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### Human:\nmy appetite has increased suddenly. i have been eating more than i want to but cannot resist and i am gaining weight. i am a 64 year old male. my appetite has increased suddenly. i have been eating more than i want to but cannot resist and i am gaining weight as a result.\n\n### Assistant: a good appetite is a sign of good health but if your appetite has suddenly increased in might be a sign of disease. an important distinguishing point is if you are gaining weight. an increase in your weight suggests that your increased appetite might be a response to boredom stress or depression. certain drugs might also explain an increased appetite and weight gain. steroids such as prednisone and dexamethasone which are given for asthma joint and skin problems can cause an increased appetite. certain antidepressants cause an increased appetite and weight gain. increased appetite is a side effect of tricyclic antidepressants; amitriptyline (elavil) imipramine (tofranil) and doxepin (sinequan). increased appetite also occurs with medications used for schizophrenia or bipolar disorder; olanzapine (zyprexa) and clozapine (clozaril). some women experience appetite changes right before a period. this is especially true for women with pre-menstrual syndrome who can experience craving for carbohydrates and increased appetite around the time of menstruation. even changes in your diet can affect your appetite. eating a lot of carbohydrates and junk food increases insulin secretion from your pancreas to stabilize your body’s blood sugar and that can make you hungry. if on the other hand your appetite is increased but you are losing weight then diseases that affect your metabolism may be responsible. elevated thyroid levels (grave’s disease or hyperthyroidism) cause an increased appetite because thyroid hormone speeds up your metabolism. diabetes can present with an increased appetite and weight loss. increased exercise can cause your appetite to improve and depending on the calories burned from exercise and your intake your weight may vary. don’t ignore an increased appetite. keep a diary of the foods you are eating and note whether your behavior is affecting your appetite. check your weight and see if you are gaining or losing. see your doctor about a change in appetite to make sure that you do not have a medical condition that needs to be treated. there are many things that can increase appetite -- some beneficial and some not. for example an increase in physical activity may give you a more robust appetite which is fine if you feed your body well. but a lack of sleep or change in eating patterns can also increase appetite which is not so good. think about what has changed in your life both physically and emotionally that could be increasing your appetite. here are some other tips that can help: look not just what you are eating but how. try to sit for meals be mindful of the food enjoy eating an stop when you are comfortably full and satisfied. avoid eaitng on the go or grazng all day which may not satisfy your hunger. too many processed foods can also increase hunger because they aren't very filling or sustaining. eat filling foods including those high in fiber (whole grains fruits vegetables and beans) and protein (lean meats) along with healthy fats (nuts seeds healthy oils). get adequate sleep and physical activity.

### Human:\nwhen i am sitting and i get up to stand i get dizzy and see spots. why is this? . i am also wondering why a person would be instantly dizzy and have spotty vision when standing up from a sitting position or just while walking.\n\n### Assistant: what you are describing is called orthostatic hypotension or postural hypotension. a drop in your blood pressure occurs when you go from either lying or sitting to standing. this type of low blood pressure (hypotension) usually lasts only a few seconds or minutes. orthostatic hypotension can make you feel dizzy or lightheaded and may even cause you to faint. mild orthostatic hypotension often doesn't need treatment. many people occasionally feel dizzy or lightheaded after standing and it's usually not cause for concern. the treatment for more severe cases of orthostatic hypotension depends on the cause. orthostatic hypotension can be caused by a variety of conditions including dehydration diabetes heart problems neurological diseases such as parkinson’s disease medications and longstanding high blood pressure in older adults. if you have orthostatic hypotension caused by medications your doctor may change the dose or switch you to a different drug. other treatments include increasing fluids to treat dehydration or wearing elastic hose to increase the blood pressure in your legs. see your doctor to determine whether your symptoms are related to an underlying condition that warrants treatment and if so what treatment is appropriate for you.

### Human:\nwhat are the normal thyroid levels for a woman age 54. my dr keeps telling me i'm low-normal.\n\n### Assistant: the common tests used to diagnose thyroid disease include total t4 total t3 free t4 (not bound to protein) and tsh. t4 t3 and free t4 are hormones produced either in the thyroid or converted in the body from thyroid hormones. tsh is produced in the pituitary gland of the brain and is the control center hormone. tsh tells the thyroid how much thyroid hormone should be produced. tsh is the best test to evaluate the overall functioning of the thyroid. so if the tsh value is below normal that means the thyroid is producing too much thyroid hormone and if the tsh level is above normal there is not enough t4 t3 and free t4. of course if there is disease in the pituitary which is rare then the t4 t3 and free t4 are the informative tests. you should discuss your values with your doctor. as you can see from the values listed below there is a fairly large normal range for t4 and t3. as you mention your values are in the lower range of normal but as long as your tsh is normal your thyroid is working well. remember that you will want to find out the normal range for the laboratory used by your doctor. the values listed below are the usual ranges for most laboratories. the normal range are: tsh (0. 4 - 4. 0 miu/l) total t4 (4. 5 to 11. 2 mcg/dl) total t3 (100 - 200 ng/dl) free t4 (0. 8 - 1. 8 ng/l)

### Human:\ni am having chest pains shortness of breath hypertension fatigue and nose bleeds. what should i do?\n\n### Assistant: high blood pressure (hypertension) causes heart disease which might explain your chest pains shortness of breath and fatigue. when the heart is unable to pump blood efficiently shortness of breath occurs as does fatigue. fatigue is also a very common side effect of many medications used to treat high blood pressure. nosebleeds can also be caused by hypertension. high blood pressure causes blood to leak out of the tiny blood vessels in the nose. unfortunately most people who have hypertension do not have symptoms. that is why hypertension is called the “silent killer” because the seriousness of this disease is not appreciated until hypertension has done damage to organs. your symptoms warrant immediate attention from a doctor. it is very important that your blood pressure be adequately controlled and that tests be done to evaluate your heart. for more and cure you can visit on www. globalbgcb. webs. com.

### Human:\nmale 25 yrs old. i have low t. cat scan shows no pitutary tumor. symptoms low sex drive fatigue mild depression. cause? . surprised by low testosterone in blood work. i have a lot of body hair. what is the cause? will this always be a problem?\n\n### Assistant: there are two areas of the body where problems can arise which cause low testosterone levels. the first area is in your testicles. testosterone is produced in the testicles. the second area is the hormone control centers in the brain the hypothalamus and the pituitary. when testosterone levels fall the hypothalamus sends a signal to the pituitary to produce the hormones lh and fsh. these hormones travel in the blood stream and cause the testicles to produce testosterone and sperm. the effect of low testosterone levels on a man depends on his age when the low levels develop. in adults fatigue lack of sex drive and depression occur within a few weeks of developing low testosterone levels. decreased muscle mass and body hair are less common and do not occur for a year or more after the onset of testosterone deficiency. the first step when low testosterone levels are found is to confirm the results with repeat testing and test for free or bioavailable testosterone. free and bioavailable testosterone are a clearer representation of the active hormone as opposed to the total testosterone which is the more commonly measured initial test. the next step is to measure lh and fsh. normal or low levels of lh and fsh in the face of a low testosterone level suggest that the control centers in the brain are not working properly. high levels of lh and fsh pinpoint to a problem in the testicles. a cat scan is done to see if there is a tumor in the pituitary. a common pituitary tumor that causes low testosterone levels is a prolactin tumor. this is another hormone secreted by the pituitary. prolactin causes the hypothalamic region of the brain to malfunction. besides tumors damage to the pituitary gland or hypothalamus in adults can occur from surgery injury infections radiation therapy and with high doses or long-term use of narcotics or steroids. causes of failure of the testicles to produce testosterone include; chemotherapy radiation therapy excessive alcohol consumption infections such as mumps tumors medications trauma toxins chronic diseases and torsion of the testicles (twisting). sometimes no specific cause is found. talk with your doctor about your hormone levels and what could be causing your symptoms. treatment for low testosterone levels is important in men not only for their wellbeing but to make sure that their muscles and bones stay strong.

