yet, something is definitely wrong.

  • Depression –no help from anti-depressnts
  • Hair falling out, sometimes in clumos
  • Foggy mind
  • Disorganized
  • Low energy
  • Lack of initiative
  • Salt cravings
  • Low blood pressure or feeling dizzy when you get up from a lying or seated position
  • Crave caffeine, can’tlive without it
  • Irritable
  • Secnd wind after supper

Do others perceive you as being

  • Lazy
  • Mean
  • Don’t care
  • Forgetful
  • Unconvincing
  • Always snacking
  • Gaining weight
  • Lack illpower
  • Disorganized

Adrenal fatigue was first described in 1898, and the medical professionals know it as hypoadrenia, in theory – but we almost never diagnose it. In the US it may affect 60-80% of adults, and it likely playing a role in the increase we are seeing in fibromyalgia, depression that still remains unfixed by anti-depressants, chronic fatigue syndrome, hypothyroidism, increased ulcers, and allergies.
We simply were not designed for the levels of constant stress we undergo today.
We were designed for
Wake up at sunrise
See the next meal gocathcht it
Someone wants to make me their meal, let me run
Go to sleep at sunset



PRP Facial Therapy Case 2

Published by DR, M.D. Simone Van Horne in SKIN · 22/9/2015 19:58:00

https://vimeo.com/80330954



Dark Circles Under Eyes

Published by DR, M.D. Simone Van Horne in SKIN · 22/9/2015 19:57:00


Dark Circles Under Eyes

“To make women look young. Then their outlook changes. They feel more joyous.”  Coco Chanel.

reduce-dark-circlesThe eyes are a big issue in most women.  Most people do not want to be told they look tired, especially when they don’t feel tired and feel great.  Most people think that a lack of sleep causes circles.  There are, however many more reasons.  Here are some of the things that can alleviate this.

Fatigue or illness

A good night’s rest and consistent sleep habits.  Sleeping 7-8 hour a night is best, and not sleep that add up to 7-8 hours. Reduce stress, drinking a lot
of water and cessation of smoking go a long way.  Exercise is always good for the circulation that it enhances everywhere.

Allergies, Congestion, Sinus problems:

Allergy medications, nasal sprays, rinsing out sinuses, eucalyptus oils
Hyperpigmentation

This refers to too much melanin around the eyes.  In most instances, this is genetic.  Sunscreen can be used to prevent them from getting darker.  Skin lighteners – vitamin C, Kojic acid, retinoids, will help them to improve. The skin is very thin, so be careful not to be too aggressive. Boron Nitride is a naturally occurring mineral that reflects light away from the eye area, leaving dark circles and under-eye bags immediately brighter. Niacinamide, Fraxinus Excelsior Bark Extract and Silanetriol as a combination of ingredients reduces eye puffiness, dark circles and under-eye bags while providing antioxidant protection

Thin Skin

Retinoids can thicken skin.  Retinoids really for anyone above the age of 40 is a must.  Drinking water again is a must for this.  Products with elastin and collagen help and IPL and other lasers close blood vessels which may be seen through the skin, especially when fair, or when a lot of weight is shed quickly.  Citrus Aurantium Dulcis Callus Culture Extract (Orange Stem Cell Extract) – strengthens skin structure to maintain healthy and youthful-looking skin; it organizes and firms the skin to reduce the appearance of fine lines and wrinkles.

Anemia

Many women will realize that when they are menstruating their circles will become worse.  Iron intake needs to be optimal with supplements, red meats, broccoli or liver.

Bruising

Do not rub eyes.  Be gentle when removing contacts, or removing makeup. Put on eye cream with ring fingers

Common home remedies which can be used to alleviate all of the above:

  • Cold cucumber slices
  • Tea Bags
  • Cold spoons
  • Potato slices



Adrenal Fatigue and the role of the Hormone Cortisol…

Published by DR, M.D. Simone Van Horne in Health · 22/9/2015 19:54:00
Adrenal Fatigue and the role of the Hormone Cortisol… 

The Dalai Lama, when asked what surprises him most about humanity, he said, “Man. He sacrifices himself to make money. Then he sacrifices money to recuperate health. And then he is so anxious about the future, he does not enjoy the present.”

That describes the rat race in which we live. Like the energizer bunny, we keep going and going and going. Maybe I should speak for myself, but I know I am not alone. Sacrificing ourselves – and the poor adrenal gland feels the brunt of that sacrifice.

The adrenal gland is that little gland at the top of the kidney, little, but very important as the storehouse of many of the hormones we need to fight, or to have flight, to endure stressful times. At high levels it acts as an anti-inflammatory and increases blood sugar. These are good things, at first. Our immune system is on high alert, and we have elevated blood glucose levels to do what we need to do, even if we do not eat. In an effort to create a balance, it then also begins to suppress the thyroid gland and this helps to slow us back down. Nature will always create balance with an inherent feedback mechanism. The aim of this is prevent more cortisol release.

