Archive for the ‘Age management medicine’ Category

LOOK BETTER, FEEL BETTER, LIVE LONGER

Thursday, January 7th, 2010

Richard M. Foxx, MD

For years the medical profession has been aware of the benefits that accrue when patients take the time and make the effort to care for themselves. In the last few years, however, we have become increasingly aware of the improvement in general health when we take the time to improve our appearance.

Not long ago a group of physicians in the UK published several papers showing that patients who used effective cosmeceutical products and who underwent regular maintenance treatments were more likely to eat healthy foods and follow a workout program. The result was a general improvement in quality of life and a decreased incidence of depression.

Just recently, researchers from the University of Southern Denmark tracked almost 1800 sets of twins and found that perceived age was significantly associated with survival. Not only was there an association between perceived age and physical and mental functioning, they also found the bigger the difference in perceived age, the more likely it was that the older-looking twin died first.

That’s a good nugget to remember next time someone says that aesthetic medicine is all about fluff.

Richard M. Foxx, MD is the Founder and Medical Director of The Medical and Skin Spa in Indian Wells, CA. He may be reached at 760-674-4106 or at drfoxx@medicalandskinspa.com

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BROWN SPOTS

Thursday, February 12th, 2009

BROWN SPOTS

Richard M. Foxx, MD

Perhaps the single most common question I get from patients concerns brown spots. They seem to plague everyone, particularly here in SoCal. And the problem definitely increases with advancing years.

Brown spots, also known as lentigenes, liver spots, or melasma, arise when the pigment called melanin is deposited in melanocytes, or pigment carrying cells, in the dermis. We see it most often in response to long-standing sun exposure, but it may be made worse by certain environmental factors and hormone challenges such as pregnancy or contraceptive pills.

The treatment of brown spots at our office runs the gamut from a series of exfoliative skin treatments and the use of pigment-blocking products to state-of-the-art minimal-downtime laser treatments. Improvement can be achieved over a three to four month period with a series of dermal planing skin treatments which mechanically lighten the spots followed by daily use of a skin product containing hydroquinone. Hydroquinone blocks the uptake of the melanin pigment into the cells. It is not a bleach, however, and the entire process takes several months before a result is seen.

Adding pulsed light treatments hastens the process. The dark cells melanocytes preferentially absorb light, break apart, and come to the surface where they flake away. At least three to four treatments are required over three months, however, as the depth of the spots varies.

By far the most effective method at this time is FRAXEL®. Developed about seven years ago by a group at Harvard, FRAXEL works by placing approximately 2000 columns of laser energy, each smaller than a hair, in a square centimeter (about the area of a dime). Twenty percent of the skin is treated at each of four visits with 80 percent left untreated. The amount of untreated skin results in very little downtime.

The columns of skin that are vaporized by the laser are replaced by healthy new skin over the next few weeks and many of the brown spots are removed.

It is important to understand that no brown spots treatment is permanent. Any brown spot treatment program I a long term commitment and must be accompanied by regular facial treatments, the use of good products, topical anti-oxidants such as Vitamin C, and the daily use of a sunscreen with an SPF of at least 30 and UVA blockers such as Zinc, Titanium, Mexoryl®, and Parsol®.

Doctor Foxx is the Founder and Medical Director of The Medical and Skin Spa, a medical skin clinic in Indian Wells, CA, at Hyatt Grand Champions Resort, one of the country’s only resort-based medical spas.  He may be reached at drfoxx@medicalandskinspa.com or at 760-674-4106

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Posted in Age management medicine, Non-surgical aesthetic enhancement, Non-surgical aesthetic procedures | 1 Comment »

HORMONE REPLACEMENT REVISITED

Tuesday, December 16th, 2008

by Richard M. Foxx, MD

When discussing “hormone replacement,” the most important element is to be clear about the terms that are used. Almost nowhere else in medicine is there such confusion in terms.

The ill-conceived and subsequently discredited Women’s Health Initiative (WHI) study did not employ “estrogen” or “progesterone” as hormone replacement. Rather it used Premarin®, derived from the urine of pregnant mares and containing up to 40 percent horse-specific estrogen (for which we humans have no intrinsic neutralizing enzyme), and medroxyprogesterone acetate, known as Provera®. A synthetic “progestin” rather than true progesterone, Provera possesses a host of unwanted side effects including masculinizing properties.

WHI was not a ”hormone replacement” study, but rather a study that explored replacement of hormones with hormone-mimicking drugs.

Literally millions of women stopped using hormones when the WHI findings were released in 2002. As a substitute, they were offered drugs like Prozac and Zoloft to control their hot flashes and slow the degradation of the quality of their lives.

Now a rehash of the old, flawed analysis has come out and all of the old bogeymen have been resurrected. I expect women will throw their hormones away and run for the hills, or run for Zoloft or Prozac. Trouble is, replacing one drug with another made no sense at all in 2002 and even less now.

An alternative approach is to replace the hormones that are lost in menopause with true natural hormones among which may be estrogen and progesterone. These are also called bio-identical in that they are exactly the same as the hormones produced in human bodies. Non-equine bio-identical estrogen has been virtually exonerated in breast cancer as has natural (bio-identical) progesterone.

Each patient is different, and of course this is not to be construed as medical advice. It is important for women to discuss their own particular situation with their own doctors. It is important, however, to know and to understand there may be safe alternatives out there that will improve the elusive quality of life.

Doctor Foxx is the Founder and Medical Director of The Medical and Skin Spa in Indian Wells, CA, at Hyatt Grand Champions Resort.  He may be reached at drfoxx@medicalandskinspa.com or at 760-674-4106

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