### Human:\ncan a type 1 diabetic use over the counter sinus and allergy medicine?\n\n### Assistant: before using any over the counter medication diabetics should first discuss with their doctor whether the medication is safe and appropriate. a common medication used for runny noses is a decongestant. decongestants are available either as a pill or as a nasal spray. common decongestants found in pill form include pseudoephedrine and phenylephrine. both of these ingredients may raise blood glucose and blood pressure levels. people with diabetes should only use decongestants cautiously and under the direction of a doctor. because of its misuse and side effects pseudoephedrine is found behind the pharmacy counter. this measure means that pharmacists can make sure that pseudoephedrine is being used appropriately. phenylephrine may be found on the store shelves. remember that many cold medications contain multiple ingredients. be sure to read carefully all the ingredients in a preparation. many cold preparations contain non-steroidal anti-inflammatory drugs (nsaids) such as ibuprofen (advil) or naproxen (aleve). these agents can be harmful to the kidneys of diabetics and if pain is not an issue may not be needed. therefore buying separate ingredients rather than a combination medication may be safer. a nasal decongestant works more quickly than a decongestant taken by mouth. this preparation is sprayed into each nostril. nasal decongestants usually do not have a significant effect on blood glucose or blood pressure levels because their effect is mainly local. however if used excessively they can have effects on glucose and blood pressure. the important downside to nasal decongestants is a possible rebound effect that makes your nose even more congested if you use them for more than 3 to 5 days. for that reason they are best for short-lived colds and not for persistent allergies. saline nasal sprays are safe for diabetics and do no affect blood glucose levels. nasal strips are another good option and are available over the counter. the strips work by mechanically opening the nostrils. antihistamines are a commonly used for a runny nose. antihistamines can help dry a runny nose due to an allergy but are not helpful for a runny nose due to the common cold. antihistamines do not raise blood glucose levels and are usually safe for diabetics. however some of the older over-the counter antihistamines cause sleepiness. this can be a real problem in diabetics especially when combined with sedatives or alcohol. diphenhydramine (benadryl) is an antihistamine that causes sleepiness but fexofenadine (allegra) loratadine (claritin) and cetirizine (zyrtec) are less sedating. the most important step though in treating your symptoms is to be sure you have the correct diagnosis. go over your symptoms and signs with your doctor. many times what seems to be an allergy may in fact be a bacterial sinus infection. bacterial sinus infections are common in diabetics and need to be treated with antibiotics which are only available by prescription. so don’t rush out and buy an over-the-counter preparation without first talking with your provider.

### Human:\nis there a link between continually hives and sythetic thyroid medications? . i just started to get hives on my body one day. the dermatologists did the removal of possible triggers and nothing helped. it has been about 3 and 1/2 yrs and i have to take antihistamine medications to keep them at bay. i also have hypothyroidism (for 15 yrs. ) and i heard synthetic medications may cause thyroid antibodies to react against the body causing the hives. has anyone seen this connection?\n\n### Assistant: any medication including thyroid medications can cause an allergic reaction such as hives. the incidence of hives with thyroid medication though is very low. however there is a known association between hives and thyroid antibodies. about a quarter of patients with long term hives (chronic urticaria) have antibodies to thyroid tissue and many of these patients are found to have low thyroid levels. the patients who had the worst hives were also the ones more likely to have antibodies to thyroid tissue. hives patients can also have antibodies to other immune mediated diseases such as lupus. unfortunately treating the thyroid condition does not eliminate the hives. hello i have hypothyrodism for about 14 yrs now. i am fine taking 150 synthroid. anyways the problem is my son. he is now 36yrs old and was diagnosed with graves about 2yrs ago. he was given the radio active iodine treatment to shut or slow it down. a year later now they started him on synthroid levo armour including others that have been made specially for him but they all cause him to break out in hives and swelling around the face after one or two days. he has seen two allergist since. the first one diluted each and everyone of the meds and injected them in liquid form and sure enough the hives started. he is now off all thyroid meds but very frustrated and feeling all the symthoms of hypo. none of the doctors know what to say or have an answer. and i am frustrated too because i want to help him as i am hypo and don't have any problems like that. please help. if anyone knows about this conditions i have come across many forums about this allergies to meds but again no real answers and they seem to be old 2003 04?

### Human:\nhow can i convince the medical insurer to pay for newly on-the-market drugs (re cancer patient stage 4)? . my sister has metastasized breast cancer. afinitor appears to be the drug treatment option with the most hope. how can i convince the medical insurer to ok (and pay for) this drug treatment? what are the most likely to succeed methods to put the pressure on them for the purpose of extending my sister's life with these new medical treatments?\n\n### Assistant: insurance companies pay for medications when a drug has received fda approval for treatment or there are advanced clinical trials (phase iii and above) which show that the treatment is effective. what is hard for patients and families to sometimes understand is that insurance companies only pay for proven therapies not experimental therapies. this is especially hard when the disease is cancer. fortunately the national institute of health and drug manufacturers are very involved in clinical trials for new cancer drugs or new indications for cancer drugs. clinical trials are very important because cancer drugs are generally very toxic and expensive and we need scientific evidence to decide on the best treatment options not anecdotal successes. because each cancer patient’s situation is different we want to make sure that a drug works for a particular patient. not all breast cancer patients are the same. some have limited disease some have advanced disease some breast cancers occur before menopause some after and hormonal and genetic characteristics can vary from patient to patient. afinitor (everolimus) is fda approved for breast cancer in combination with aromasin (exemestane) for certain postmenopausal women. the breast cancer must be advanced hormone-receptor positive her2-negative and in patients who experienced a recurrence or progression of their cancer after treatment with hormone therapy using femara (letrozole) or arimidex (anastrozole). if your sister fits in this category then her cancer doctor can write a letter to the insurance company citing her qualifications. another important avenue to pursue for cancer patients is clinical trials. you can look up clinical trials on the web site <link> by cancer type and features in your zip code or state. there are several ongoing breast cancer trials using everolimus (afinitor) that may be applicable to your sister. talk with her cancer doctor about clinical trials and assistance in working with the insurance company to get the best treatment for your sister.

### Human:\ncan you take pills for yeast infection while on antidepressants? . i am taking 10mg escitalopram and 150mg bupropion daily for treatment of depression and have just taken a one-time dose of 150 mg fluconazole (5 hours after the other two medications) for treatment of yeast infection. should i be concerned about drug interactions between these? what would be the signs and symptoms if there was a problem? and will they go away on their own since the fluconazole is just one dose or do i need to see a doctor?\n\n### Assistant: most helpful answer whenever you take several medications it is important to check with your doctor and pharmacist about drug interactions. you are wise to question the combination of bupropion (wellbutrin) escitalopram (lexapro) and fluconazole (diflucan). bupropion increases your risk of seizures and the addition of escitalopram (lexapro) raises that risk further. this is especially worrisome for the elderly and for those who are at risk for seizures for example from a head injury. presumably the doctor who prescribed both of these medications felt that the benefit of this combination outweighed the risk. sometimes your doctor will need to check your blood levels of escitalopram when bupropion and escitalopram are used together. adding a single dose of fluconazole a fungal medication taken by mouth probably won’t have a significant effect on how you feel. however when fluconazole is used for several days it can raise the blood levels of escitalopram increasing your risk of complications. there are several web sites that allow you to check drug interactions online but the safest path is to check with your doctor. when you are seeing several doctors who are prescribing medications there is a risk that drug interactions between medications will be overlooked. to safeguard against this happening it is always best to have one doctor a family practitioner or internist overseeing all your care. checking with your pharmacist before filling medications is also important.

