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Monthly Archives: October 2016

Illegal Silicone Injections Can Be Deadly

The 30-year-old woman arrived at the Henry Ford Hospital emergency room in Detroit out of breath and coughing blood.

It didn’t take long for doctors to figure out why: The woman admitted to having been at a party at a hotel five days prior at which she — and others — received injections of liquid silicone to “enhance” the buttocks and various body parts.

The silicone was not the medical silicone that is sometimes used for implants, but the type easily procured at hardware stores like Home Depot. The fat solvent used to make the silicone had quickly traveled to her lungs and gotten stuck in the airways, resulting in “silicone embolism syndrome,” or clots, in this case, in the smaller vessels in her lungs.

The syndrome, admittedly rare, was first seen in transsexual men wanting to augment their breasts in the 1970s.

“There are two types of side effects [that can result from silicone injections],” said Dr. Angel Coz, the pulmonary and critical care specialist who treated the woman. “Lungs is one of them. The other goes to the brain. The mortality in lungs is close to 20 percent but in the brain it’s close to 100 percent.”

This woman, who was attempting to augment her buttocks, was one of the lucky ones. She survived after receiving steroids, said Coz, who is slated to present information on the case Monday at the American College of Chest Physicians’ annual meeting in Honolulu.

Others have died.

“We’ve been hearing about this,” said Dr. Malcolm Z. Roth, president of the American Society of Plastic Surgeons. “There are ‘pumping parties,’ involving high-volume injections to fill up the face, lips, cheekbones, chin or breast. Often it’s buttock enhancement and often it’s not sterile.”

And these illicit procedures may be on the rise, thanks to a slow economy and pocketbooks that aren’t full enough to afford licensed plastic surgeons, said Roth, who is also chief of plastic surgery at the Albany Medical Center in New York.

“It’s really a white-coat deception,” Roth said. “Sometimes the person doing the injections claims to be a physician from another country and in some cases the patient knows very well it’s not a physician but, feeling they can’t afford to go to a legitimate board-certified plastic surgeon, they find a short cut.”

Two other, similar cases of patients developing complications after silicone injections are also being presented at the meeting this week.

One involved a 22-year-old woman who showed up at the UCLA Medical Center emergency room, also with shortness of breath. This quickly progressed to right ventricular failure of the heart and the patient died despite the physicians’ best efforts.

Most likely, the silicone and solvent had damaged the lungs, leading to collapse of the heart.

This patient had had injections in her buttocks from “a doctor in Mexico” earlier that day, a friend told doctors.

The researchers presenting the case said this is the first documented case of right ventricular failure from silicone injections.

The third case was a 23-year-old woman with the familiar symptoms, shortness of breath and cough, who had had several silicone injections in her buttocks.

She was diagnosed with silicone embolism syndrome but, after receiving oxygen and steroids and spending five days in the hospital, recovered and went home.

According to Roth, patients should “run away from these procedures.”

“You don’t do medical procedures in a hotel room or garage. This procedure is illegal,” he said. “Patients need to do their homework and check the credentials of the professional they’re considering for their cosmetic procedure.”

“This is something that is not done by doctors,” added Coz. “It’s completely out of the realm of what any physician would do.”

Tips to Hide a Cold Sore

 Cold sores have a habit of breaking out when you have a cold, but they can be also caused by stress. That’s why you might discover a cold sore on your lip or around your mouth when you least want to deal with it.

Whether you’re going to a wedding or a big job interview, it’s hard to feel your best with a cold sore on your face. Using makeup such as concealer may help, but the timing can be tricky. “I wouldn’t recommend trying to cover a cold sore if it is not partially healed or scabbed over,” says Denise Gevaras, a professional makeup artist in Toms River, N.J. “Most cold sores will ooze in the beginning, and trying to put makeup on them will not only draw attention to them but can probably prevent them from healing properly.”

“It’s hard to conceal a cold sore when it has blistered and is still weeping,” agrees Danielle M. Miller, MD, a dermatologist at the Lahey Clinic in Burlington, Mass. “But you might be able to use a concealer safely when cold sores are in the healing stage. You also might be able to use an antiviral medication to prevent a cold sore from breaking out or to make it heal more quickly.”

