Brau events Dr. Shazia Ali
BRAUN Reveals Its Complete Beauty Collection At An Exclusive Event 
KSA, November 2015 – Braun the world’s No. 1 epilator brand hosted an experiential event in Jeddah, which was attended by some of the most influential beauty and fashion leaders in KSA. The experiential beauty event “Braun Beauty Girls Night In” was the first of its kind as Braun highlighted that when women feel confident they can realize their potential, wear anything they want and embrace unlimited choices.
Braun revealed the Silk-épil 5 the latest addition to the Braun beauty collection, the Silk-épil 9 Wet & Dry, the ultimate portable skin spa and beauty essential every woman needs to look and feel their best was also available for the ladies to experience and finally, the guests were given a chance to customize their skin care regimen and switch on a Hollywood flawless glow by using the Braun Face and the latest beauty brushes.
Braun event Saudi Arabia

Guests were transformed from girl next door to a glam Braun Beauty as they were given an in depth skin consultation with renowned dermatologist, Dr. Shazia Ali and were also treated to a complete make over from beauty specialist Inas Hammoud.
Associate Brand Director from Braun’s Global team, Leonara Scarpa attended the event and was eager to talk to the ladies about Braun’s BreakFree Campaign which called on women worldwide to support and encourage each other, ” We are excited to showcase the Braun beauty collection at this beautiful event today. The Braun Silk-épil line up which includes Silk-épil 9, Braun Face and now Silk-épil 5 truly is a customized approach to beauty regimes. At Braun we strive to provide women with the latest beauty essentials that can help them take control of their beauty routine.”
To sum it up, the event was an enjoyable and informative evening for all the guests as it gave them a chance to experience the entire Braun beauty collection as well as look and feel Beautiful.
Braun events dr shazia ali

Braun events dr shazia ali
Braun event dr shazia aliBraun events dr shazia ali


How To Keep Your Chin Up In Today’s Beauty Obsessed World

Juvederm for chin
Connoisseurs of beauty agree that a good facial architecture is necessary to emphasize the allure of any face whether you’re a man or a woman. Inspired by the beauty criteria prescribed by poets and painters women have been obsessing over sexy lips, long lashes, high cheek-bones, etc. but recently the renaissance sculptors — a.k.a the aesthetic doctors of today — have diverted attention towards the lower face focusing on chin and jaw-line.

Exhibit One Kim K — looking at these before and after’s you can clearly see that the position of chin is fundamental when judging the golden proportions of a face. 
kim kardasian chin enhancement
A youthful V-shaped face blessed with well angled/sized chin can elevate beauty of any visage if the correct proportions are restored.

Hot Or Not Finger Trap Test — Lets put your beauty to a bone fide “Rickett's E-line” test to verify your lower facial symmetry and proportions. For a quick determine if you're 'beautiful' —place your index finger against your chin and nose and see if your lips touch it. If they do, congratulations, you're officially hot.

This concept of measuring lower face proportions dates back to the 1950s and is credited to orthodontist Dr. Robert Ricketts, who focused on what he called the 'E-plane'. According to him in an average Caucasian face a  'pleasing facial profile' was determined — when a simple line drawn from the tip of the nose to the tip of the chin, the lips touched the plane — or in the finger trap's case, the finger- running from the nose to the chin. Like the Golden Ratio devised by the ancient Greeks, its one of the tests practiced by some cosmetic doctors to assess and plan cosmetic treatments.

Reality Of Life Not everyone is born with a perfect facial structure. Some of us are born with a recessive or weak chin. Aging can also play a role as lax skin and the effects of gravity disrupt the contours of a once beautiful face. Fat layers on the form of a double chin can also distort the beauty and elegance of a face.

Proportions of Chin

Facial proportions

Non Surgical Solutions

Liquid Implants like Hyaluronic Acid (Juvéderm® Ultra Xc, Juvéderm Voluma®, Teosyal Ultra Deep) and Calcium Hydroxyapatite (Radiesse) can be expertly injected to define the golden proportions of chin in contrast to the face.

chin injections

Fat Injections a natural option that can also be used to reshape and volumize a recessive chin and restore the golden proportions of chin.

Aesthetic medicine now can non-surgically give you, what only genetically blessed people had it naturally in the past. Enjoy the reaps of modern medicine balance your inner beauty with your outer beauty and smile bright.