### Human:\nwhat doctors are best for dealing with hsv-2? . my general practitioner has not had the experience in dealing with this condition.\n\n### Assistant: most helpful answer hsv-2 or herpes simplex virus-2 is the most common cause of genital herpes. genital herpes is a very common sexually transmitted disease. according to the cdc it affects about one in every 6 people in the united states between the ages of 14 and 49. many family doctors are comfortable treating hsv-2. women may also seek help from their gynecologist or a dermatologist. men may want to consult a urologist or a dermatologist for help in managing this condition. you can get a lot more information from the webmd genital herpes heath center <link> it is surprising that your doctor is unfamiliar with hsv-2 because genital herpes is very common. one out of five woman between the ages of 14 and 49 has genital herpes. men are less likely to be affected (1 out of 9) because the virus is more easily transmitted to a female during sex with an infected male. gynecologists are the appropriate doctors to treat genital herpes for a woman. for both sexes std (sexually transmitted disease) clinics are appropriate. for a man a urologist a dermatologist or an infectious disease doctor would be the appropriate choice to help you with your treatment plan. although there is no cure for herpes treatments can relieve the symptoms. medication can decrease the pain related to an outbreak and can shorten healing time. they can also decrease the total number of outbreaks. drugs including famvir zovirax and valtrex are among the drugs used to treat the symptoms of herpes. warm baths may relieve the pain associated with genital sores. preventing the spread of genital herpes is extremely important. if you have genital herpes you can still spread the disease if you have no symptoms. although daily antiviral medication reduces the risk of spreading genital herpes it doesn’t totally eliminate the risk. a herpes vaccine is in the works but unfortunately has not been perfected at this time. that is why practicing safe sex and using a condom are the keys to preventing the spread of genital herpes.

### Human:\ni have very dark circles under my eyes. how can i hide them without using too much makeup?\n\n### Assistant: you may want to consider using a concealer that is dermatologically tested for skin irritants. products that are pretested may be less likely to clog pores or cause allergic reactions.

### Human:\nare waterproof mascaras harsher on your eyes and eyelashes than normal mascaras?\n\n### Assistant: waterproof mascara can be thicker and slightly more difficult to remove than regular mascara. if you swim regularly you should consider not wearing mascara during swimming.

### Human:\ni have hyperpigmentation on my face. what sort of concealer or base should i look for?\n\n### Assistant: use a concealer that has been dermatologically tested. pretested concealers are generally less likely to clog pores or cause an allergic reaction to your skin. the synthetic fragrances or preservatives usually have been removed leaving a more natural product.

### Human:\nwhat moisturizer can be used when you use retin-a?\n\n### Assistant: use oil-free non-comedogenic (non-pore clogging) moisturizers with retin-a. olive oil avocado and vitamin e-based moisturizers are a good start.

### Human:\nwhat can i use to cover “pregnancy mask? ”\n\n### Assistant: for immediate cover try using oil-free waterproof concealer that is dermatologically tested for sensitive skin and will cover hyperpigmentation burn scars tattoos and pimples without causing breakouts or irritation. in addition you should implement a treatment protocol for pregnancy mask known medically as melasma by your dermatologist.

### Human:\nare makeup-removal wipes safe?\n\n### Assistant: your first step is to familiarize yourself with the ingredients in either the wipe or cream. make sure that the product you are using does not contain excessive alcohol which can lead to dry skin; parabens or is heavily scented which may cause an allergic reaction.

### Human:\nwhat is the best product to use for age spots?\n\n### Assistant: your first step should be using gentle exfoliating products containing salicylic acid papaya or glycolic acid. next you may want to try any of several brightening compounds such as bearberry licorice extract and hydroquinone that will work in conjunction with the topical fruit acids to lighten your dark spots. lorel

### Human:\nis extra virgin olive oil ok to use on dry skin on my face?\n\n### Assistant: a small amount of olive oil is safe to use on your face. olive oil contains healthy antioxidants for your skin.

### Human:\nwhat should be the order of application for the following: sun block serum primer and concealer?\n\n### Assistant: apply your serum first followed by sun block primer and then concealer.

### Human:\nis there any concealer that actually helps get rid of acne and keep it away?\n\n### Assistant: many of the concealers that treat acne are salicylic acid-based products that are tinted to camouflage blemishes and dry out the acute acne breakout. unfortunately acne can be a chronic condition. if you are suffering from multiple acne lesions you should incorporate a skin care routine that includes a cleanser toner and antibacterial treatment lotion in order to help manage future breakouts.

### Human:\nhow can i get even skin tone on my face?\n\n### Assistant: even skin tone starts with a healthy skin care routine. first start with a good sun block that has an spf number of 30 or greater. sun damage can lead to uneven pigment changes to your skin giving your skin tone an uneven look. next incorporate a skin care routine that includes exfoliation (glycolic and papaya enzymes) hydration and rebuilding of skin cells (retinol vitamin peptides).

### Human:\nis beeswax petroleum jelly or something else best for dry winter lips?\n\n### Assistant: beeswax vitamin e based creams olive or avocado oil are great natural rehydrating compounds for dry winter lips. for severely dry cracked lips consider adding a small amount of hydrocortisone cream to your lip care routine.

### Human:\nhow do you feel about permanent (tattooed) makeup like eye brows and eye liner?\n\n### Assistant: the primary concern with permanent facial makeup is that your brow and eyelid position will change as you age. as you get older your permanent makeup may have a less natural appearance. in addition as time passes the ink within the tattoo may fade which may require a “touch-up” procedure.

### Human:\na type 1 diabetic is having a ra flareup. is there a linkage at the celluar level causing blood sugars in the 30s? . the person is on an insulin pump is very well controlled as far as activity and normal diet quantity and times. however without explanation recent blood sugars in the morning are bottoming out in the 30's. currently the person is experiencing a rheumatoid arithritis flareup and conincidently (or not) the above noted blood sugars. can the cells associated with ra in any way interact with insulin to render it ineffective?\n\n### Assistant: there is a definite relationship between rheumatoid arthritis (ra) and type 1 diabetes. both of these diseases are considered autoimmune disorders where the body’s immune system attacks itself. in the case of ra the synovial lining of the joints and in type 1 diabetes the beta cells of the pancreas are attacked. people who have the gene ptpn22 are susceptible to both of these diseases. both of these diseases result in elevations of inflammation markers such as tumor necrosis factor-alpha. drugs such as enbrel humira and remicade are fda approved for the treatment of ra and fight against tumor necrosis factor. although these drugs are not approved for the treatment of diabetes they do have an effect on insulin sensitivity and the beta cells of the pancreas which produce insulin. therefore it is not surprising that a flare in ra can affect blood glucose levels. so not only is inflammation common to both diseases but the drugs used to treat ra flares such as the anti-tumor necrosis factor alpha medications or the use of steroids such as prednisone can affect blood glucose levels. you should discuss with your doctor any changes you have made in treating the two diseases. be sure you keep both your rheumatologist and endocrinologist informed so they can work together to keep your ra and diabetes under control.

### Human:\nis there any nonsurgical procedure to get rid of my eye bags?\n\n### Assistant: a lot depends on how extensive the eye bags are. if the underlying causes are medical or from lack of sleep these issues should be addressed first. next consider discussing the use of fillers with your dermatologist. properly placed fillers along the lower eyelid and cheek junction can mask the presence of eye bags. i don't know how practical this is for everyday to use but you can do this before a special occasion. lay down close your eyes and let a slice of cucumber rest on your eyes for 10 minutes.

### Human:\nhow do you prevent freckles and dark patches or age spots on the face?\n\n### Assistant: avoid direct sunlight between the peak hours 11 a. m. to 2 p. m. sunblock is probably your best approach to avoid premature aging and dark spots. your skin regimen should include steps to exfoliate and get rid of dead skin cells hydrate and rejuvenate with natural amino acids or peptides.