Concealer to Hide a Cold Sore

Once your cold sore has begun healing, you can use makeup to lessen its appearance. “To cover a healing cold sore, I would recommend using a highly concentrated heavy concealer,” says Gevaras. “I have done this often in the past with clients having a breakout right before their wedding.”

Gevaras recommends these steps to best conceal a cold sore:

  • Use a concealer with a creamy texture, not a liquid. These concealers are usually sold in small jars, tubes, or compacts, and are very concentrated.
  • Only a small amount of a heavy concealer is needed — a little goes a very long way.
  • If you have a lot of redness, you may benefit from using concealer in two different shades: a yellow-based concealer to neutralize redness and a concealer that matches your skin tone.
  • Dab on the yellow concealer using a disposable makeup sponge. Start with a very small amount and build it up, if necessary, to avoid cakiness.
  • After the yellow concealer is applied, top it with a very light dusting of finishing powder. Pat it on lightly to avoid disturbing the concealer.
  • Next, gently dab on the concealer color that matches your skin tone and use a stipple motion to blend.
  • Apply another light dusting of finishing powder to set.

“Because cold sores are contagious, to avoid contaminating makeup products, use only disposable sponges and brushes, even if the cold sore is scabbed over,” warns Gevaras. “Never ‘double dip’ in the concealer or powder with the same makeup sponge or brush.”

Getting Rid of Cold Sores Sooner

While there is nothing you can do about an active, oozing cold sore, you might be able to shorten the life of the cold sore or even keep it from showing up.

“In many cases, symptoms of numbness and burning around your mouth or lip are early warning signs of a cold sore,” explains Dr. Miller. “Taking medication at this stage may suppress the blistering phase and shorten the duration of cold sores.”

If you commonly get cold sores or you have the early warning symptoms of a cold sore, ask your doctor if a prescription antiviral medication can help you.

Could Divorce Trigger Hair Loss in Women?

 As if the heartache of divorce wasn’t hardship enough, it appears that women enduring marital break-up may also have to deal with hair loss.

New research reveals that, genetics aside, the next strongest predictor of midline (central) hair loss among women is their marital status, with the loss of a spouse (through either divorce or death) raising the risk for thinning hair above that of married or single women.

“Most likely, stress is the aspect of a troubling divorce that appears to lead to hair loss among women,” noted study author Dr. Bahman Guyuron, chairman of the department of plastic surgery at Case Western Reserve School of Medicine.

Excessive drinking and/or smoking also appear to boost the risk for hair loss among women, the study found.

Smoking and heavy drinking also contributed to thinning locks among men, the study found. But in other respects the two genders were affected differently, with various patterns of male hair loss sparked by overexposure to the sun, cancer history and having a “couch potato” lifestyle, among others.

“What we can say is that we identified factors that appear to both raise risk and lower risk, for both men and women, independent of genetic disposition,” Guyuron said.

He is slated to present the findings from two related studies on Sunday at the American Society of Plastic Surgeons’ annual meeting, in Denver.

In the first study, the authors focused exclusively on a pool of 84 female identical twins, all of whom completed lifestyle questionnaires, followed by hormone blood level testing and an extensive photo analysis of their hair. Studies of identical twins can be useful because each twin carries the same genes as the other, ruling out genetic differences as a potential cause for a trait or illness.

Across the temporal area (near temples) of the head, the team found that the more years a woman had smoked the greater the hair loss. A history of skin conditions also contributed to hair loss in that area, while having just a couple drinks per week actually seemed to reduce the risk.

Hair loss in the coronal area (nearer the top) of the head among women was linked to being diabetic, having some form of skin disease and being a current smoker, while being overweight or obese was associated with lower risk of hair loss.

Guyuron said the findings indicate that female hair loss can also be sparked by excessive sleeping patterns, as well as situations commonly associated with stress such as having multiple children and/or getting married.