Strangle Yourself Thin — The Waist Training Trend

Waist training
The corset— that symbol of 19th-century patriarchal oppression and torture has been experiencing a bit of a comeback and Hollywood along with its zaftig partners-in-crime: the Kardasian clan have been taking full credit for it. Lily James starring as Cinderella recently ignited a serious debate on all social media platforms, which circled particularly around her 17inch cinched-waistline — naturally slim or corset magic? Our latest obsession with waif waistlines is not a new fad, in fact it is a boomerang effect as if a subliminal message has been passed back to us through centuries: Be it a Disney princess, Victorian era heroine,  a modern day working gal or a reality TV princess a minuscule waistline elevates female-form imparting it with a magical edge ascending gal-next-door to the status of an ethereal beauty at some level we all crave it unconsciously— don't you?
waist training

Since corset training to curb mum-tums has become all the rage, celebs like Jesica Alba, JWoww, Ciara and Brooke Burke-Charvet all have professed to practice and believe in the power of a corset cinched waist. Inspired eves in Jeddah have been popping into my practice in throws inquiring about the legitimacy of this dernier cri, hence I have decided to write about it, so you can all know my view on this fad once and for all.

What is Waist Training?
Corset training draws on the age-old Elizabethan trend used by women to cinch their waists and make their busts appear larger. Modern corsets used for “waist training,” (the fitness buzzword) combine the traditional structure of corsets to give the illusion of a tinier waist with the modern technology of compression fabric. Theoretically speaking the compression fabric encourages thermal activity and perspiration to help stimulate weight and inch loss in the core. 

The Hardcore Truth— You don’t have to be an M.D. to realize that “training” your waist to shrink in size permanently sounds suspiciously iffy. While you are wearing the corset fat is simply pushed to another area of the body for a temporary amount of time. Once you take the garment off, your body will return to its usual size. The fix is temporary.
Believers say that the tightness of the garment makes you sweat a lot, but scientifically speaking it’s really not possible to perspire so much that inches can get shaved off from your midsection in any permanent way. There is also the theory that the stomach will be squeezed into a smaller size, causing less hunger and less overall intake of calories with weight loss as a result.
So far there is no clinical proof, that thermal effect, or squeezing the tummy can be effective or beneficial in reducing fat permanently. In fact, it may be harmful to a woman’s body over time. If a waist trainer is too tight; which many of them appear to be (if recent celeb photos are any indication) it could cause discomfort, interfere with breathing, or contribute towards heartburn. Your stomach might get pushed up beyond the diaphragm, which could cause acid reflux or hernia.

Weighing The Risks— Let’s explore the possible risks involved in this new slimming craze. As a corset squeezes a woman’s outsides, it is also squeezing the insides. This pressure on the internal organs can be a serious health concern. If the lungs are prevented from properly expanding, it can increase risk of pneumonia. As the stomach and colon are prevented from moving its contents, heartburn and chronic constipation can occur. Forcing the ribs and muscles into a tight and restrictive garment can cause chronic pain and bruising. The corset can also prevent return of blood flow to the heart, which can affect blood pressure and may result in dizziness and even fainting. Homes in the 18th century had "fainting couches" for this very reason.
waist training

Word to the wise, if you’re wearing a waist trainer and you experience any of above mentioned symptoms, that’s a definite sign that you need to loosen it up or take it off.

Practicing The Trend While Working Out— Waist training trend encourages women to wear the corset while working out! According to fitness experts, this is a huge no-no as our bodies need as much oxygen as possible during cardio and the use of restrictive garments prevents your lungs from expanding fully. In fact, some experts believe that regularly wearing a waist trainer can actually decrease core strength— exactly the opposite of what you want if you’re aiming for sexy stomach musculature.

Lilly James Verdict On The Corset — in Cinders own words, "If you ate food it didn't really digest properly, and I'd be burping all afternoon and it was just really sort of unpleasant". She actually went on a liquid diet to survive shooting through the movie to be able to fit into the ultra-constricting corset.
waist training

Final Verdict— Waist trainers can’t have any lasting effect on waist size, shape, or appearance. They’ll make you look slimmer while you wear them, but you may have to put up with some discomfort and maybe even some health risks in return. You're better off eating a balanced diet and investing in a personal trainer. After all, there's a reason we stopped wearing gowns with corsets in the 19th century!

