Can I use Retin A if I am pregnant?

Tretinoin, a.k.a Retin A, is a great medication for skin; it increases collagen turnover, which improves the appearance of fine lines and rough skin. It also helps with acne. Tretinoin is a prescription medication, and is available under several different brand names, e.g. Renova, Retin A, Avita. Tretinoin can be very irritating to the skin, so you may initially see some redness and flaking. I’ve talked about the correct way to use tretinoin in previous posts. Today I’m going to discuss tretinoin and pregnancy.
Topical tretinoin is a pregnancy class C medication. This means that using the medication is only recommended if the benefit of use outweighs the risk. For a cosmetic treatment like tretinoin, the safest course of action, therefore, is to stop using the medication if you are pregnant or trying to become pregnant.

www.obagi.com

www.obagi.com

But what if you recently discovered you are pregnant- do you need to worry about your baby’s exposure? Tretinoin has not actually been studied in pregnancy in humans for obvious reasons. The studies that have been done were all in rats. High doses of tretinoin were given orally to pregnant rats to see if it could cause birth defects, and the conclusion was that it can. But these studies don’t necessarily apply to the way tretinoin is used in people. The most important difference is that tretinoin is used topically, not ingested. And only very little tretinoin is absorbed into the bloodstream when the medication is applied to the skin. So even if you have used tretinoin while pregnant, most likely your baby was exposed to very little, if any, tretinoin. Stop using tretinoin as soon as you discover you are pregnant, and I would also recommend discussing any medications you are using with your Ob.

 

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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 the Difference Between Varicose Veins and Spider Veins?

Abnormal leg veins are a common complaint among men and women. They may appear as spider veins, varicose veins, or both. The two types of abnormal veins are treated differently, and by different types of doctors. So how do you know which one you have?

Varicose veins are enlarged veins which most commonly appear in the legs. They may appear bluish, red, or flesh colored, and are ropy or twisted looking in appearance.

Photo Credit: Wikipedia.com

Photo Credit: Wikipedia.com — Varicose Veins

Photo Credit: Wikipedia.com

Photo Credit: Wikipedia.com

Veins have valves that prevent blood from flowing the wrong way. The movement of the leg muscles helps move the blood back toward the heart, and the valves prevent the blood from backflowing. When these valves become incompetent and no longer function correctly, the blood pools in the legs, causing varicose veins. There are several factors that contribute to the development of varicose veins:

  • Increasing age
  • Family history of varicose veins
  • Obesity
  • Sitting or standing for long periods of time without moving around

Varicose veins may cause throbbing, cramping, or aching pain in the legs. The legs often become swollen as well. Varicose veins are a medical problem, and insurance will cover treatment for varicose veins that are symptomatic. Varicose veins are treated by a vein specialist (phlebologist) or a vascular surgeon.

In comparison to varicose veins, spider veins are much smaller (see image below) and are present just under the surface of the skin. They may appear in any area of the body, but most commonly appear on the legs and on the face.  Spider veins are also caused by a backup of blood. They commonly appear in association with varicose veins, but may also appear in people without varicose veins. Spider veins are commonly associated with

  • Hormone changes. Spider veins often appear during pregnancy.
  • Damage to the skin. Spider veins may appear near the site of a trauma such as a cut to the skin, or a surgical site.
Photo Credit: shutterstock.com

Photo Credit: shutterstock.com — Spider Veins

The good news is that effective treatment options are available for both spider veins and varicose veins. The Women’s Health webpage put out by the Department of Health and Human Services has a great information page if you’d like to find out more.

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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 Tummy Tuck

I’ve discussed how an abdominoplasty, a.k.a. tummy tuck, is performed in previous posts. Today I’d like to delve a little deeper into subject by discussing the possible complications. I’ll divide these into normal expected postoperative sequelae, and true complications.

shutterstock.com

shutterstock.com

Normal postoperative side effects include:

  • Numbness: Abdominoplasty surgery involves elevating the skin up to the level of the ribs and removing the excess. This process means that small cutaneous nerves which give sensation to the skin are divided. So numbness over the abdomen is normal after abdominoplasty. The nerves take several months to regrow, and there may be permanent numbness right over the incision.
  • Swelling: In addition to dividing the nerves, raising the skin up means that lymphatic system is disrupted as well. The lymphatic system is responsible for draining excess fluid from tissue and rerouting it back into the blood supply. Disrupting this system results in swelling, which may take several months to completely resolve.
  • Bruising: Bruising is very common after most types of surgery surgery, and can take a few weeks to resolve.
  • Excess skin. Skin does stretch over time. If you have an abdominoplasty and then gain weight or become pregnant, your skin may stretch, resulting in laxity.

True complications:

  • Blood clots: Blood clots in the deep veins of the legs known as a DVT (deep vein thrombosis), and can happen after periods of immobilization, including anything from surgery to a long plane ride. The risk is increased with age, smoking, hormonal birth control, and certain medical conditions. If a clot forms, part of it can break off and travel to the lungs. This is known as a pulmonary embolism (PE), and can actually be fatal. Fortunately the risk of both DVT and PE are very small. Your physician will assess your risk preoperatively, and may start you on a blood thinner in the postoperative period if your risk is higher than average.
  • Hematoma: A hematoma is a collection of blood that develops in a surgical site. This is a risk of any type of surgery, and abdominoplasty is no exception.
  • Seroma: A seroma is a collection of clear fluid within a surgical site. This is the fluid which your lymphatic system normally drains. To prevent this fluid from collecting, drains are placed after surgery which stay in place for 1-2 weeks. If either a hematoma or a seroma develop after surgery, they can usually be drained in the office, and only rarely would require a return to the operating room.
  • Wound healing problems are also a risk of any type of surgery. If a wound-healing problem develops, it usually shows up as a small area of the incision which heals more slowly than the rest. A more severe wound healing problem occurs if some of the skin on the abdomen does not have good blood supply after surgery, and dies. This is called skin necrosis. It is more common in patients predisposed to healing problems, such as diabetics or smokers. It can also happen if liposuction is done over the abdomen at the same time as an abdominoplasty.
  • Infection:  Antibiotics are given before the start of surgery to prevent infection. This is a very rare complication after abdominoplasty.
  • Contour deformities may also occur after abdominoplasty. The skin over the upper abdomen is thicker than the skin over the lower abdomen, and this can result in the edges of the incision being uneven. This will get better as the swelling resolves, but a scar revision may need to be done down the road if there is a significant step-off between the top and bottom of the incision, or if the incisions bunch up at the ends.

This isn’t an exhaustive list, but it does cover the more common, and more serious, risks of abdominoplasty. If there are other topics you’d like to learn about, I would love to hear them!

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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.