Tag Archives: treatment

Cellulite: What Is It? How Can You Treat It?

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28

Spring is here. You can finally stop salting your icy sidewalk and start focusing on summer issues, like cellulite.

What is cellulite?

It’s the dimpling and nodularity that occurs in women on the thighs, pelvis and abdomen. Cellulite is the result of fat pouching out of holes in the connective tissue on the skin. It occurs in 98% of girls and women post puberty. That’s right. Essentially all females have cellulite. It is a normal characteristic of sexually mature women.

Here’s what cellulite is not:

  • Cellulite is not fat. It is the appearance of the superficial fat held loosely beneath the skin. The fat is held more tightly in men which is why we do not develop cellulite.
  • Obesity doesn’t cause cellulite. Look around and you will see that skinny women have cellulite (in real life anyway).
  • Cellulite is not an accumulation of toxins or fluids; it is normal fat.

How Can You Get Rid of Cellulite?

The best treatments for cellulite have at most shown mild improvements in the appearance. Unfortunately, in almost all cases, the improvements are not maintained over time. This is because it is hard to change the loose connective fibers under the skin, which are the primary cause.

  • Weight loss can improve cellulite, but not always. Losing weight can make the skin sag, and weight loss has been shown to actually worsen the appearance of cellulite in some women.
  • Endermologie is a kneading system (like my grandmother would knead the pizza dough). Although there is some evidence it can reduce thigh circumference, how long the effects last is questionable.
  • Liposuction removes fat through suction. It is not a good treatment for cellulite because the fat is too superficial. Liposuction combined with a laser to treat cellulite sounds interesting, but has not been shown to work better than ordinary liposuction.
  • Subcision, which targets the connective tissue bands by snipping them, is a great idea, but in practice has not been shown to be very effective. There is some concern that snipping the connective fibers might actually make the fat looser, worsening the problem.
  • Mesotherapy is the injection of medications under the skin to dissolve the fat. Although it has worked for some, the results are unpredictable and can cause adverse side effects such as bruising or pain.
  • Radiofrequency treatments like TriActive or VelaSmooth generate heat under the skin damaging the fat and connective tissue, hopefully smoothing the cellulite. Improvements have been reported, but no long term efficacy has been demonstrated.
  • Herbal creams have been studied and had no effect on cellulite. It is unlikely that any topical treatment can penetrate far enough down and be potent enough to have any effect.
  • Diet has no effect on cellulite.
  • It is possible that regular exercise can improve the circulation of cellulite areas, improving the appearance, but no studies have shown that it has a significant impact. Work out because it is good for you, but stop looking at your behind in the gym mirror.
  • There are some upcoming technologies that are promising. I’ll post about them later.

What Should You Do About Cellulite?

Because it is a normal occurence in women, it’s reasonable to simply tell yourself: “Hey, this is normal!” and stop killing yourself trying to eliminate it. Many women have been pleased with any of the above treatments, but they’re all expensive and likely all temporary. If it is worth spending $500 to have a 50% improvement in your cellulite, then make an appointment with your dermatologist or plastic surgeon to discuss your options.

Keep in mind that your friends or partner might not notice that your cellulite is 50% better (what does 50% better cellulite look like anyway?). If you’re worried that you might be featured in a magazine, don’t fret. You will receive the only known cure for cellulite: Photoshop.

Do you have cellulite? Have you tried to eliminate it? How successful was it?

Photo: Tassoman

Red Spots

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Lots of women have been Going Red lately. “Go Red” is a campaign to raise awareness of heart disease in women. Some women I see are often going red for a different reason: they’re covered in little red spots called cherry angiomas.

Cherry angiomas are tiny lumps of overgrown blood vessels in the skin. Their name derives from their often bright or deep red color. Like a cherry. Get it?

In your thirties and forties you might have a few. By the time you’re 80, you’ll probably have many (hence their other, more unfortunate name: senile angiomas). They cluster on the chest and back and can number in the hundreds. Although they grow on men and women equally, women are more likely to see a physician to have them checked.

Cherry angiomas are harmless, but many people hate the way they look. Fortunately, they’re easy to treat. Each little red spot represents a tiny, tangled knot of blood vessels. Treatments destroy the tiny vessels, making the red spot disappear. Treatments include:

Liquid nitrogen: A blast of icy cold air freezes the vessels. Often a blister develops the next day and can leave a lightened spot.

Electrocautery: A zap of electricity burns the vessels. It can sometimes leave a tiny scar.

Laser: The blood in the vessels absorbs a blast of light energy, exploding the tiny vessels and removing the spot. The ruptured vessel can cause a bruise that lasts for weeks.

All three methods are effective at removing the red spots, although each hurts a little and each usually requires multiple treatments. The more destructive the treatment, the more likely it is to work the first time, but the more likely it is to leave a scar.