Sure Shot Way To Shed Pounds Around Your Belly You guessed it — eating healthy and being active on a regular basis. It’s not trendy, but it’s the one thing that works, whether you want to drop baby weight or just a few stubborn lbs.


The A List Antiaging Secret — The UltraLift

Ultralift, Ultrasound assisted facelift
Thanks to a steady diet of lasers, lights, RF, and needles, middle-aged celebs have been defying aging with legitimate denials of surgical interventions.  How do they stay so youthful and fresh beyond their years is not a big SECRET anymore — Forget diamonds a dermatologist is a celeb’s best friend these days!

Talking about secrets — minimally invasive, no downtime, lunch-time procedures are what A-list celebs are relaying on these days to maintain their youthful image and skin. These are real exciting times for anti-aging medicine, the modern day anti-aging experts are armed, ready, and able to deliver revolutionary yet natural results — knives are being shelved and instead cutting edge devices are emerging as new youth dispensing heros. One such technology generating the loudest buzz in A-List anti-aging circles is: high intensity focused Ultrasound waves (HIFU to be more precise) — sound waves whispering youth into the aging skin (literally).

Yup, ultrasound facials my youthistas are the latest trend in lunch-hour high-tech treatments., these sessions comes with a solemn promise (backed by medical studies) to wipe years off of any visage with zero down time. The unique Ultralift (ultrasound assisted facelift) tightens the skin as well as the deeper support layer below it, without cutting or disrupting the surface of the skin. Rumored to be a favorite of Courtney Cox this technology holds the strongest promise yet to reduce fine lines, firm sagging skin and tackle open pores and pigmentation marks.

Let’s You Up Close & Personal With The UltraLift

The UltraLift is a non-surgical face, neck and body treatment that uses ultrasound to actually lift and tone loose skin without any downtime. It is a truly revolutionary treatment that can specifically target the SMAS; the deep foundation below the skin that is addressed during facelift surgery without cutting or disrupting the surface of the skin. 

Here are some questions that most people want to know about this latest nonsurgical facelift, before they consider test-driving the procedure personally.

How is The UltraLift different from Lasers and Radiofrequency technologies?

Lasers and RF technologies typically address issues in the superficial layers of the skin (e.g. fine lines, wrinkles, pigment changes). The focused ultrasound technology can address the skin as well as the deeper layer called SMAS, which makes the foundational muscle layer that drapes and lends support to the skin. The UltraLift therefore can provide more powerful lifting effect when compared to other technologies. Lasers in particular target pigment tissue of skin making some treatments in skin of color a little risky. Ultrasound on the other hand is not absorbed by the pigment elements of skin allowing treatments for even darker skin types more safely without any pigmentation related side effects

Who is a good candidate for The UltraLift?

Ultheraoy, ULtrasound facial

A good candidate for The UltraLift is someone with early to medium signs of aging someone with skin that feels less firm and looks sagging. A lowered brow line or sagging skin on the eyelids, for instance, is often the first sign of "aging", ill-defined jaw-line with hanging jowls, deepening marionette lines and laugh lines and sagging cheeks can all be addressed with Ultralift. While The Ultralift is not a replacement for surgery, there are many people who want some lifting but are not ready for surgery either mentally, financially or logistically.

What To Expect After The UltraLift Treatment?

Immediately after the procedure there is mild redness and swelling which subsides in few hours. Most people enjoy this edema as an initial lifting effect, but the ultimate lifting and toning takes place over the next 2-3 months, as tired and damaged collagen is renewed and replaced with new and stronger collagen. When eye area is treated it takes 3-7 days for the swelling to subside.

Is there any downtime with The UltraLift treatment?

With UltraLift, there is no downtime, most people are able to return to their normal activities right away, and no special measures are needed. It also can be carried out at any time of the year with no restrictions, with regard to sun exposure.

Will I feel the ultrasound during the treatment?

Yes. What you are feeling during the treatment is actually tiny amounts of concentrated ultrasound energy (micro coagulation zones) being deposited below the surface of the skin. While treating bony areas (jawline, cheek bones, bony area above eyes) there can be some discomfort while the energy is being delivered, but it is temporary and a positive signal that the collagen-building process has been initiated.