But what happens when the stress is chronic? The feedback mechanisms do not work as they were not designed for that. Your blood sugar levels continue to be high. If you don’t exercise, and curb eating, then insulin is secreted in excess. What happens next? Diabetes. The great anti-inflammatory effects we had at first, from cortisol, now become dysfunctional. Food intolerances, weird allergies, chronic infections, pain issues now become more common. The pain is everywhere. This we are now beginning to understand are the roots of fibromyalgia and chronic fatigue. The interplay with other hormones also become dysfunctional. Osteoporosis is accelerated, cortisol is a steroid, after all. Fat begins to accumulate in the waist and protein breaks down more, because of insulin excess. Salt and water retention increase, hunger increases, insomnia is worse. These are effects of the steroid.

In the first stages of adrenal dysfunction, we will see elevated cortisol and the effects on other hormones become apparent on testing. The symptoms are:

  • poor sleep (melatonin effects)
  • loss of muscle (insulin and cortisol effects)
  • weight gain around the abdomen (insulin and cortisol)
  • depression (serotonin effects)
  • fluid retention (aldosterone effects)

In the last stages of adrenal dysfunction, we will see on testing, low cortisol levels. The adrenals cannot keep up with the super normal elevated cortisol levels we demand. Many other steroid hormones will also flatline. Testosterone, DHEA (dehydroepiandrosterone), progesterone as they are all steroid hormones and they all positively and negatively affect each other’s production. These are also apparent on testing. The symptoms now extend into:

  • fatigue
  • carb cravings
  • mental fogginess
  • headaches
  • salt cravings
  • exercise intolerance
  • poor wound healing
  • dark circles under eyes
  • heartburn
  • lack of sexual interest
  • inability to perform sexually
  • low blood pressure
  • fainting or feeling as though you will faint when you get up from a lying or seated position
    Practical ways to reduce high cortisol levels:

  • Balanced diet with low glycemic carbs
  • – whole foods
  • -high fiber in foods
  • wheat over white
  • protein, fat and carbs in each meal
  • low salt
  • Eliminate alcohol
  • Eliminate Stimulants – caffeine, energy drinks
  • Sleep
We will deal with medications and natural therapy to deal with adrenal fatigue next time.



Women, Hormones and Skin….

Published by DR, M.D. Simone Van Horne in SKIN · 22/9/2015 19:52:00


Women, Hormones and Skin….

Beauty to me, is about being comfortable in your own skin.  That, or a kick – ass red lipstick.”
Women are hormonal creatures. We are.  At any time of the month women will have a predominance of estrogen, progesterone, or testosterone going on.  Sometimes this re
sults in a harmonious symphony of harps, violins, and flutes, and other days, it’s a Metallica concert – heavy metal rock at it’s finest.  And the skin behaves the same way.
Estrogen is our beauty hormone.  And our mood is actually better when we have more estrogens.  It actually is the progesterone that wreaks havoc on our skin.  During the actual menses, oestrogen is at its peak.  By day 7 after menses, testosterone is beginning to increase.  This can make the skin oilier and if prone to breakouts, this is when it surely will happen
Days 15-28, progesterone rises, and this is when chaos will ensue if there is dysfunction.  Acne causing bacteria love high progesterone environments.  If you are stressed and your cortisol level is too high, and  this is the week before that “time of the month” is due, you can now appreciate why that really bad breakout.  Saliva testing can give a look into where you are on the spectrum.  Oilier skin during our formative years, however, has a good caveat.  It does help slow down aging.
At age 35, fertility begins to decline, and the fluctuation is real, and so
me women are horrified.  Melasma can present itself, or if there already can worsen.  Acne breakouts can worsen (unlike our parents insistence that you will “grow it out”).  There is also no pattern to the shifts that are occurring and therefore it can make things difficult to treat.
When menopause comes, estrogens tank, and this is when many women are just devastated.  Especially since hormone replacement is something that most women try not to do unless they absolutely have to.  The skin is dry; the cell turnover drops significantly the skin looks sullen.  Yikes!!  If that wasn’t bad enough, for those who are acne prone breakouts still happen as the sebum gets trapped around the hair follicles.  Double yikes!!!!
To this end, a skin regimen is essential at all stages of a woman’s life, but particularly when the cell turnover decreases.  Oilier skin types should have either a peel or a facial every two weeks.  The facials should concentrate on proper extractions and decongesting the follicles.  When the skin turnover gets stimulated with peels, purging will happen, and facials will be a great complement.
Home care should have a facial wash and toner with alpha hydroxyl acids, and if skin is acne prone, benzoyl peroxide and gluconolactone.  Toners should be alcohol free.  Moisturizers for acne prone skin should have an anti-inflammatory.
For the perimenopausal skin type, vitamins A, C, peptides and retinoids are crucial ingredients to look for.  Peels can be done monthly, or every three weeks, and many of the beneficial ingredients can be added as boosters to a good peel regimen.
After menopause, hydrating the skin is crucial – silicone, Shea butter, niacinamide are additional things to look for in addition to the vitamins A, C, peptides and retinol.
And, of course, always have sun block!
So remember, beauty is in the eye of the beholder, and that beholder is you.



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