Can I use my Health Savings Account for Botox?

It’s nearly December, the time of year when people find themselves looking for ways to use up the money in their Health Savings Account (HSA) before the year ends.  I am frequently asked if this money can be used for Botox, hair removal, or skin care products.  The short answer is: no, it can’t.  Money in an HSA does not cover cosmetic treatments.  But it can be used for things that regular insurance does not always cover.

Flu shots are covered by an HSA, as are blood pressure monitors, and blood sugar testing kits.  Your HSA may also cover hot or cold packs, bandages, and splints or ACE wraps.  So this is a great opportunity to set your household up with a first aid kit.

photo credit: www.wikipedia.com

photo credit: www.wikipedia.com

Condoms and pregnancy tests are usually covered as well, so you can always stock up if this is something you might need in the next year.

One slightly hazy area is prescription medication.  HSAs can be used to pay for pretty much any prescription medication.  And this is great for medications that are often not covered by insurance, such as EpiDuo, which is used to treat acne.  But there are some medications that are provided by prescription for cosmetic use, e.g. tretinoin.  Tretinoin does have some medical uses, but is most commonly used to treat wrinkles and fine lines.  It’s a prescription medication, but may be considered cosmetic, so I would check with your HSA first to see if it’s covered.

What’s the most interesting or creative thing you’ve used your Health Savings Account to pay for?

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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.

Which is better -chemical peel or laser peel?

The goal of any peel is to remove the very outer layers of skin, revealing smoother, younger appearing skin underneath.  This can be done either with chemicals or using a laser.  The results you see are directly dependent on the depth of the peel.  That is, the deeper the peel, the more significant the results.   Superficial peels are confined to the epidermis, which is the outer layer of skin (see diagram below).  Recovery from a superficial peel is characterized by a few days of redness and flaking of the skin.  Deep peels may go down into the dermis, creating what is essentially a partial thickness burn.  And healing from a deep peel can take two weeks or longer.

wikipedia.com

wikipedia.com

 

Deep or superficial peels can be done with both laser and chemicals.  But I think the trend is moving toward chemical peels being a lighter depth peel, and a laser being used for deeper peels.  Aestheticians and cosmetic therapists can perform superficial chemical peels.  These peels come in a kit (e.g. the Vitalize Peel by Skin Medica), and the results are very predictable.  There is minimal to no redness afterward.  Mild flaking starts at about two days after the peel, and lasts 3-5 days.  Deeper peels should be done by a physician.  I prefer to use a laser because the depth of the peel is very consistent and easy to adjust.  The deeper the peel, the more impressive the result is, and the longer the downtime.  Having a series of peels instead of a single peel will also give more dramatic results.  So chemical peels and laser peels are really just different tools used to achieve similar goals.  Your doctor will help guide you toward a specific treatment depending on the results you’re looking for, how much downtime you have, and your budget.

 

Do you have a question about peels?

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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.

Complications After Breast Reduction

The internet is a great way to find information, but sometimes it’s difficult to know how to interpret the information you find.  Case in point: looking up medical information.  Many of my patients research operations and treatments online before they see me.  I recently had a patient ask about complications after breast reduction surgery.  She had looked this up on Google, and was terrified by what she saw.  But fortunately very little of what she saw actually applied to her specific case.  Here is what I told her:

Breast reduction surgery removes a large amount of tissue: anywhere from 1-4+ pounds of tissue per side.  When the remaining tissue does not have adequate blood flow, healing problems can occur.  These might range from a small area that is slow to heal all the way up to losing a nipple.

Google Search Results

Google Search Results

The major risk factors for healing problems are

  • Smoking
  • Diabetes
  • Very large breast size
  • Obesity

If none of these apply to you, your risk of complications is significantly reduced.  But what if they do?  Can you reduce your risk of complications?  The answer is yes.  Let’s cover each individual situation.

  1. Smoking: The simple answer is to quit smoking.  Nicotine causes your blood vessels to constrict, resulting in decreased blood flow to the site of surgery.  So you need to avoid all nicotine products during the healing period, which is about 6 weeks.
  2. Diabetes: Good management of your diabetes lowers your risk of complications.  This is measured by your hemoglobin A1c level.  If your level is higher than normal, you may need to work with your primary care physician or endocrinologist prior to having surgery to achieve better management of your diabetes.
  3. Large breasts: If you have very large breasts, your surgeon may recommend a free-nipple reduction, where the nipple is taken off the breast and put back on as a skin graft.  This ensures good blood flow to the nipple in its new position.
  4. Obesity: Studies have shown that complications of breast reduction are increased in obese patients.  There is no strict weight cutoff, but I recommend my patients get to a BMI of 35 or below prior to having surgery.

Have you ever been confused or overwhelmed by medical information you found on the internet?  Where did you go for help?

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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.