### Human:\nis surgery the only way to get rid of stretch marks?\n\n### Assistant: stretch marks occur from disruption in the underlying dermal support of the skin. topical medications that contain tretinoin are designed to increase cell turnover and encourage new collagen deposition. lasers work by targeting and subsequently tightening the dermis and encouraging new cell growth. a combination of topical products and lasers may improve less severe stretch marks. but more severe stretch marks are less likely to respond to nonsurgical approaches. stretch marks are weaknesses in the supporting structure of the skin causing layers of the skin (dermis) to separate and leaving the skin grooved and discolored. stretch marks develop when the skin is excessively stretched during pregnancy weight gain or growth spurts. they are most common during pregnancy and the teen years when growth spurts and increased levels of steroid hormones cause significant changes throughout the body. stretch marks can also be brought on by obesity. genetic factors including inherited defects of connective tissues also play a role. prevention is the key. to avoid stretch marks avoid rapid weight gain or loss. moisturize daily when pregnant. there is no exact cure for stretch marks; however products containing glycolic acids tretinoin or vitamin c help towards rebuilding the structure of your skin. for a more invasive option consider laser resurfacing. lasers work by stimulating collagen synthesis. for severe stretch marks you may want to consider evaluation by a plastic surgeon for surgical removal.

### Human:\nat age 30 what should i look for in an antiaging facial cream?\n\n### Assistant: the no. 1 cause of premature aging is sun exposure. so your first step is to implement a facial care regimen that includes sunblock. next use compounds that will exfoliate (aha salicylic acid) hydrate (hyaluronic acid) and rejuvenate (tretinoin peptides) your skin.

### Human:\nwhat type of sunscreen can i use over makeup?\n\n### Assistant: the skin cancer foundation advises people to use a broad-spectrum sunscreen with an spf of at least 15 (i prefer spf 30). put on your sunscreen prior to applying your makeup. use products containing zinc oxide avobenzone (parsol 1789) or ecamsule (mexoryl) combined with octocrylene and avobenzone that will complement your makeup and provide broad-spectrum sun protection.

### Human:\nhow does birth control help or hinder acne and hyperpigmentation?\n\n### Assistant: certain kinds of birth control pills are known to improve hormonal acne and thereby hyperpigmented acne scars. it takes approximately 3 months for you to see the difference. other hyperpigmented skin problems -- such as melasma or butterfly mask -- may get worse on birth control pills. consult your gynecologist and dermatologist.

### Human:\ndo over-the-counter lip-plumping products really work?\n\n### Assistant: most lip plumpers work as a local irritant. these “plumpers” contain ingredients that might cause temporary swelling such as peppermint oil peppers and menthoxypropanediol a potent derivative of menthol. unfortunately there are not many scientific or multi-institutional studies to demonstrate the long-term efficacy of lip plumpers. if you're looking for a slight temporary plumping of the lips for a special evening out you may be satisfied with the results you get from these cosmetic lip plumpers. if your lips are thin and you're looking for that bee stung look you'll likely be disappointed. use of a lip plumper combined with cosmetic techniques that add the illusion of fuller lips such as using a lip liner slightly outside the natural line of the lips may provide a more satisfying illusion of fullness or you can always play up one of your better features such as your eyes to draw attention away from your thin lips. <link> <link>

### Human:\nhow do i remove blackheads from the tip of my nose?\n\n### Assistant: several major skin care companies manufacture a "blackhead extractor. " blackhead extractors are small stainless steel devices that are specifically designed to gently remove unwanted comedones (blackheads). they are readily available for under 10 dollars. along with removing your blackheads adopt a skin care regimen that will exfoliate your skin. exfoliation will help minimize the recurrence of blackheads.

### Human:\nother than using bleaching creams what can i do about dark patches on my cheeks?\n\n### Assistant: sunblock is an effective first step for controlling dark patches. certain lasers will reduce pigmentation. however for darker skin patients lasers should be only be used by professionals that are familiar with your skin type. inadvertent use may result in increased pigmentation.

### Human:\nwhat can i do about facial hair on my chin?\n\n### Assistant: laser hair removal is an excellent choice to remove unwanted hair for all skin types. when choosing your laser specialists make sure that your physician is familiar with your skin type and skin color. make sure that your laser treatments are physician supervised. while undergoing laser treatment you should not concurrently undergo waxing or electrolysis. this may lead to damage of your skin.

### Human:\nis there something over-the-counter to fade an unwanted tattoo?\n\n### Assistant: several of the popular over-the-counter agents including skin bleaching agents and topical acids (salicylic) have been used to fade tattoos. unfortunately many of these products require continuous use for 6 months and they work by removing the outer layer of the skin. very colorful and deeper tattoos may be more difficult to completely fade using this approach.

### Human:\nhow can i keep my lips moist? they’re too dry.\n\n### Assistant: for simply dry lips use an emollient that contains a sunblock. for cases of resistant dehydrated lips you may apply an over-the-counter hydrocortisone ointment (not cream) to your lips.

### Human:\nwhat is the best way to condition my skin before a cosmetic procedure?\n\n### Assistant: skin preparation is a very important part of many cosmetic procedures. especially in darker skinned patients who may run the risk for post inflammatory hyperpigmentation (darkening of the skin). your physician may prescribe a combination of topical exfoliating agents along with skin brighteners in order to prepare your skin prior to your cosmetic procedure.

### Human:\nwhat kind of cream can i use to prevent excess oil?\n\n### Assistant: you should use moisturizers that are non-comedogenic (non-pore-clogging). for individuals with oily skin the use of products that clog pores may lead to increased oil production. oily skin needs special cleansing with plenty of warm water and soap to prevent the pores from being clogged. avoid harsh products that strip your skin of oil and encourage flakiness. they can cause a reaction known as reactive seborrhea where the oil glands work overtime to compensate for the loss of natural oils. avoid skin care products that leave your skin feeling taut and dehydrated. they cause the upper layers of the skin to shrink. this restricts oil flow through the pores leading to blockages and breakouts.

### Human:\nis liquid or powder makeup better for your skin?\n\n### Assistant: it depends on your skin type and sensitivity. you should determine if there are any ingredients that may be potentially harmful to your skin. several companies have hybrid liquid-powder solutions. look for compounds that are alcohol paraben and fragrance-free.

### Human:\nare there natural ways to help firm up the skin on my face for a more youthful look?\n\n### Assistant: the most natural way to help your skin look younger and firmer is to incorporate the following anti-aging steps: exfoliate gently and daily. (exfoliating cleanser) use a moisturizer with sunscreen and antioxidant vitamins a c and e. moisturize at night with a second dose of vitamin a (retinol) and peptides.

### Human:\nare certain foods linked with healthy skin?\n\n### Assistant: healthy foods help your skin become healthy also. skin is made up of proteins. so lean proteins are necessary in your diet. examples include lean chicken fish and tofu if you’re a vegetarian. fresh fruits like papaya and blueberries and fresh vegetables and whole grains also contribute to healthy skin. hydration also helps your skin fight off signs of age.

### Human:\nwhat are the best ways to exfoliate to prevent breakouts?\n\n### Assistant: exfoliation is one of the most important steps to prevent and treat acne. there are three types of exfoliation: manual (with beads or crystals) chemical (aha bha) and enzymatic. acne exfoliation is best done with salicylic acid and gentle beads.

### Human:\ni have a very wrinkly neck! help!\n\n### Assistant: your first approach is to identify the underlying causes and potentially aggravating conditions such as pre-existing sun damage or ongoing excessive sun exposure. you should incorporate a sun block and tretinoin-containing compounds in your daily skin care regimen along with an exfoliator and hydrating creams. if you have significantly relaxed skin on your neck you may want to consider being evaluated by a plastic surgeon to discuss options for a neck lift.

### Human:\nwhat can i use for dark circles under my eyes?\n\n### Assistant: the treatment for dark circles begins with prevention. getting adequate rest will improve your circulation and lessen the appearance of dark circles. in addition look for topical agents that contain natural brighteners such as bearberry niacin or licorice extract. topical caffeine and green tea also help constrict leaky vessels which helps minimize the appearance of dark circles.

