Does Arnica Really Work?

Patients often want the least downtime possible after cosmetic procedures.  Bruising can be a dead giveaway that you’ve had something done, and unfortunately bruising is very common after both surgical and nonsurgical treatments.  Arnica is a homeopathic remedy that claims to decrease bruising and swelling, and patients frequently ask me if it works.  So today I’m going to give you the lowdown on what exactly Arnica is, and whether or not you should take it.

image taken from wikipedia.com

Image taken from wikipedia.com

Arnica is an herb native to Central Europe, also known as Wolf’s Bane.  As I mentioned before, arnica is actually a homeopathic remedy, which is a type of alternative medicine founded in Germany nearly 200 years ago.  Homeopathic medicine is based on three principles:

  1. The law of similars (also known as “like cures like”). – A disease is cured by a substance that produces similar symptoms in healthy people.  Thus if you are trying to treat a symptom of bruising, you want a medication that causes bruising, which arnica does when taken in large doses.
  2. The principle of the single remedy – a single medicine should treat all the symptoms the patient is experiencing.
  3. The principle of  the minimum dose –  theory is that the lower the dose of a medication, the greater its effectiveness. Thus in many homeopathic medicines no trace of the original substance actually remains.

Homeopathic medications are monitored by the FDA for the way they are marketed; if they meet certain requirements, they can be sold without proof of either safety or effectiveness (in contrast to traditional medications, which must be proven both safe and effective prior to being approved).  Homeopathic arnica is considered safe, but arnica in higher doses can cause serious complications such as bleeding, heart arrhythmias, or even death.  Numerous studies have looked at the effectiveness of homeopathic arnica, but data are conflicting.  Some studies show reduction in swelling, pain or bruising.  Other studies show no difference.

The bottom line: it is probably safe to take homeopathic arnica provided by a physician, but it may or may not help reduce bruising and swelling.

If you would like to read more about homeopathic medicine, check out the links below:

Do you have any experience with homeopathic medicine?  We would love to hear from you!

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

What is skin needling?

Skin needling is a method whereby small needles, usually attached to a roller, are used to penetrate the skin.  The injury caused by the needles stimulates production of collagen.  Over time this can result in reduction of fine lines. It may also improve acne scars and even out skin tone.

taken from http://www.swide.com/beauty/cosmetic-treatments/skin-needling-the-new-collagen-boosting-technique/2012/11/26

taken from http://www.swide.com/beauty/cosmetic-treatments/skin-needling-the-new-collagen-boosting-technique/2012/11/26

 

This is actually the exact same method by which Profractional or Fraxel laser treatments work.  Multiple treatments are needed for both Profractional laser and for skin needling, and results develop very gradually over a period of months.  Both treatments are somewhat uncomfortable: numbing cream is used prior to treatment.   You can expect several days of redness and swelling after both treatments as well.

The biggest difference between the two treatments is who can administer them.  In the state of Ohio, only a physician can administer a laser treatment (the exception is laser hair removal), whereas an aesthetician can perform needling.  If you are considering either needling or Profractional, you should ask your care provider how he or she was trained and how many of these procedures he or she performs in a year.  I also recommend asking how many treatments are recommended, what the recovery time is like, and how the instruments are cleaned.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

What is Juvéderm VOLUMA™ XC?

Allergan recently released Juvéderm VOLUMA™ XC and the company has been marketing the product heavily.  You may have seen the ads that compare the apples of your cheeks to, well, apples.  So how is this product different from the original Juvéderm™?  And how is it different from the many other fillers on the market?

The original Juvéderm™ is a hyaluronic acid filler, which is the fluid that lubricates your joints.  It was created to fill lines and wrinkles, and is most frequently used to add volume to the lips and to fill the smile lines (nasolabial folds) around the mouth.  The new product is more highly cross-linked, meaning the individual molecules have more connections between them.  This results in a product that is a little thicker and less pliable than the original.  Juvéderm VOLUMA™ XC was created specifically to add volume to the cheeks, and cannot be used in any other location.

There are currently two other products on the market that can also be used to add volume to the cheeks (although neither is specifically FDA-approved for this purpose): Radiesse™ and Sculptra™.

  • Radiesse™ is made of calcium hydroxylapatite, a mineral found in bones and teeth.  It is administered in a single treatment.  The results are immediate, and last for about 9-12 months.
  • Sculptra™ works by stimulating your body to make collagen, so the results take several weeks to develop, and do not necessarily diminish with time (i.e. the change may be permanent).