Remembering Thermage Is The UtraLift painful?

Usually a numbing cream is applied half an hour before the procedure, which makes the procedure relatively painless. Some people feel no discomfort at all, on the other hand some people who are more sensitive with very low pain threshold feel the procedure is uncomfortable but tolerable. In such sensitive cases oral ibuprofen or a nerve block might be used to make the procedure more acceptable. My personal experience — patients typically leave comfortable and excited about the benefits to come.

Are there any side effects?

There may be slight redness for up to an hour or so following the treatment, and a small percentage of people may have slight swelling, tingling or tenderness to touch, but these are mild and temporary in nature. There is always the possibility for other less common post-procedural effects, which your doctor will review with you in detail before the procedure.

How long does it take to perform The UltraLift?

A full face-and-neck treatment takes approximately 60 minutes, and a partial face treatment can take around 30-minutes.

What will my skin feel like after the procedure?

Immediately following the UltraLift procedure your skin should feel tighter, smoother and more youthful. Over time (2-3 months) you may notice additional tightening. The most frequently reported incidents are as follows and they all resolve within a few days of treatment:
·      Redness
·      Swelling
·      Tingling of the skin
·      Tenderness
·      Bruising

What areas can be treated with UltraLift?

The UltraLift is perfect for tightening and lifting the skin on the neck, under the chin, the jawline, the brow, around the eyes, and treating wrinkling and sagging on the décolletage and body (areas of which that can be targeted include: chest, arms, armpits, abdomen, flanks, thighs and lower legs).

How long before I can return to my normal activities?

Most people can return to their regular activities immediately following the UltraLift procedure. You should avoid exposing your skin to extremes of heat and cold and protect your skin with a sun block cream. Your normal makeup regime can be followed immediately.

Important Question Everyone Is Thinking About - Is The UltraLift safe?

After demonstrating safety in clinical studies, the device and the procedure have been cleared by the U.S FDA. Tens of thousands of treatments have been performed worldwide without any significant adverse events. In addition, ultrasound energy has a proven track record, with use in the field of medicine for more than 50 years, including pregnancy scans.


Chasing The Curse Of Sweaty Armpits

Hyperhydrosis, Excessive sweating
WE ALL sweat…. it is an essential process through which our body regulates temperature, but in certain genetically predisposed individuals (1-5% of population) perspiration can get so excessive that it cannot be controlled by even the strongest antiperspirants. In such cases that are sweating bullets constantly the drenched armpits exhibit the tell tale and embarrassing hallmark of “focal excessive sweating”. The prospect of ugly sweat patches appearing on clothes all the time can make any person very self-conscious and constantly battling with such a condition can eventually affect work as well as other social aspects of life. Today we’ll get you comfortable with the condition and introduce you to remedies that are available to function sweat free.

Hyperhidrosis is the medical name for such abnormally excessive sweating. It mostly affects the armpits, hands and feet.

Why I Sweat All The Time? It is thought that the nerves that trigger sweating malfunction causing the sweat glands to produce much more than required. What causes them to malfunction is not clear but up to two thirds of patients have a family history of the disorder suggesting, it may have a genetic cause and the trait usually appears after adolescence.

Secondary hyperhidrosis can also be triggered by some medications such as the antidepressant venlafaxine, the breast cancer treatment tamoxifen, and gonadotrophin-releasing hormone antagonists, a class of drugs used to treat fertility problems and prostate cancer.

Fighting Excessive Sweating

Hyperhydrosis Treatments excessive sweating

Standard Treatments include strong “prescription-only antiperspirants” and drugs such as propantheline or oxybutynin that work by blocking messages from the nerves that control the sweat glands. Unfortunately side effects of these medications can include a dry mouth, blurred vision, and problems with urination, hence they are not very popular for regular and long term use.

Iontophoresis works by sending low electronic waves through the skin passed through water or a wet pad, which helps to block the sweat glands. Mostly hands and feet are ideally treated by iontophoresis. Treating underarm hyperhidrosis with iontophoresis is not as common (although some people can have success with it) because the skin in the armpits is likely to be irritated by the process and because the physical structure of the underarms makes iontophoresis difficult to accomplish.