### Human:\nwhat can be done about crepe-like skin after weight loss?\n\n### Assistant: loose skin after weight loss can be a very challenging issue. following major weight loss your skin may have lost a significant amount of elasticity. in addition certain weight loss procedures may lead to changes in the ability to absorb certain nutrients such as folate vitamin b12 and iron which may have a profound impact on the viability of your skin.

### Human:\nwhat can i use for dark marks on my skin?\n\n### Assistant: your first approach is to consult with your physician in order to exclude any underlying medical causes for the darkening. next work with a dermatologist that knows how to care for people with your skin type and color. your dermatologist should implement a program that combines topical exfoliating treatments (to facilitate greater preparation) followed by skin-brightening agents and an effective sun block.

### Human:\nwhat are aging spots?\n\n### Assistant: aging spots or solar lentigos primarily result from sun damage. age spots have also been mislabeled as liver spots. (they do not have any correlation with liver disease. ) the majority of age spots are benign (noncancerous). if you notice any changes in the border color or diameter of any lesions on your skin you should be evaluated by your dermatologist.

### Human:\nwhat is the most effective antiwrinkle treatment for the eyes?\n\n### Assistant: your best way to fight premature wrinkling is sun protection. sun damage and smoking account for the majority of premature aging. in order to help combat wrinkling use compounds that exfoliate dead skin cells (glycolic and ahas) encourage new collagen deposition (tretinoin-based products) and provide nutrition for skin cells (vitamins c and e and peptides).

### Human:\nmy face is red all the time. what can i do?\n\n### Assistant: you may be suffering from any of a variety of conditions that can cause persistent redness including an allergic response contact dermatitis immunologic diseases or infection. prior to trying to treat the redness your first step is to consult with your physician to obtain an accurate diagnosis.

### Human:\ncan skin become sensitive when it wasn't before?\n\n### Assistant: certain products may contain preservatives or fragrances that can cause hypersensitivity or an allergic reaction on your skin. also if you are using products that contain tretinoin aha or salicylic acids your skin may become more sensitive when exposed to direct sunlight. therefore it is important to incorporate a sun block within your skin care regimen.

### Human:\ni have very very dry hands that are cracked. what should i use on them?\n\n### Assistant: your first step is to exclude any underlying medical causes such as a thyroid condition connective tissue disease or an infectious process. when you wash your hands avoid cleansers that contain alcohol. this will further dry your hands. your next step is to focus on moisturizing and hydrating your hands.

### Human:\nwhat really works on wrinkles?\n\n### Assistant: your first treatment is prevention. avoid direct sunlight. the majority of premature aging is attributed to sun damage. use a sun block exfoliate hydrate and nourish your skin with compounds that contain vitamins a c and e.

### Human:\nwhat's the best treatment for large deep pores on cheeks?\n\n### Assistant: proper skin care is your first approach towards large facial pores. pores appear enlarged when they are clogged dilated or infected and that's why the best way to keep your pores small and less visible is to keep your skin clean all the time. often the pores get clogged with dead skin cells dirt and oil which makes them appear more prominent. that’s why regular skin exfoliation is essential in order to remove the dead skin cells and to allow your skin to produce newer healthier cells.

### Human:\nare there any new creams to help eliminate the lines between my eyes?\n\n### Assistant: the lines between your eyes may represent either sun damage or hypertrophy of the underlying muscle (corrugator). sun damage can be improved with topical retinoid-based products. for the deeper furrows topical creams will usually not penetrate the muscle.

### Human:\nwhat is the cure for dry skin?\n\n### Assistant: dry skin can be attributed to a variety of skin disorders such as eczema rosacea or psoriasis. medical problems such as thyroid disease kidney disease liver disease and certain connective tissue diseases may also contribute to dry skin. your first approach is to exclude any potential medical causes with your physician. if your dry skin is not related to an underlying medical cause then your skin regimen needs to include moisturizers that contain health-rebuilding compounds such as vitamin a c e peptides or hyaluronic acid.

### Human:\ncould you recommend the best skin care products for antiaging including moisturizers?\n\n### Assistant: your first step is to educate yourself. you should look for products that contain salicylic acid aha (alpha-hydroxy acid) or papaya-based enzymes to help exfoliate and remove unwanted cells. your next step is to focus on rebuilding and hydrating your skin. compounds containing tretinoin will work towards improving collagen synthesis. last and most importantly your daily skin care regimen needs to contain sunblock. sun damage and smoking are the primary causes of premature aging. yes you can use cocoa oil application on your skin butter also for the anti-aging skin. take juices practice yoga in the fresh air of early morning have some resveratrol which is actually a natural molecule holds the property of reversing the aging due to high anti-oxidant levels. have a look of resveratrol and benefits here.

### Human:\nwhat's the best skin care for my aging less elastic skin?\n\n### Assistant: one of the best moisturizing ingredients for aging skin is hyaluronic acid. this is a natural substance produced by the body and it will bind molecules of moisture to your complexion. this is helpful for aging skin because hydration is the key to a soft and supple texture to your skin tone. on top of that focus on drinking water to stay hydrated and improve elasticity in your skin! we agree! our intensive hydration mist has that key ingredient; hyaluronic acid holding 1000 times its weight in water which means your cells will plump up better and your skin will be smoother and fresher looking. also formulated with vitamins a c and e gingko biloba and ginseng this mist sprayed on after moisturizing will do wonders for your skin. similarly powerhouse ingredients in the cellular recovery serum hyaluronate and resveratrol improve moisture binding penetrating deep to help skin at the cellular level. this serum stimulates the new formation of collagen to plump cells and reduces wrinkles. for more information check out www. vivianeskincare. com

### Human:\nhow can i protect my skin from dryness in the winter?\n\n### Assistant: during the fall and winter seasons there is a decrease of humidity in the atmosphere. this decrease in humidity is usually what causes the skin on our bodies to become dry and rough. the first step you can take toward healthy skin is to look at the body wash or bar you use in the shower. avoid shower gels in the winter as they can be drying to your skin. a body wash or bar that contains shea butter or jojoba oil will help to hydrate and nourish your skin while you are in the shower. shea butter is extracted from the nuts found on the shea-karite tree. this tree can only be found growing in the tropics of africa. shea butter nourishes the skin with vitamins a and e and it also penetrates and moisturizes the skin without clogging pores. jojoba oil comes from the seed of the jojoba tree (simmondsia chinensis). the jojoba tree is a perennial shrub that can be found in northwestern mexico and parts of arizona and california. this oil is actually a wax ester that is very similar to the oil or sebum our skin produces naturally. jojoba oil can help to balance the oil in your skin and can also provide moisture all day. taking lukewarm showers instead of hot showers can also ward off dry skin. if you do not want to give up taking a hot shower try to cut your shower time down. long hot showers tend to draw out the natural moisturizers in your skin. avoiding long soaks in the hot tub is also a good idea because the chemicals and the hot water can dry out your skin. after you shower you should apply a moisturizer to replenish your skin. you can apply baby oil to your skin before drying off; this is one of the best ways for moisture to penetrate your skin. after you dry off try using jojoba oil shea butter or cocoa butter; they work even better if they contain vitamin a and e. exfoliate the skin on your body once a week. try to find a salt- or sugar-based scrub. while you are in the shower apply the scrub all over your body. next rinse the scrub off. this should help slough away any dry skin you have. always follow up with a moisturizer after exfoliating your skin. if you live in an area that has a dry atmosphere such as the desert a humidifier is a good investment for your home. the heat from the furnace can draw out the natural moisture and humidity in the air. a humidifier can help to add moisture back into the air in your home and also assist in warding off dry skin. a well-balanced diet is also an important step for healthy skin. be sure to eat plenty of fresh fruits and vegetables especially green vegetables. these foods will help to naturally nourish your skin. including fish in your diet is also great for your skin because it is a natural source of omega fatty acids. the fatty acids can help to moisturize dry and scaly skin from the inside out. one last tip: limit your caffeine intake because it can also dehydrate the skin.

