If your cheeks have suddenly become red and pimply, and you think you’ve developed acne or an allergy, please don’t try to treat it yourself with over-the-counter lotions and creams. See a dermatologist. You may be one of the 16 million Americans with a chronic facial skin condition called rosacea, and you need to get professional help because it’s not going to go away on its own. You’ll also likely do yourself more harm by playing doctor.

April is Rosacea Awareness Month, so I was pleased to interview Dr. Estee Williams about the disease and effective treatment. A board-certified New York City dermatologist in private practice, and assistant clinical professor of dermatology at Mount Sinai Hospital, Dr. Williams is trained in medical dermatology, skin cancer detection and screening, cosmetic dermatology, injectables (Botox and fillers), lasers, anti-aging procedures, and pediatric dermatology.

FABOVERFIFTY   WHAT IS ROSACEA AND WHO IS MOST LIKELY TO GET IT?

DR. WILLIAMS  “Rosacea is mostly a facial skin condition of redness and sensitivity that typically affects Caucasian women in their 30s, 40s and 50s (especially those of Northern European descent).  It can, however, affect men and people with skin of color, but we don’t see it in children.

“Rosacea almost always affects the cheeks, usually the nose (which may become enlarged and bulbous and may look red, swollen and distorted), and sometimes the chin. It can include flushing and blushing that comes and goes, or it can look like acne with pimples all the time.  Some pimples may heal and new ones can form. Patients across the board report that their skin is extremely sensitive, with stinging, itching, burning or a tight feeling. Their skin is dry, red and irritated, and usually not oily. At times active and at other times quiet, rosacea generally is a chronic condition.”

WHAT CAUSES ROSACEA AND WHY ARE 30-TO 60-YEAR-OLD WOMEN MORE AT RISK?

“Rosacea is considered a multifactorial disease, which means it has a number of causes. First,  the nerves aren’t properly communicating with the blood vessels in a patient’s skin, and when they inappropriately signal the blood vessels to dilate, it manifests as redness. Second, high levels of inflammation in patients’ skin is believed to link rosacea to other conditions, such as high blood pressure and even migraine headaches. Third, some think that the skin of rosacea patients has a higher level of Demodex, a mite that’s actually on everyone’s skin, although this has become a controversial subject.  

“No one knows exactly why women 30 to 60 years old constitute the largest rosacea population, but there’s definitely a hormonal component, and this is when women experience significant hormonal changes. Rosacea tends to quiet down once a patient is around 55 or 60. The same is true for adult onset acne, which usually affects women in their 30s through their 50s.”

DOES ROSACEA AFFECT A PATIENT’S MENTAL STATE?

“Studies from the National Rosacea Society show that up to 90 percent of patients report they have low self-esteem and low self-confidence due to the condition. It’s not a life-threatening or a dangerous disease, but it can take up a lot of a person’s attention. Imagine if you’re going to an event or on a job interview and have to cover up a very red face or bumps. It can affect your social interactions because that’s what people see.”

HOW IS  ROSACEA TREATED AND CAN IT BE PERMANENTLY CURED?

“I enjoy treating this condition because we have therapies that work really well, from the right sunscreen to prescription pills that are FDA approved specifically for Rosacea. The FDA also has approved an antiparasitic cream that kills skin mites.

“I also like to use lasers and IPL (Intense Pulsed Light) Devices, particularly the Lumenis M22. It’s my favorite IPL device, which I use it pretty much on all my rosacea patients who are willing to try it. The treatment is safe and works great.

“Treatments can achieve full clearness of the disease but there’s still always the potential for a flare up. There’s no cure, so patients must continue on treatments.”

PLEASE EXPLAIN HOW THE LUMENIS IPL WORKS ON ROSACEA.

“We first cover the face with a very cold coupling gel to keep a patient comfortable and give her goggles. The Lumenis IPL produces a series of different wavelengths of light that we use to target and heat up the blood vessels, which causes them to spasm and close up. Sometimes, I even see a tiny little blood vessel turn purple in real time, which tells me that the blood inside the vessel has clotted.”

HOW LONG DOES IT TAKE FOR THE ROSACEA TO DISAPPEAR AND HOW MANY TREATMENTS ARE NEEDED?

“It takes a few weeks for patients to see a significant improvement, especially if they’re very red.  My most severe patients will come in about every six weeks. Someone with a quieter rosacea can evenly space their treatments throughout the year.

“It also depends on what medicine a patient is taking.  Some patients prefer not to take any medications, so the M22 is their only rosacea treatment and they come in more often. Other patients also take pills and use creams, so they don’t have to come in as often, maybe every few months.”  

HOW LONG IS EACH TREATMENT?

“Seven to 10 minutes.” 

WHY IS THE LUMENIS M22 YOUR FAVORITE IPL DEVICE FOR TREATING ROSACEA?