Sympathectomy Patients suffering from extreme sweating in some cases undergo an operation known as “Endoscopic Thoracic Sympathectomy”, which involves cutting into both armpits and collapsing the patient’s lung in the process to destroy the nerves activating the sweat glands in the armpit region. This is no doubt a risky surgical procedure and that’s why a very few number of patients opt for such an extreme measure to zap sweating.

Botox Injections have transformed excessive sweat treatment options since the past few years. The procedure works and is quiet safe the only catch here is that the injections have to be repeated two to three times a year and the cost of the procedure is on the expensive side.

Laser Dry is a minimally invasive and relatively quick procedure, which has become quiet popular among hyperhydrosis patients since the past 3-5 years. It takes less than an hour or so to perform, a solution containing a local anesthetic is infused into the fat layer of the skin in the axillary (armpit) area where the sweat glands are located. This fluid numbs the area locally. Next, a laser cannula measuring 2mm in diameter is inserted under the skin. The laser heats and melts the sweat glands and the surrounding fat, permanently reducing the ability of the sweat glands to produce sweat. The recovery from this procedure is quick and post-operative pain minimal. After the procedure patient has to wear a compression garment for 3-4 weeks and exercise is off limited for one week.

MiraDry is a new and quick procedure (1 – 1.5 hours) performed in a medical clinics, and it doesn't involve any surgical incisions or cuts. MiraDry works by delivering precisely controlled electromagnetic energy to the underarm area, eliminating the underarm sweat glands. Following local anaesthetic cream, the glands are suctioned to the surface and then eliminated after being blasted with electromagnetic waves. Patients need one or a maximum of two sessions for sweating to be stopped almost completely for ever. Done under expert hands side effects from Miradry are limited but those undergoing treatment are likely to experience swelling for several days. Patients are advised to put ice packs under their arms and take ibuprofen for 2-3 days.


Biologic Treatments In Dermatology Beyond Psoriasis

Bilologics in Dermatology
Here’s a very informative catalogue of the off-label use of biological drugs in Dermatology by Martinez Leborans et al. which was shared with the dermatological community as Poster at EADV Annual Meeting 2015 – Copenhagen, Denmark

The Off-Label Use Of Biological Drugs In Dermatology  - Our Experience In The Last 10 Years

Biologics have a targeted action against very specific molecules involved in the pathogenic mechanisms of the disease.
For instance, psoriasis treatments often target cytokines involved in the pathogenic pathway, such as Tumor-Necrosis Factor (TNF)

In this study from Spain spanning from 2002 to 2014, 45 different biologic drugs were given for off-label indications in 38 patients (25 male, mean age 41.7 years old)

In which indication were the biologics used ? (percentage of total)
-47% = hidradenitis suppurativa (HS; Verneuil’s disease)
-22% = pemphigus vulgaris (PV)
-11% = Pyoderma Gangrenosum
-9% = Atopic dermatitis (AD)
-3% = Behcet’s disease
-2% = Pityriasis Rubra Pilaris (PRP)
-2% = Psoriatic arthritis (PsA)
-2% = Eosinophilic Folliculitis (Ofuji’s disease)
-2% = Bullous Pemphigoid

Which biologics were used ? (percentage of total)
-44% = Infliximab (Remicade)
-24% = Rituximab (Mabtera, Rituxan)
–18% = Adalimumab (Humira)
-9% = Estekinumab (Stelara)
-5% = Etanercept (Enbrel)

What were the response rates ? (percentage of total)
-25% = total response
-37% = partial response
-20% = no response
-18% = loss of efficacy

Was it safe ?
1 patient had a severe adverse event (AE), and only 8 did not respond

-This study shows that biologics are given for off-label indications
-Although some biologics have shown indications for off-label treatments, there is no specific data shown in this study…it does however show that they are effective.


Spring Cleaning For Summer Affiliated Skin Afflictions

Tinea versicolor, Moluscum Virus, Folliculitis, Bug bites
Summer is "officially" almost over and what we are dealing with right now is the after math in the form of different skin afflictions. Yup we’ve all been there —you’re staring at that funny patch of skin and frantically Googling the possible causes. But before you diagnose yourself with a rare ailment, check to see if your symptoms match up to anything on this list of slightly embarrassing, but totally common —post summer skin issues.