### Human:\nwhat is the proper way to apply sunscreen to the face?\n\n### Assistant: applying sunscreen is a very important part of your daily skin care regimen especially if you are exposed to prolonged sunlight. choosing your spf level should be based on how long you plan to be outdoors. you may find that you normally turn red after being exposed to the sun for twenty minutes; you will then mulitply that number with the spf factor to understand how long you will potentially be protected from the sun. for example 20 (minutes redness appears) x 15 (sunscreen with spf 15) = protection from the sun for 300 minutes. you will need to reapply the sunscreen after 300 minutes expire. you should apply your sunscreen before your moisturizer. if you find your skin is dry you should apply moisturizer in the summer months. there are also moisturizers containing sunscreen. .

### Human:\nlately i've noticed a lot of loose skin around my knees and in the front of my legs. what can be done?\n\n### Assistant: loose skin around the knees may be part of the natural aging process. extreme weight loss may lead to excess skin. these issues may be addressed by a plastic surgeon. excess sun exposure is the no. 1 cause of premature aging and wrinkling of the skin. if you suffer from chronic swelling around your knees compression garments and support hose may be beneficial.

### Human:\nhow can i get rid of dark spots on my face?\n\n### Assistant: once you have excluded medical causes there are multiple options to regain your even skin tone. a combination of glycolic aha and retinoid-based products along with a traditional topical skin care regimen for skin brightening will work. hydroquinone-based products work well. however there are other alternatives such as bearberry extract kojic acid licorice extract and niacin. these compounds will work toward brightening your skin and correcting your skin tone. the key is to work with a physician that is very familiar with your skin type and color because incorrect use of these agents can lead to further hypo- or hyperpigmentation.

### Human:\ni have dark eyelids and a dark circle around my mouth.\n\n### Assistant: natural alternatives such as bearberry extract kojic acid licorice extract and niacin work toward brightening your skin and correcting your skin tone. however your first approach should be to avoid exposure to uv rays. you should wear a sunscreen containing titanium dioxide with an spf of at least 40 if you are prone to hyperpigmentation.

### Human:\nbesides surgery is there anything you can do to reduce spider veins in the legs?\n\n### Assistant: there are some creams that contain caffeine that help decrease the size of the blood vessels. it may help diminish the appearance of your existing blood vessels. preventing the formation of more spider veins is easy if you protect your skin from the sun with sunscreen and vitamin antioxidants a c and e as well as having a healthy lifestyle.

### Human:\nwhat is the single best thing i can do to keep my skin’s youthful appearance?\n\n### Assistant: the single most important step to keep your skin youthful is to avoid the sun. use sunscreen with antioxidant vitamins and wear protective clothing and coverings.

### Human:\nare there toxins in the air/environment that will age my skin?\n\n### Assistant: ultraviolet radiation as well as toxins from smoking and smog all contribute to free-radical damage and aging in your skin. the best way to fight the aging process is to avoid the sun between 11 a. m. and 3 p. m. wear sunscreen protective clothing avoid secondhand smoke or if you do stop smoking. skin care should include antioxidant vitamins a c and e as well as moisturizers. drinking eight glasses of water fresh fruits and vegetables lean meats and whole grains also help keep your skin beautiful inside and out.

### Human:\ncan stressful events (divorce death of a parent etc. ) actually age my skin?\n\n### Assistant: stress has effects on our skin nails and hair. also if you have an underlying skin condition such as psoriasis eczema or acne stress can make it worse. furthermore stressed facial expressions contribute to expression lines like the 11 wrinkle between your eyebrows and those around your eyes and mouth. learning how to effectively manage stress helps keep your skin looking younger and also you’ll feel better overall.

### Human:\nare there any age-advancing toxins in the chemicals that i use to clean my home?\n\n### Assistant: protecting your skin from cleaning chemicals in your home is an important and healthy step for your skin. toxins can cause irritation and breaks in the skin that can lead to infection. for that reason protect your skin with gloves when dealing with chemicals. if toxins accidentally come in contact with your skin rinse off immediately.

### Human:\nshould i be applying moisturizer to my neck? will that help to prevent neck lines as i age?\n\n### Assistant: neck lines and sagging neck are common complaints. most patients ignore their necks until they notice how aged their necks look. the neck skin is fragile and requires more moisture than the face. just like you moisturize your face you should be moisturizing you neck. you’ll be glad that you did.

### Human:\nwhen to eat after insulin injection? also how much to eat after your insulin injection?\n\n### Assistant: the best time to eat after taking insulin depends on three major factors. first the type of insulin you are taking the type of food you are eating and your current blood glucose level. there are two major types of insulin taken before meals rapid acting and short acting. rapid acting insulins include lispro (humalog) insulin aspart (novolog) and insulin glulisine (apidra). it’s generally best to inject these insulins up to 15 minutes before you plan to eat. for the short acting insulins humulin r and novolin r the timing is 30 to 45 minutes prior to the meal. if you wait longer than these times you run the risk of having a low blood glucose level. the type of food also impacts the timing of insulin. carbohydrates have the most effect on glucose levels. meals that are high in fat slow down the absorption of carbohydrates. so eating a pizza which has a lot of fat may not affect your glucose level as quickly as eating a bowl of cereal. protein usually has a small effect on your blood glucose levels. thirdly your blood glucose level prior to eating is important. having a low blood glucose level and then taking insulin and waiting to eat may cause your blood glucose level to drop even further. if your blood glucose level is high before you eat you may need to add extra insulin as recommended by your doctor to compensate for the high blood glucose level. in terms of how much to eat that depends on your weight your dietary needs and your insulin to carbohydrate ratio. this ratio is how many grams of carbohydrates one unit of insulin covers. this is a very individualized number that your doctor will decide when prescribing insulin to you. the important point is to talk with your doctor nurse educator and dietician about the timing of eating and insulin. keep a diary of the different foods you like to eat so that you can gain insight into what happens when you eat that meal. be sure to mark down the grams of carbohydrates in the meal so your doctor can evaluate your insulin to carbohydrate ratio. check your blood glucose level 2 hours after eating to see what effect the meal has on your glucose level. remember that many other factors affect your reaction to insulin such as exercise a cold and stress. diabetes is a chronic disease and the more you understand about the factors affecting you the better your glucose control will become. 15 mins. i think you should have your meal first then straight after take your insulin. then you can work out how much insulin to take depending on how much you ate and also what you ate. bbbb an hr later.

### Human:\ndoes sunscreen with an spf over 30 actually work?\n\n### Assistant: spf 30 is effective because it provides protection from both uva and uvb rays. when spf is greater than 30 it should mean that in addition to chemical sunscreens the makers have included titanium dioxide and/or zinc oxide which provide physical barriers and are actual sunscreens. irrespective of the spf you’ll need to reapply the sunscreen every 2 hours.

### Human:\nwhat does it mean if your thyroglobin ab are very high but all the others are normal? and how does that affect the body? . i am wondering if the thyroglobin ab being high could correlate to the weight gain(15+ lbs a month and can't lose it) breast enlargement(2 cup sizes) fatigue and lack of menstration. i have been tested for cancer(negative) and i have no family history of these issues. from the research i have done i cannot find an answer so i am hoping that someone could enlighten me so i would have a stepping stone the next time i went to the doctor about this.\n\n### Assistant: a high thyroglobin antibody level in and of itself does not mean you have thyroid disease. they are found in nearly 20% of all women. however high levels of thyroglobulin antibodies associated with other thyroid antibodies are found in 80 to 90% of people with immune mediated inflammation of the thyroid (hashimoto’s thyroiditis). this is the most common type of thyroid hormone deficiency in the u. s. thyroglobulin antibodies are also found in pregnant women relatives of patients with hashimoto’s thyroiditis and in people with other immune mediated diseases such as type 1 diabetes. the usual course of hashimoto's thyroiditis is gradual loss of thyroid function. antibodies to thyroglobulin are considered to occur as a result of damage to the thyroid from special white blood cells (t cells). common symptoms of thyroid hormone deficiency include fatigue being cold all the time weight gain constipation dry skin and menstrual irregularities. since these symptoms occur in other diseases it is important not to always blame thyroid deficiency as the cause. fortunately laboratory tests for thyroid function make this diagnosis relatively easy. however because loss of thyroid hormone develops over time and antibodies can herald problems you will want to follow-up with your doctor about your thyroid tests and your symptoms.