“IPL machines aren’t uniform from office to office. I love the M22 because I can crank up the energy and make it stronger, or I can keep it light, depending on the patient’s needs. I can customize the wavelengths of light depending on the redness of the different areas of the skin. Many of my rosacea patients want to go back to work right after their treatments, so I generally won’t go too strong to avoid bruising.

“I also can use the M22 to remove hair, freckles or sunspots, and for acne scarring.  I like the IPL for a full-face treatment because of its other benefits.”

WHAT IS THE COST OF IPL TREATMENTS AND ARE  THEY COVERED BY INSURANCE?

“A treatment can be $350 or $400 with a dermatologist in New York, less in other parts of the country.  Some insurance covers IPL treatments up to 90 percent. If a patient is on a budget, and her insurance doesn’t cover the treatments, I’ll start with medications and/or creams and see how well it goes.  We can add the IPL later.”

CAN ONLY MEDICAL DOCTORS PERFORM IPL TREATMENTS?

“The laws vary from state to state. In some cases it’s not necessary to have a medical background to use an IPL. But you absolutely have to be educated to properly fire the wavelengths of light. You just don’t plug in the settings and flash lights.  You also must carefully observe how the patient’s skin is responding during the treatment. These are serious treatments. I have extensive training and I’ve used the IPL on many patients. I do all the treatments myself.”

 

NEAR YOU!

This is a “sponsored post.” Theraworx Relief compensated FabOverFifty with an advertising sponsorship to write it. Regardless, we only recommend products or services that we believe will be helpful for our readers. All insights and expressed opinions are our own. —Geri Brin

Like most women my age, I’ve experienced agonizing foot and leg cramps. I’d wake with a jolt in the middle of the night, the muscles in one calf tensed up and knotted in excruciating pain. The agony could last as long as 10 minutes, then I’d toss and turn until morning, and be wiped out the rest of the day. I tried everything, from soaking my legs in mineral salt baths to slathering on over-the-counter pain creams and ointments, but nothing worked.

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At last, my legs are cool and calm all through the night! I rub the super light Theraworx Relief foam onto my calves every day (it has a lovely green apple scent, by the way), it absorbs in a jiffy, and I haven’t had a single cramp in over a year. Theraworx Relief contains an exclusive blend of safe and gentle ingredients and can be applied daily. But even if you don’t use it every day, you’ll get quick relief by applying it the moment a muscle acts up. Rest assured!  Best of all, I can get Theraworx Relief at Walmart and most drug stores, so it’s easy to pick up a new bottle whenever I need it!

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Debilitating muscle cramps are extremely common as we age, affecting 50 percent of American adults, especially women, according to American Family Physician.

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Sixty one percent of the 310 women responding to a FabOverFifty survey said they’ve never tried medications or home remedies for their leg or foot cramps, but 81 percent reported that they’d definitely be interested in learning about new solutions to relieve them of their often debilitating episodes. They’ll be excited to hear they can get relief starting today!

 

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Ladies, meet Dr. James A. Simon, a Washington, DC-based physician who treats women from adolescence through the menopause transition, and beyond, encouraging his patients to be part of their own wellness, disease prevention, treatment and recovery. An esteemed clinical researcher, Dr. Simon’s interests include clinical management of peri-and postmenopausal women, female sexual dysfunction, osteoporosis, contraception and reproductive endocrinology. He has served as principal investigator on over 300 clinical trials, research grants and scholarships in the area of women’s health, which enables him to offer his patients one-of-a-kind opportunities to experience the latest innovations in the field.

Former president of the North American Menopause Society (NAMS), Dr. Simon currently serves as president of the International Society for the Study of Women’s Sexual Health (ISSWSH). He is co-author of the 2001 book Restore Yourself: A Woman’s Guide to Reviving Her Sexual Desire and Passion for Life. Determined to advance the cause of women’s sexual health in the United States (“it’s a disaster,” he says), Dr. Simon won’t rest easy until he does.

I had the privilege to attend the ISSWSH annual meeting in Atlanta, GA, a few weeks ago, where Dr. Simon talked about “How US Governmental Agencies Inadvertently Conspire Against Women’s Sexual Health: A Personal Perspective.”  Bear in mind, this is Dr. Simon’s “personal perspective, not a government or organizational perspective,” he emphasized.

If you’d like to make an appointment to see Dr. Simon or one of his colleagues, you can call INTIMMEDICINE Specialists at 202-293-1000.

 

MEDICARE CARES ABOUT MEN’S SEXUAL HEALTH, NOT SO MUCH ABOUT OURS

“About 60 million people receive Medicare benefits in the United States, which is about 18 percent of the entire population, yet up until December 31, 2018, women didn’t enjoy the same rights as men from the Centers for Medicare and Medicaid Services (CMS). While Medicare paid for penile implants for men with difficult-to-treat erectile dysfunction, it didn’t pay for medical treatment for menopausal women who experienced painful sex, although up to 75 percent of postmenopausal women report they find sex painful.