Tinea Versicolor

Folks this ailment is particularly prevalent in places that are humid all year round like the tropics, but in the summer can be seen across the globe —roughly 1 in 1000 people are usually affected. Typically it manifests its self in the form of light and dark patches of blotchiness on the skin. (Fun fact: The name versicolor actually means varied color). They’re often mistaken for sunspots, but this uneven skin tone is actually caused by a fungus that normally lives on the surface of your skin. When people sweat a lot, the fungus can take over, which is why symptoms tend to crop up during the spring and end of summer.
Tinea Versicolor

Prevention And Treatment
This yeast bonanza can be prevented by staying clean. The best preventative measure is to rinse off after a particularly sweaty day. Hop into the shower ASAP after exercising in humid weather.
For mild cases of tinea versicolor, you can try applying Selsun Blue or Nizoral Shampoo to the affected areas, leaving for 10 minutes, and then rinsing. If you want a guaranteed fix, your dermatologist can prescribe an antifungal medicine, either a pill for more serious all-over cases, or a topical foam that you rub on smaller patches of affected areas. (Tip: make sure to put foam on the splotches as well as beyond the borders of it.) The unexpected last step is getting a dermatologist-approved tan, as the fungus produces enzymes that leave skin hyper or hypo pigmented. Your skin won’t even out in color until you venture back out into the sun.

If you live in workout clothes or spandex, you could be at risk for developing folliculitis. It is particularly easy to contract this bacterial infection in the summer months. Bacteria, like yeast, love the warmth. They thrive in warm, moist dark conditions. Essentially summer sweat is bacteria’s dream but it’s definitely not ours. Folliculitis tends to look like red bumps or pustules and is commonly found on shoulders, thighs and bottoms. Folliculitis can be itchy or burn. It is especially common in patients that are wearing tight clothes, if you are wearing spandex on the upper thighs and that compresses the hair follicle bacteria is more likely to grow there. Folliculitis can also be contracted in hot tubs or hammam maghrabi (Morrocan or Turkish baths). It is important to be sure that your bath place uses good sanitary and hygiene measures and every hot tub you spend time in should be properly chlorinated.


Prevention And Treatment
After sweating exercise it’s important to change out of tight clothes after working out and try not to wear spandex all day in the summer months. Do your best to shower right after a work out. If you know you will be out for the whole day and it is very hot outside, bring a change of clothes. To nip the evil in the bud its wise to invest in an antibacterial cleanser that can prevent and treat folliculitis. If you notice something that looks like folliculitis contact your health practitioner, more severe cases require an oral antibacterial.

Molluscum Virus
It is seen most often in children, while not particularly dangerous, mollusum is annoying. It causes whitish translucent tan bumps anywhere on the body. These bumps can last for up to four years. Molluscum thrives in under chlorinated water, which is why it occurs so often over the summer. The virus can be passed from skin-to-skin contact. The reason why kids get it so commonly and adults don’t is because the immune system mounts a reaction to the virus. Eventually you can be exposed and not get the bump because your immune system knows how to fight it. When kids are first exposed to it, the body's immune system reacts, and this reaction leads to the bumps.

Molluscum Virus

Prevention And Treatment
Preventing molluscum can be tricky. No one wants to avoid pools all summer, let alone stop kids from jumping into a pool. Check with the pool owner to make sure that they are properly chlorinating it. It is also important to wash off as soon as you get out of the pool. Maintaining good hygiene is a way to prevent molluscum (as well as many other viruses.)

Pesky Bug Bites
Ouch! They are downright annoying but can also lead to some more serious health issues like malaria, dengue fever, Lyme disease or West Nile virus. Scratching a bug bite until it bleeds can also lead to infection. Hot weather means fewer clothes, more bugs and more bug bites. Bug bites can range in size from barely there specks to massive welts. Bug bite size does not correlate to bug or bug size. The idea that the size of the bite is determined by the bug is a misleading urban myth, that’s why most of the times just by looking at the bitten area it is difficult for your dermatologists to determine the bug’s specific species.
Initially the “cause” of a bug bite seems pretty straightforward. However the bug’s decision-making process is more complicated than just easy access to human blood. There are two major reasons why people get bitten by bugs, one: Carbon dioxide production, and second: the lipid mix on the surface of the skin. Mosquitos find humans by determining where carbon dioxide is being produced. As humans, producing carbon dioxide is pretty much unavoidable (we can’t exactly stop breathing to prevent a mosquito bite). Each person’s lipid mixture is a bit more varied. Everyone has a different composition of lipids on the surface of the skin. This mixture is made up of cholesterol, triglycerides, ceramides and other fats and certain lipid mixtures are more appealing to bugs. This is why it is common for some people to get bitten more than others.