Women who drank coffee, used sun protection (such as a hat) and were happily married all faced a lower overall risk for hair loss, he added.

The team’s second study similarly looked at hair loss among 66 male identical twins.

The results: in addition to smoking and sun exposure, having a history of dandruff also boosted midline hair loss risk, while cumulative sun exposure and a history of cancer elevated risk for both temporal and coronal hair loss.

Men who didn’t exercise regularly and had high blood pressure also had a higher risk for coronal hair loss.

Men who exercised outdoors a lot also face a higher risk for hair loss, and Guyuron believes sun exposure could play a role there.

Dr. Doris Day, an attending physician in dermatology at Lenox Hill Hospital in New York City, expressed little surprise at the findings relating divorce to hair loss in women.

“It’s complicated,” she noted, “but it’s not a shock to suggest that various kinds of stress can lead to hair loss. Or that men and women don’t experience stress in the same way, so that their hair loss patterns may be different.”

“And in the end, I am a big proponent of the idea that it’s how you handle the stress that can make a difference,” she added. “The mind-and-body connection is incredibly powerful. It helps to try and keep perspective, put the big things that happen in life, the major milestones, in their place and keep an open mind.”

“Of course, you can still get treatment,” said Day. “You can still go for Rogaine drops or laser hair treatment, for example. There are always medical things that can be done, and one does not preclude the other. But patients also need to try and control what they can control in terms of the way they approach stress and handle situations.”

Top 7 Tips for Healthy Winter Skin

 Dry winter air can wreak havoc on your skin — leaving it dry, itchy, and irritated; but there are many simple ways to combat dry skin causes and help keep your skin feeling moist and supple all winter long. Here are 7 ways to get started.

Top 7 Tips for Healthy Winter Skin

1. Invest in a humidifier. Using a humidifier in your home or office will add moisture to dry winter air and help keep your skin hydrated. Run a humidifier in the rooms you spend the most time in, including your bedroom.

2. Lower the thermostat. When it’s chilly outside, what’s the first thing you want to do? Crank up the heat! But central heat can make the air in your house even drier. Try setting the thermostat at a cool, yet comfortable setting — 68°F to 72°F — to maintain healthy skin.

3. Skip hot showers. Although it may be tempting to warm up with a long, steamy shower, hot water dries out your skin by stripping it of its natural oils. Instead, take a 5- to 10-minute lukewarm shower (or bath). You should also avoid using excessively hot water when washing your hands — if the water causes your skin to turn red, it’s too hot.

4. Choose cleanser wisely. The wrong soap can worsen itchy, dry skin. For instance, steer clear of regular bar soaps, since they tend to contain irritating ingredients and fragrances. Instead, start washing with a fragrance-free, moisturizing cleanser or gel. You can also prevent winter skin problems by using less soap, so limit your lathering to necessary areas, such as your hands, armpits, genitals, and feet.

5. Modify your facial skin care regimen for the season. During the winter months, choose cream-based cleansers, and apply toners and astringents sparingly, if at all. Many astringents contain alcohol, which can further dry your skin. Look for products that contain little or no alcohol — unless your skin is excessively oily. At night, use a richer moisturizer on your face.

6. Moisturize frequently. Maintain healthy skin by moisturizing after washing up. “Blot skin dry and apply a thick moisturizer within a few minutes after bathing to seal the water into the skin,” says Linda Stein Gold, MD, director of dermatology clinical research and division head of dermatology at Henry Ford Hospital, West Bloomfield, MI. “It’s best to use a cream or ointment in the winter. Lotions are better in warmer, humid climates. And don’t forget your hands,” says Dr. Stein Gold. “Constant washing will cause the hands to take a beating. Apply hand cream after each washing, and wear waterproof gloves when washing dishes or cleaning around the house.”

7. Apply sunscreen — even in winter. It is still important to protect your skin from harmful UV rays on cold, dreary days in winter. Before going outside, apply a moisturizing, broad-spectrum sunscreen with an SPF of 15 or higher to all exposed areas of your body.