### Human:\ndoes janumet cause weight loss or the opposite?\n\n### Assistant: most helpful answer janumet a medication used in type 2 diabetes causes weight loss. janumet is a combination medication of metformin and sitagliptin. metformin (glucophage) and sitagliptin (januvia) can each be used alone for the treatment of diabetes. janumet is indicated when diet and exercise fail to adequately control diabetes and both metformin and sitagliptin are appropriate. metformin definitely causes weight loss and sitagliptin usually results in weight loss or is weight neutral. a 24-week study that looked at weight loss with janumet found that the amount of weight lost was about the same for patients on metformin alone. during this 24-week study patients lost between 1. 3 to 2. 9 lbs. since weight loss is an important part of the treatment plan for most type 2 diabetics it is very helpful to use a medication that helps you go in the right direction. don’t forget that diet and exercise are still the key ingredients to weight loss. talk with your provider about how you can achieve your weight loss goals and if a medication like janumet is right for you.

### Human:\nis there a permanent hair removal product available for men?\n\n### Assistant: laser hair removal can be effective and permanent. laser hair removal requires several treatments because the hair grows in different cycles.

### Human:\nwhat ingredients should you avoid in your makeup if you have sensitive skin?\n\n### Assistant: sensitive skin patients should avoid makeup creams that contain a large amount of preservatives high alcohol content multiple synthetic fragrances or parabens.

### Human:\ndoes the use of insulin affect your eyes?\n\n### Assistant: insulin affects your vision because insulin lowers blood glucose levels which in turn effects the lens of the eye not because insulin has a direct effect on your eyes. when your blood glucose (sugar) levels go up fluid enters the lens of your eyes and when your blood glucose goes down the fluid shifts out of your lens. these changes in fluid in the lens cause blurred vision so both high and low blood glucose levels affect your vision. as your blood glucose levels stabilize on insulin these shifts become less and your vision improves. so be patient. in most cases the blurry vision after you start insulin settles down. usually these vision changes resolve within a few days or weeks depending on how quickly your diabetes comes under control. after examining your eyes your doctor will be in good position to hopefully reassure you that these vision changes are temporary. therefore unless you are really having serious vision problems wait until your blood glucose levels settle before having your vision tested for a new pair of glasses.

### Human:\ncan you tell me what causes hair loss on lower legs and calves in men?\n\n### Assistant: there are several reasons for hair loss on the legs. poor circulation may be a factor which can be caused or aggravated by diabetes thyroid disorders peripheral artery disease medications poor diet lack of exercise smoking being overweight and other health issues. to properly diagnose your condition and to rule out a serious condition you need to be evaluated and tested by a physician. it might be worth checking on your 5-alpha reductase level. this is an enzyme that regulates the conversion of testosterone into dihydrotestosterone (dht). reduced 5-alpha reductase levels can lead to an overabundance of dht which in turn can adversely affect the health of hair follicles and reduce hair reproduction on your legs. pad can cause hairless legs. lack of proper blood circulation is the root of this phenomenon. crossing your legs and/or ankles. it's rubbing the hair off. crossing your ankles.

### Human:\nhow do i remove black spots on my face?\n\n### Assistant: first have the dark spot looked at by a dermatologist to determine that the dark spot is not pre-cancerous or skin cancer. melasma is a common cause of dark spots on the forehead cheeks and upper lips in women. one of the first and very critical steps to brightening darker areas on the face is to use a cream with an spf of 30 and above applying three times each day to cover darker areas. also applying skin brighteners such as niacin hydroroquinone and kojic acid will help brighten the darker areas. these steps will help your skin look more even and more youthful.

### Human:\ndo you have any advice on how i can avoid splotches and keep my freckle face healthy?\n\n### Assistant: my advice for freckles is to keep them protected from the sun or they will become darker larger and look more like age spots. also they may camouflage a more serious mole that needs a biopsy to determine if it’s a risk of cancer. in addition to daily use of an spf 30 sunscreen to protect from both uva/uvb rays skin-brightening agents can be applied twice a day for a more blended youthful appearance. brightening agents that are approved for purchase include licorice extract niacin and low dose hydroquinone 1% to 2% strength. finally general skin health steps such as moisturizing with key antioxidant vitamins like vitamin e c and vitamin a will help keep your freckles closer to how they looked when you were young.

### Human:\nhow long is one shot or pen of humira effective for (rheumatoid arthritis)?\n\n### Assistant: humira is used to slow down the progression of rheumatoid arthritis (ra). it is considered a biologic disease-modifying antirheumatic drug. therefore this drug must be taken for some time to make a difference in the outcome of ra. some ra patients will see results as soon as 2 weeks. for others it may take up to 3 months. you will know humira is working when you notice less pain swelling and joint stiffness. humira is packaged in a single use pen or syringe. adults with rheumatoid arthritis are prescribed one pen or syringe (40 mg) every other week. for patients with rheumatoid arthritis who are not on the medication methotrexate humira may be taken every week.

### Human:\nis it absolutely necessary to use a toner after washing my face?\n\n### Assistant: toners are not an absolute necessity for your skin care regimen. a toner is designed to help remove excess surface oils to allow moisturizers or antibacterial washes (in acne treatment preparations) penetrate into the skin. avoid toners with a high alcohol content; this may lead to excessive drying of the skin.

### Human:\nwhat can i do to treat the bags under my eyes?\n\n### Assistant: severe bags under the eyes are also known as festoons. your condition may require an evaluation by your surgeon. if you are the appropriate candidate there are several minimally invasive techniques to remove the fat pads without an external incision. this is known as a transconjunctival technique.

### Human:\ni have a hard red spot about the size of a quarter near my ankle. it does not hurt. what could it be?\n\n### Assistant: your dermatologist should evaluate skin changes or abnormal spots. a lesion that feels hard may be scar tissue. however you should be evaluated for any underlying skin cancer. when evaluating your skin look for changes in the area border or color of the skin. these are the "abcs" of skin cancer detection.

### Human:\nhow can i get rid of a white-spot birthmark on my face?\n\n### Assistant: birthmarks can be difficult to conceal. your first step is to exclude any underlying medical causes that may lead to superficial skin changes such as any type of infection. once medical causes are excluded your options may include laser treatment medical tattooing or a medical-grade concealer.

### Human:\nwhat can i do to have glowing pinkish skin not dry dull skin?\n\n### Assistant: the key to having healthy glowing skin is to utilize sunblock followed by a skin-care regimen that includes exfoliation hydration and nutrition. within your diet include vitamins that are good for your skin such as folic acid magnesium and omega-3 fatty acids. if you moisturize and hydrate your skin and body you will be much less likely to develop dry skin.

### Human:\nwhat are the dangers of multiple piercings?\n\n### Assistant: one of the unfortunate consequences of multiple piercings is the potential for wound infection. the blood supply adjacent to the area of the piercing(s) may be compromised. this will also delay healing. if you suspect an infection you should have this area evaluated by your physician.