It can be difficult to determine if a red spot on your skin is a harmless cherry angioma or if it is a skin cancer. If you have spots that are changing, bleeding, or multiplying quickly, or if you have any concerns, then you should see a physician.

Photo: Bensonkua (flickr)

iPhone App Claims to Treat Acne. Does it?

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I love my iPhone. (No, that’s not me in the photo.)

My iPhone is teeming with apps that help me get through my day (like Doodle Jump for instance). An emerging iPhone trend is the development of apps that diagnose and treat diseases. For example, there is the stethoscope app to help diagnose heart murmurs. In dermatology, there is an app designed to treat acne.

We know that specific wavelengths of light can have medicinal effects such as killing bacteria (red light) and reducing inflammation (blue light). This app produces light at those wavelengths to treat acne. The claim is that by holding the iPhone to your face, the light produced from the app will treat your acne.

Although it scores a 10 on 10 in the coolness factor, it scores a 0 on 10 for proof of efficacy. The studies that looked at treating acne with light used much more intense light than an iPhone uses. The studies with more powerful light exposed faces for 60 minutes every week, which is about 8 minutes on each side every day. Even then, light treatments for acne have not been shown to be consistently better than standard acne treatments such as antibiotics and tretinoin.

So does the acne app work? Well, there are no studies to tell us. Given that the light intensity is low and that most people would not do the treatment — try holding your phone for 2-5 minutes on each side of your face every day for months — I doubt it works.

Acne is common and naturally gets better and worse at times no matter what you do. It is unfortunate that products like this are sold that do not have any proof that they work. There will be people who buy this app and believe that it helped them, (“My acne was clear in just THREE DAYS!”) but the two bucks is better spent on Doodle Jump.

See also:

Can an iPhone App Clear Up Your Acne?

In Light and Heat, Gadgets Claim to Fight Acne

Better Skin to the Touch?

Can You Treat Acne With an iPhone App?

A study to determine the effect of combination blue (415 nm) and near-infrared (830 nm) light-emitting diode (LED) therapy for moderate acne vulgaris.

Photo: Aye Shamus (flickr)

Extract from White Birch Tree Relieves Itch

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The forest is full of things that make you itchy: poison ivy, poison oak, mosquitoes, chiggers. But for the wise adventurer, the forest also provides a way to heal your itch. The remedy might be found in the beautiful white birch tree.

White birch trees are ubiquitous in cold climates. A photo of the white tree against white snow is iconic of New England winters. A bark extract called Betulin (a terpene like tea tree oil) has been shown in animal studies to be antimicrobial, anti-inflammatory, and to aid in wound healing. Research presented at the annual congress of the European Academy of Dermatology and Venerology showed that a cream containing betulin significantly reduced itching in red, irritated skin in psoriasis and eczema patients.

The study is only preliminary, and betulin will need to be tested in rigorous trials to see if the extract makes a cream much better than placebo cream; however, betulin is already available in creams in Europe.

So how do you get the extract out of the bark if you’re  itchy while hiking in a forest? I’ll wait for Bear Grylls to show us on a future episode of Man Vs. Wild. No doubt a fire and half a plastic bottle will be needed.

Photo: Nicolas T

Depressed? Maybe Your Psychiatrist Will Prescribe Botox.

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12

Botox makes you happy. So does a new Lexus, but I can’t prescribe that.

Botox® temporarily freezes dynamic lines such as crow’s feet and forehead wrinkles. When Botox is done well, it can raise your eyebrows and make your face appear well rested, younger, happier. Botox also makes it difficult to furrow your brow or frown.

Too much Botox freezes your face, making it expressionless (which could be seen in both winners and losers at the recent Golden Globes: Were they happy? Sad? Shocked? Who could tell?).

Because Botox can make people look better, it’s no surprise that people who get Botox are happier afterwards. A review in the Journal of Drugs in Dermatology actually looked at the cost of treating depressed patients with Botox. Here’s the reasoning: If you cannot frown because of Botox, then your mind will interpert this as you feel less angry or sad. Preliminary studies showed that people treated with Botox had more positive emotions and felt less depressed after their treatment.

While the logic is easily followed (and is emphatically supported by people who ordinarily pay cash for their Botox), the science is absent. There are no studies that show Botox improves depression as compared to placebo, therapy, or antidepressants. Much more research would have to be done to show that there is a real benefit (it would be  interesting to compare Botox to simply giving people $500 in cash and teaching them to frown less).

Depression is a disease and is never fixed quickly. Treating depression always requires effort, often requires therapy, and sometimes requires medication. I doubt that medication will be Botox. Or a new Lexus.

Photo: Geekadman Flickr.com