In comparison, Juvéderm VOLUMA™ XC lasts up to two years, but is not permanent.  It is administered in a single treatment and results are immediately visible.  The cost falls somewhere in the middle of the spectrum between Radiesse™ and Sculptra™.  I haven’t personally used the product yet- we have the clinical trainer scheduled to come to our office in September- but I’m excited to see how it compares.
Have you ever had filler to add volume to your cheeks?  What did you think of the result?

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Why Does My Sebaceous Cyst Keep Coming Back?

I frequently see patients who complain that they had a sebaceous cyst drained, but that it came back.  Why does this happen? To answer this question, let’s discuss what a cyst actually is.  The medical definition of a cyst is a sac lined with cells.  Cysts can occur within organs such as the ovaries, kidneys and liver, or can occur on the skin.  Cysts of the skin are commonly referred to as sebaceous cysts, but there are actually several different types of skin cysts, depending on the cell type of origin:

  • A sebaceous cyst arises from the oil glands
  • An epidermal inclusion cyst arises from the epidermal skin cells
  • A pilar cyst arises from the hair follicles

All three types cysts appear identical on exam; they appear as a large lump.  Squeezing this lump may produce a thick, white, cheesy substance (you may have seen videos of this uploaded to You Tube, or posted on Facebook.)  This thick white substance is composed of oil and dead skin cells made by the cells lining the cyst.  As the lining cells make more oil and skin cells, the cyst slowly becomes larger.  Cysts can also become infected.   In this instance, the cyst becomes red, hot to the touch, swollen, and painful as in the photo below.

"Inflamed epidermal inclusion cyst" by Steven Fruitsmaak - Own work. Licensed under Creative Commons Attribution-Share Alike 3.0 via Wikimedia Commons

“Inflamed epidermal inclusion cyst” by Steven Fruitsmaak – Own work. Licensed under Creative Commons Attribution-Share Alike 3.0 via Wikimedia Commons

To treat an inflamed or infected cyst your doctor may drain the infection and place you on antibiotics.  But draining the contents of the cyst does not remove the cyst cavity itself.  So the cyst “comes back” when it fills back up with oil and dead skin cells. Actually removing a cyst involves making an incision in the skin.  The cyst is removed, and the incision is sutured closed.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Is My Nose Broken?

Broken noses happen.  Pretty frequently in fact, especially in individuals who have a propensity for getting hit in the face (hello, contact sports!)  But I think there are a lot of misconceptions out there about how to tell if a nose is broken, and what to do about it.

Broken noses can be difficult to diagnose.  The bones are very thin, so x-rays are not helpful in determining if a nose is broken.  Yet I still see patients in my office who are x-rayed by well-meaning ER physicians.  My first piece of advice for you today- if you go to the ER with a possibly broken nose, and the doctor orders an x-ray, politely decline.  It’s just not useful, and whatever specialist they refer you to (Plastics or ENT are the options) will not need the films.  Or the ER may order a CT scan- this is useful if the doctor suspects you may have broken bones in your face other than your nose.  But if the nose is your only injury, CT is overkill.

Here’s my second piece of advice for you today: the important question is actually not if the nose is broken, but whether or not it needs treatment.  A broken nose may need to be treated operatively for two possible reasons:

broken nose - shutterstock.com

broken nose – shutterstock.com

  1. If the nose is crooked.  It may appear flattened, or pushed off to one side. Check out the photo to the right to see what I mean- this nose is definitely broken. (Does anyone else wonder why Shutterstock has stock photos of broken noses?)
  2. If there is breathing obstruction.  There will be some breathing obstruction for the first 7-10 days due to swelling, but this should resolve as the swelling goes down.

Treatment of a broken nose involves a trip to the operating room, where your nose and septum are straightened out. This should be done within about three weeks of the injury, or the bones will have started to heal.  Afterwards you have a splint over your nose, and packing inside of your nose.  This packing stays in about a week, and the external splint stays on for about two weeks.

If your nose looks like it did before you got hit, and you are not having difficulty breathing, then you don’t need treatment even if your nose is actually broken. It will heal on its own over a period of about 6 weeks.  I would recommend not getting hit in the face during that time period, although honestly I have a general policy against getting hit in the face at all.

 

Have you ever had a broken nose?  How did it happen?

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.