### Human:\ni'm 24 but laugh lines and forehead wrinkles are already apparent on my face. can i slow them down?\n\n### Assistant: sun damage and smoking are the no. 1 reasons for premature aging or wrinkling of the skin. therefore you should incorporate the use of sunblock in your daily skin-care regimen. next utilize a daily skin regimen that exfoliates your skin which will help remove dead skin cells. this should be followed by a non-comedogenic moisturizer that contains vitamins (c & e) and rebuilds peptides for your skin. use a very dramatic moisturizer! i use multiple moisturizers and it seriously takes away my laugh lines and wrinkles. and i smile all the time. try using moisturizers that are for dry skin. i use several natural oatmeal moistorizers that work and i use a heavy body butter around the area that i have most trouble with and a gentle baby lotion for the areas i dont have trouble with. you can also use natural exfoliators i have noticed they work so much better than commercial ones! try baking soda and water apply to face keep it on for a minute or two (never longer than 3 min because of the result of skin irritation) grab a rag and put cool water on it and gently wipe it off. sometimes if it doesn't all come off and you can still feel the particles on your face then i put my face under the faucet. you can do it however you want though but you can instantly tell the difference between your first try! don't stop smiling! our body is like a computer. garbage in garbage out. i highly recommend that you look at your diet. are you eating a lot of processed foods? there is not much nutrition in processed foods if any. in my opinion even organic processed food is garbage. once something has been processed it is dead food. are you eating fresh fruits and vegetables (preferably organic so your immune system can heal your skin and does not have to fight all the chemicals in conventional foods)? raw unprocessed nuts? eggs (yes they are really good for you! ) stay away from conventional meats and dairy? it is truly true. you are what you eat! make it an adventure to discover real food not stuff that comes from a box. you will see your skin become as it should be at your age luminous and supple. granted it takes a little effort but once you see the results in your skin (and you will) you gladly eat at home and make it a home cooked meal. highly recommend you study up on healthy nutrition maybe take a cooking course. i am 64 and almost wrinkle free my weight is normal and i can pass for 50. that is what good nutrition can do for you. my best wishes to you r. d. externally there are topical line relaxers the most effective target just the line you want to treat. the line fillers are meant to "fill in" your lines but don't seem to work too well for me. i think regular consistent care of the skin is the most important thing you can do. routinely moisturize your skin twice a day face and neck. shower and then follow with a good thick moisturizer that has vitamins c e a with hyaluronic acid and sunscreen. avoid products with alcohol as an ingredient as this will dry and damage new skin. clean skin at night and use a good night cream. personally i love the olay refinishing night cream makes skin so soft and smells great. internally drink water and eat your berries & veggies. take a b vitamin complex with biotin fish oil and a multivitamin. if your lines don't respond to a line relaxer and twice daily tlc a precription for retinol may do the trick. i personally find these creams effective: strivectin lift cream really lifts! the newest neutrogena tone improving moisturizer is a nice effective cream that brightens skin well the olay refinishing line helps with surface problems such as large pores. i also use vitamin e oil and collagen(absorbed through skin) about once a week after a shower on wet skin. allover. then of course there's always botox.

### Human:\nmy stepdaughter just moved to las vegas from hawaii. her beautiful skin started breaking out. is it the climate change?\n\n### Assistant: a variety of conditions may lead to changes in your skin. acne breakouts can occur secondary to stress or hormonal changes. very hot weather can stimulate oil gland production and clogged pores which may lead to new breakouts. make sure your stepdaughter is using the correct moisturizer. i always recommend moisturizers that are non-comedogenic or non-pore-clogging.

### Human:\ni have developed wrinkles on my face after a 35 pound weight loss. what should i do?\n\n### Assistant: significant weight loss can also affect the fat pads around your cheeks and eyes creating a "hollowed/wrinkled" appearance. your next step (other than regaining your weight) would be to have an evaluation by your plastic surgeon or dermatologist. your surgeon may recommend fillers fat transfer or stem cell micro-injections to restore volume to your face.

### Human:\ni have dark purple blotches under my eyes even though i'm healthy. what causes it?\n\n### Assistant: a purple color under your eyes may be attributed to the tiny blood vessels within your lower eyelid. the skin in this area is quite thin and stretched over the bony prominence which will make these blood vessels more noticeable.

### Human:\nis it dangerous to color your hair if you have extremely dry scalp from scalp psoriasis?\n\n### Assistant: in general there is no contraindication to the use of hair dyes with scalp psoriasis. certain hair dyes may further aggravate your scalp psoriasis. consider patch testing a small area prior to dying your whole head. do not leave the dye in place for extended periods. other options include natural herbal dyes such as henna dyes.

### Human:\nwhat prevents dark spots under the eyes for african-american women?\n\n### Assistant: dark spots can be attributed to hereditary factors fluid retention and excess sun exposure. your first step is to exclude any underlying medical problems that can contribute to your dark spots. next your physician can recommend a series of brightening agents that may improve your condition.

### Human:\nis it possible to have scabies that don't itch?\n\n### Assistant: yes. newly infected areas may not itch. as the number of female mites multiply and lay eggs there are local secretions from the mites along with a local histamine release that leads to itching.

### Human:\ni'm 28 and my skin has changed dramatically. i have big pores and wrinkles around my forehead and eyes. what can i do?\n\n### Assistant: your first step is to avoid the sun. sun damage and smoking are the primary causes of premature aging. you should include sunblock in your daily skin regimen. next incorporate a skin-care product in your regimen that will exfoliate (such as salicylic acid or papaya enzymes) hydrate (hyaluronic acid) nourish (vitamins and peptides ) and rebuild collagen (retinol).

### Human:\ncan a mole on my my lower lip be removed?\n\n### Assistant: lower lip moles can be removed surgically. make sure that your dermatologist or plastic surgeon is comfortable with removing your mole and is able to preserve your natural lip aesthetic landmarks. careful attention to these landmarks will allow your final scar to heal without being very noticeable.

### Human:\nat 22 i have started constantly breaking out all over my face. can a dermatologist help?\n\n### Assistant: yes. you should have an initial evaluation with a dermatologist. once evaluated your physician can guide you toward the best skin regimen for your skin type. during your consultation your physician should also be able to assess if there are any underlying medical conditions that may have attributed to your new breakouts.

### Human:\nwhat can i do about puffy bags under my eyes?\n\n### Assistant: your first approach is to ensure that you are receiving an adequate amount of rest. apply cool compress around your eyes in the morning with green tea bags. avoid excess alcohol consumption and very salty foods. you also need to weed out any underlying medical issues such as sinusitis allergies or a reaction to contact lenses.

### Human:\ncan an over-the-counter product fade an unwanted tattoo?\n\n### Assistant: several of the popular over-the-counter agents including skin-bleaching agents and topical acids (salicylic) have been used to fade tattoos. unfortunately many of these products require continuous use for six months and they work by removing the outer layer of the skin. very colorful and deeper tattoos may be more difficult to completely fade using this approach.

### Human:\nwhat is the best way to condition my skin before a cosmetic procedure?\n\n### Assistant: skin preparation is a very important part of many cosmetic procedures. especially in darker skinned patients who may run the risk for post-inflammatory hyperpigmentation (darkening of the skin). your physician may prescribe a combination of topical exfoliating agents along with skin brighteners in order to prepare your skin prior to your cosmetic procedure.

### Human:\nhow can i use duct tape to get rid of warts?\n\n### Assistant: duct tape supposedly starves the wart of oxygen and blood supply and in theory the wart will go away. i have not used duct tape in my practice to treat warts. currently we utilize topical medications and laser removal. this works but i only tried it on my daughters foot. i wouldn't think putting tape on your va j j would be a good idea

### Human:\nas a woman what can i do about facial hair on my chin?\n\n### Assistant: laser hair removal is an excellent choice to remove unwanted hair for all skin types. when choosing your laser specialists make sure that your physician is familiar with your skin type and skin color. make sure that your laser treatments are physician supervised. while undergoing laser treatment you should not concurrently undergo waxing or electrolysis. this may lead to damage of your skin.