Bug bites
Prevention And Treatment
Unfortunately, your skin’s lipid mix is based on genetics. You can’t change your DNA, but there are some preventative measures that everyone can take to avoid summer bites. The CDC recommends using bug repellents that contain DEET, picardin or oil of lemon eucalyptus. If you are into all organic and natural repellant try Para’Kito a green and safe solution to repel bugs. In addition it is important, especially in the bug season to sleep inside or in a screened in area (like a tent). 
Parakito prevents Mosquito bites
If you have a bug bite that is unusually itchy or feels painful, contact your doctor or dermatologist.


PCOS — My Skin & Me

polycystic ovarian disease
September is the PCOS (Polycystic Ovarian Syndrome) awareness month, so I’d like to wave goodbye to September by shedding some further light on the syndrome and sharing with our readers some information that might help ladies reach an early diagnosis as well as some skin related management tips for this difficult multisystem disease. It’s a grim fact that worldwide PCOS affects 6% to 10% of women, making it the most common endocrinopathy in women of childbearing age. 
Early diagnosis and establishing a good management plan are key to managing cosmetic issues and preventing long term health consequences, as there is no cure for PCOS.

PCOS At A Glance
Common symptoms of PCOS include irregular or no menstrual periods, acne, obesity/weight gain/inability to lose weight, breathing problems while sleeping, depression, oily skin/acne, infertility, skin discolorations, high cholesterol levels, elevated blood pressure, excessive/abnormal hair growth and distribution, pain in the lower abdomen and pelvis, multiple ovarian cysts, and skin tags. Some women have only a few symptoms, while others have several.

How Do You Know If You Have PCOS?
You can be diagnosed with PCOS if you have at least 2 of the following 3 criteria

1. Irregular or absent periods,
2. Blood tests or physical signs that show high androgens,
3. Polycystic ovaries.

Polycystic Ovarian Disease

Health Risks With PCOS
Women with PCOS have greater chances of developing several serious health conditions, including life-threatening diseases. Recent studies found that:

·      More than 50 percent of women with PCOS will have diabetes or pre-diabetes (impaired glucose tolerance) before the age of 40.
·      The risk of heart attack is 4 to 7 times higher in women with PCOS than women of the same age without PCOS.
·      Women with PCOS are at greater risk of having high blood pressure.
·      Women with PCOS have high levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol.
·      Women with PCOS can develop sleep apnea. This is when breathing stops for short periods of time during sleep.
·      Women with PCOS may also develop anxiety and depression. It is important to talk to your doctor about treatment for these mental health conditions.
·      Women with PCOS are also at risk for endometrial cancer. Irregular menstrual periods and the lack of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Progesterone causes the endometrium (lining of the womb) to shed each month as a menstrual period. Without progesterone, the endometrium becomes thick, which can cause heavy or irregular bleeding. Over time, this can lead to endometrial hyperplasia, when the lining grows too much, and cancer.

Skin & PCOS
Polycystic Ovairian Disease
Being a dermatologist I’d like to focus on the skin-related symptoms of PCOS, which include oily skin, adult acne, increased/abnormal hair growth, skin tags, and dark velvety skin patches on neck known as acanthosis nigricans.

Acne and oily skin:
One of the earliest signs of PCOS is acne and oily skin which are primarily the result of hormonal disorders caused by androgens (male hormones). PCOS-related acne tends to flare in areas that are usually considered “hormonally sensitive,” especially the lower third of the face. This includes your cheeks, jawline, chin, and upper neck. Ladies with PCOS tend to get acne that involves more tender knots under the skin, rather than fine surface bumps, and these acne lesions tend to flare before the menstrual period. This type of cystic acne doesn’t resolve quickly and takes time to go away.