“When ED drugs such as Viagra don’t work on men who had prostate cancer, for example, penile implants can help them return to their old sex lives. The implants cost upwards of $30,000 without insurance. But women had to pay out of pocket to treat their painful sex. “If a woman chose to alleviate her pain, the CMS considered it a ‘lifestyle choice,’ which is just weird. Who do they think the men with penile implants were supposed to have sex with?

“So a large group of us lobbied the CMS and told them, ‘You can’t have older men with penile implants having sex with wives, girlfriends or intimate partners with significant pain. It’s just not fair.’ When they didn’t agree with us, we said ‘either you’re going to fix it or we’re going to go public.’  Fortunately, they fixed it, as if women didn’t have vaginas until then. Medicare now mandates that all secondary drug plans have some coverage for vulvar and vaginal atrophy (VVA) or Genitourinary Syndrome of Menopause for painful sex after menopause. They have to cover the class of meds that make an older woman’s vagina capable of having sex with her partner without pain.”

VAGINAS ARE VERBOTEN  

“Now let’s talk about the FCC, the agency that controls what we hear on radio and what we see on TV.

Although the FCC says you CAN SAY the word ‘vagina’ or TV, it can’t be used to describe anything titillating or related to sex. Now, I know that the vagina is for birthing babies, but I also know it’s an organ to have sex, and hopefully pleasurable, not painful, sex. So how do you advertise a medical device or a medication that’s meant for improving the health of the vagina, especially the sexual health of the vagina, considering how the FCC restricts the use of the word?

“Imagine if a fireman couldn’t say the word ‘fire.’  Would he have to make a call to get his troops out by saying ‘there’s red hot flamy stuff everywhere’? It’s a little bit challenging for us. There’s a big gap between talking about the vagina as a sexual organ and talking about it as sexual organ that’s indecent, which is what the FCC is trying to avoid.

“This is why none of the products we prescribe for sexual pain are advertised on TV. Yet, there are plenty of women with vaginas.”

THE ABORTION ABERRATION

“The executive branch of the government recently called for new rules that will eliminate Title X funding for those agencies that provide health services to the poor and disadvantaged, in particular,  Planned Parenthood.

“The government doesn’t want to be seen as paying for abortion services, but all abortion services provided through Planned Parenthood are typically funded by private donations and grants, not by the government.  Yet, if you make it difficult for poor and disadvantaged women to get contraception and other family planning services, you’re more likely to see unintended pregnancies. For this, I like to quote Dr. John Guillebaud, an emeritus professor of family planning from London, who said:  ‘Most accidents are caused by humans and most humans are caused by accidents.’”

LORDY, THOSE DANG DRUG LABELS

“I have a lot of problems with the Food and Drug Administration (FDA) about a number of women’s health issues, but let’s talk about the labels that are required to be placed on low-dose vaginal estrogen products to treat women who have VVA, or painful sex.

“The labels must say that these products cause an increase in endometrial cancer, stroke and deep vein thrombosis, an increase in probable dementia, and an increase in breast cancer when used with a progesterone-like drug. Now, that sounds pretty terrible.  Why would anybody who has painful sex exchange it for a heart attack, stroke, dementia, or breast cancer? It just doesn’t sound like a fair exchange. The problem is that none of those things is true.

“The FDA originally came to this determination because some of the increased risks I just mentioned were found to be true in a Women’s Health Initiative government study from 1993 to 2005 where large numbers of women were getting systemic treatment like pills and patches with estrogen and progesterone. It subsequently came to light, however, that a branch of this study involving women taking low-dose estrogen, only in the vagina, for painful sex after menopause, had not experienced an increase in any of the risks.

“Despite the publication of this new information, the FDA still requires the warning label for low-dose vaginal estrogen products, including on a product that was recently introduced.

“The experts from the NAMS and ISSWSH filed a citizen’s petition in 2015 to have that labeling requirement changed, but in mid-2018 the FDA said they’re not changing it.”

THE IRS GETS INTO THE ACT

“No one likes the taxman, whether the IRS or the state tax assessor in the first place. But what would you say if I told you that the IRS or most states are  hurting women’s sexual health? You’d probably say, ‘Come on, Dr. Simon.’ Well, they are  hurting women’s sexual health because our government taxes Tampons and other sanitary products. Only 10 states don’t have the tax, including Nevada, Wisconsin, Illinois, Florida and a bunch of states in The Northeast.

“I do a lot of research on women with heavy menstrual bleeding. Many of them can’t even be employed because they aren’t able to leave the house for one week a month, when they’re bleeding so heavily. And many of these are poor or African American  women, or both, who have uterine fibroid tumors.

“Canada removed this so called ‘tampon tax’  in 2015 and India removed its 12 percent tax in 2018. We still have it.”

If so many of us don’t hear as well as we used to, why don’t more of us get our hearing checked? And why do the majority of hearing aid wearers say they’re unhappy with them? Learn how 140 women in the FabOverFifty community responded to this often sensitive issue.