Memorial Day weekend in South Florida was hot! Unfortunately, I wasn’t where all of the action was in South Beach. I was actually invited to speak at the annual meeting of the Florida Society of Dermatology and Dermatologic Surgery in Boca Raton. I spoke about hyperhidrosis.
Hyperhidrosis is excess sweating and is common on the hands, underarms, feet and even in the groin. It almost always gets worse in the summer so I thought it would be a good time to shed some light on this condition and treatment options. If you suffer from hyperhidrosis, you are not alone. Around 2.8% of people have hyperhidrosis. It tends to run in families and can start in childhood. Most people grow out of it but for some it can persist into 30’s and 40’s. Antiperspirants that contain aluminum chloride are the best first line treatments. HydrosalPro is an excellent new product from Canada that has worked well on many of my patients. Antiperspirants with aluminum chloride are actually used at night so that they can penetrate better and clog the sweat ducts. Usually they are applied nightly for 4-7 nights and then as needed.
If topical antiperspirants don’t work, Botox injections are another excellent option. Some insurance companies cover the procedure and Botox typically stops sweating for 3- 6 months. For severe cases, there are also two surgical procedures to treat hyperhidrosis. One involves liposuction of the sweat glands in the underarms and is a permanent safe solution. The other procedure is called sympathectomy and is a more significant surgery that cuts the nerve that causes sweating of the hands. Although this procedure is very effective, up to 30% of people get sweating in other locations so there are significant risks involved.
For anyone with hyperhidrosis, I always recommend the website sweathelp.org. It has tons of detailed information on all of treatments I discussed today. If you have hyperhidrosis, don’t get discouraged this summer. There are many treatment options available…you just have to find the one that works best for you.
Recently I was at an outdoor event and walked by a temporary tattoo stand. It looked like fun and was “temporary” so many people were lined up to get inked. These temporary tattoos are also known as black henna tattoos and vendors typically explain that they will wear off over several weeks.
Interestingly, as a dermatologist I have seen many reactions to these tattoos that range from mild itching to severe blisters. Those with the most severe reactions can actually heal with scarring. When I first saw these reactions I was surprised because henna is a natural vegetable dye and has been used for centuries; however, the truth is that black henna tattoos also contain para-phenylenediamine (PPD) which is a black dye. Authentic natural henna tattoos are actually orange/brown in color and need to be left on for hours to stain the skin. They rarely cause any type of allergic reaction.
Vendors often add PPD, to the natural brown henna because it stains the skin more quickly (within ½ hour) and looks darker like a real black tattoo. This black dye is the same ingredient in black hair dye and is a common cause of contact dermatitis in people who are allergic. In hair dyes, the FDA requires that the concentration of PPD is less than 6% due the significant risk of allergic reactions to this ingredient. In some of the black henna pastes used for tattoos, the concentration of PPD can range from 10%-80%.
So how can you know if a temporary tattoo has PPD? It is simple… if a paste stains skin black in less than ½ hour, it has PPD in it. Also if the paste is mixed with peroxide, or if peroxide is wiped over the design to bring out the color, it has PPD in it. It is best to avoid these temporary tattoos unless you are 100% sure they do not contain PPD…otherwise, if you are allergic, these tattoos may not be so temporary after all.
The Brazilian blowout goes by many names (i.e “Brazilian Keratin Treatment” and “Keratin Hair Treatment” just to name a few). These products involve applying a keratin solution to hair to seal the cuticle resulting in smooth, frizz-free tresses.
There are so many of these treatments on the market, it is hard to figure out which ones are safe. Well, here is a little history on this increasingly popular hair trend. The original keratin treatments from Brazil had very high concentrations of formaldehyde. The treatments were so toxic that they had to be performed next to a window with masks and a fan to prevent inhalation of the formaldehyde. Unfortunately, a young woman in Brazil actually died after one of these treatments.
When keratin treatments arrived in the United States a few years ago, the FDA was quick to attempt to regulate these products and banned all products that contained higher than acceptable levels of formaldehyde. The problem is that formaldehyde makes the hair straighter so manufacturers are tempted to increase the levels to get better results. In fact, last month the US Occupational Safety and Health Administration (OSHA) announced that these treatments “can release unsafe levels of formaldehyde, posing a risk to salon workers and customers.” OSHA officials also said they found formaldehyde in many hair products that are labeled “formaldehyde-free” and are now investigating complaints about the products.
So what should you do if you want to try a keratin treatment? Well first you need to look for products that are labeled formaldehyde free. Make sure you read the bottle yourself and don’t just rely on what the stylist says. But you must keep in mind that even if it says formaldehyde free there is a chance that it still contains formaldehyde. The good news is that formaldehyde has a very strong odor and it should be pretty obvious if the fumes are strong. The other good news is that the FDA and other agencies are really cracking down on illegal products so they could be cleared off the market soon. Remember to be vigilant, because it simply is not worth it to risk your health in an attempt to get straight hair.
Recently the FDA approved the use of Botox for headaches. Neurologists have been using Botox to treat chronic headaches for years but the treatment was “off label” which means it was not FDA approved. People with chronic migraines experience a migraine more than 14 days of the month.
In the clinical trials, these patients were treated with Botox or placebo injections every 12 weeks. They received the injections into the forehead and neck. Treated patients had significant improvement in their migraines when compared to patients that received the placebo injections. In the study, some of the patients in the Botox group did experience worse headaches because of the injections so this treatment isn’t for everyone; however, most of the treated patients got better.
Of course, a great side effect is that all patients that got Botox had less wrinkles! So if you suffer from chronic migraines, ask your doctor about this newly approved treatment.
One of the estheticians at my office recently attended a conference in Miami where the 24Karat Gold Facial was very popular. So I wanted let you know if this facial is worth the BIG $250 price tag. First of all, I must say gold has been used in dermatology, but this was many, many years ago. It was primarily given as an injection into the muscle to treat diseases like psoriasis and arthritis. Dermatologists stopped using gold decades ago because it was considered risky and had many side effects. Interestingly, dermatologists did not typically use gold creams. The gold that was prescribed was taken internally.
These new facials use a gold leaf that is applied to the face. There are also many gold creams on the market. They claim to revitalize and rejuvenate, but there is no evidence to back up that claim. In fact, gold on the skin can be very irritating and is a common cause of dermatitis in jewelers. So save your money and avoid these pricey facials. They are not likely to work, and may make your skin worse. Chemical peels, performed by a dermatologist or an experienced esthetician are much more likely to give better results without the hefty price tag.