Reduce Under Eye Puffiness

Noting quite ages us like the eyes! What can be done short of surgery? Some suggestions include gel eye masks, watching the salt intake. increasing your consumption of leafy greens, avocados, bananas, celery and treating any underlying allergies. Additional remedies include applying cucumber slices, cold tea bags or other types of cold compresses. Of course, always consider having a thyroid or underlying sinus issue evaluated. These days, I am seeing more “under eye puffiness” due to the placement of dermal fillers, like Juvederm or Restylane. Often, the puffiness can last in excess of 12 months after the injection. The “dark circles” are often not “dark circles”, but rather are the dermal filler reflecting ambient light. The good news is that it can be reversed!
I have had a lot of positive feedback on the Dr Josh’s “Under Eye Remedy”. This unique blend of anti-inflammatory and collagen boosting ingredients has finally gotten the “nod of approval” from one of my most critical “prove it to me” clients! To paraphrase what she said “I’ve tried everything, but this Under Eye Remedy actually works! Nothing has really done it for me before….except this”. I personally think of it as one of the best “quick fix” products on today’s marketplace. OK…I might be biased, but as you know, I’m also very honest about avoiding hype.
Use Under Eye Remedy 1-2 times a day to get the best results.

Health News You Can Use: March 2014

Here are some Health News You Can Use Headlines for March 2014, courtesy of “Internal Medicine News”


New Knee Arthritis Guidelines from the Osteoarthritis Research Society International:

The Society now looks favorably on a knee steroid injection as a means to significantly decrease short term pain, and more so than hyaluronic acid injections. The use of hyaluronic acid injections may have long term benefits, but we still aren’t sure. The society also recommended bio mechanical knee interventions, exercise, weight management, Tylenol, warm soaks in mineral rich water, canes, topical capsaicin, Cymbalta and NSDAIDS [for example  Naproxen] when appropriate. By bio-mechanical support, they mean foot orthotics and knee supports. They also support a topical use of an NSAID.


Using Zinc for Colds:

Zinc is everywhere. Sunblocks, cold remedies, etc… Does it work? Randomized, double blinded, placebo controlled studies were evaluated recently in a “Cochrane Review”. These studies looked at Zinc for 5 days to treat a cold or for 5 months to prevent a cold. Sixteen therapeutic trials and two preventive trials were looked at by the researchers. Zinc was found to reduce how long you have a hold, but doesn’t make the symptoms any better. Still, less time being sick does mean something! The dose needed was 75 mg/day in a lozenge form. In terms or prevention……sorry. Doesn’t seem to work.



Testosterone Replacement: More Harm then Good?

Low T syndrome….we all bought into it. Lots of medical articles and major pushes on direct to consumer advertising. Happy scenes, gray hair, loving affection. Life is beautiful. Now the FDA is investigating testosterone’s cardiovascular risks. Two studies have now been published, observational studies, that reported an increased risk of heart attacks, strokes and death. The risk of a heart attack doubles within 90 days of starting testosterone in men 65 and older, and tripled in younger men who had a  history of heart disease.  The increased risk was seen in men that had coronary artery disease as well as in men who did not have coronary artery disease.


New Hot Flash Therapy Available:

The FDA has approved “Brisdelle 7.5 mg” as a non-hormonal option to treat hot flashes, or “vasomotor symptoms” of menopause. Since this drug works via a non-hormonal manner, it cannot be combined with any other medicines that increase the level of serotonin, or affect the metabolism of serotonin, or a fatal “serotonin syndrome” can occur.  This drug is of a class known as “SSRI’s” and its real name is Paroxetine also known as “Paxil”.  As usual, there is a whole list of “things to watch out for” while on this drug, so check with your Internist or Gynecologist before considering.


A New Treatment for Hepatitis C?

A new experimental drug developed by Bristol-Myers Squibb called “Daclatasvir”, which works by in inhibiting a “non structural protein called NS5A”, when combined with “Sovaldi” [which inhibitis RNA polymerase that Hep C uses to replicate its RNA] was able to achieve a greater than 90% sustained virologic response in patients with chronic Hepatitis C. This once a day oral treatment also worked on patients who had failed to respond to or developed resistance to protease inhibitor therapy [“telaprevir and boceprevir]. It was effective against all types of Hep C, meaning types 1, 1a,  2 and 3, as well as those with the “non-CC IL28B” genotype.



Laser Scar Revision in Westchester

There has been a lot of progress in scar treatment. Certianly, the use of “fractionated” laser has been a game changer. Since its original use in 2004, there has been change in the way we approach scars, thanks to leading innovators such as Victor Ross, M.D. and Nathan Uebelhoer, D.O. at the Naval Medical Center in San Diego.  The new approach can be called “HELD FASTER” which means High Energy, Low  Density, Fractional Ablative Scar Treatment at Rehabilitation. Some of the most rewarding work has come in the treatment of scars that are restrictive in nature, many of which may occur in burn patients and in our Wounded Warriors. HELD FASTER has had a predictable benefit in these restrictive scars, especially if treated within the first 6 months of an injury. Most of the work done has focused on the CO2 laser.

As for scar revision in westchester, we have seen some excellent results with an Erbium laser, which has a different wavelength than a CO2 laser, but essentially both lasers target water in the skin. I have had good results in patients with  depressed facial scars that are decades old, as well in scar treatments that can be followed in “Chrissy’s Story” in my newsletter.

Recently, I had treated a scar that was the result of a bad facial infection several years ago. This was a case in which the laser was not my first choice. You see, scars are very sensitive to changes in their environment, this according to Dr Donelan at Mass. General Hospital. Now, scar “rehabilitation” is superior to scar “excision” in most circumstances. However, sometimes the skin tension associated with the scar needs to be relieved before I use a laser. Decreasing the scar tension seems to change the skin environment in a beneficial way. There are numerous procedures, with a “Z Plasty” being quite popular.

Better than any scar treatment is the prevention of unfavorable healing. Patients and Physicians both need to understand and interact on wound care better and physicians need to emphasize that the care does not stop when the bandage is placed on the wound.