Unwanted Hair Growth:
Unwanted hair growth is also triggered by an excess of male hormones leading to excessive growth of facial hair, as well as hair on the abdomen and around the nipples. The same hormones are also responsible for hair loss on scalp, which is why ladies suffering with PCOS struggle with thinning hair on scalp and increased hair on face and body at the same time. Shaving, waxing, depilatories, and tweezing are all options, but each has its limitations and each demands ongoing efforts. Vaniqa cream has shown promising results to reduce facial hair growth. Laser hair reduction is another good long-term option.

Medications called anti-androgens may reduce hair growth and clear acne. Spironolactone (Aldactone), first used to treat high blood pressure, has been shown to reduce the impact of male hormones on hair growth in women. Finasteride (Propecia), a medicine taken by men for hair loss, has the same effect. Anti-androgens are often combined with birth control pills.  These medications should not be taken if you are trying to become pregnant.

Metformin (Glucophage) reduces insulin levels, and this change, in turn, reduces the ovarian testosterone levels by competitive inhibition of the ovarian insulin receptors. This drug is effective in treating increased hair in women with PCOS.

Hair Loss:
The type of hair loss women with PCOS experience is directly related to the excess production of male hormones caused by the disorder. Referred to as male-pattern baldness, it can be successfully treated with over-the-counter medications containing Minoxidil or Saw Palmetto along with oral contraceptive pills (Diane 35) and anti-androgen (Spironolactone) medication.

Skin Darkening:
The brown skin discolorations that occur with PCOS are unique, and are called “Acanthosis Nigricans”. They appear as darkened, velvety swaths of dark brown patches that most often develop on the nape of neck, armpits, inner thighs, or under the breast areas. Although these discolorations are not related to sun damage, the treatment is the same: daily exfoliation, sunscreen, and use of a topical over-the-counter skin-care product with 2% hydroquinone or other skin lightening agents. For stubborn cases, you may need a prescription-strength skin lightener that contains 4% hydroquinone.

Acanthosis Nigricans & Skin Tags

Skin Tags:
Fleshy skin growths in the armpits and neck regions are commonly spotted in PCOD. Once the hormones are fixed we can surgical remove or cauterize these growths.

Management Plan
Lifestyle modifications are considered first-line treatment for women with PCOS. Such changes include the following:
·      Diet - Low-fat, high-carbohydrate diets may increase insulin levels, so you may want to consider a low-carbohydrate diet if you have PCOS. Don't severely restrict carbohydrates; instead, choose complex carbohydrates, which are high in fiber. The more fiber in a food, the more slowly it's digested and the more slowly your blood sugar levels rise. High-fiber carbohydrates include whole-grain breads and cereals, whole-wheat pasta, bulgur wheat, barley, brown rice, and beans. Limit less healthy, simple carbohydrates such as soda, excess fruit juice, cake, candy, ice cream, pies, cookies and doughnuts.
·      Exercise - Exercise helps lower blood sugar levels. If you have PCOS, increasing your daily activity and participating in a regular exercise program may treat or even prevent insulin resistance and help you keep your weight under control.
·      Weight loss - Obesity makes insulin resistance worse. Weight loss can reduce both insulin and androgen levels and may restore ovulation. No single specific dietary approach is best, but losing weight by reducing how many calories you consume each day may help with polycystic ovary syndrome, especially if you're overweight or obese. Use smaller plates, reduce portion sizes and resist the urge for seconds to help with weight loss. Ask your doctor to recommend a weight-control program, and meet regularly with a dietitian for help in reaching weight-loss goals.

Medications used in the management of PCOS include the following:
·      Oral contraceptive agents (eg, ethinyl estradiol, medroxyprogesterone)
·      Antiandrogens (eg, spironolactone, leuprolide, finasteride)
·      Hypoglycemic agents (eg, metformin, insulin)
·      Selective estrogen receptor modulators (eg, clomiphene citrate)
·      Topical hair-removal agents (eg, eflornithine)
·      Topical acne agents (eg, benzoyl peroxide, tretinoin topical cream (0.02–0.1%)/gel (0.01–0.1%)/solution (0.05%), adapalene topical cream (0.1%)/gel (0.1%, 0.3%)/solution (0.1%), erythromycin topical 2%, clindamycin topical 1%, sodium sulfacetamide topical 10%)

The optimal management for PCOS is a multi-factorial approach involving diet and lifestyle modification along with appropriate medication. If you think that you have any symptoms which point towards PCOS speak to your GP as soon as possible.