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HOUSE CALL; Discussing Dermatology: Age Spots,' Woman's Facial Hair

Posted on: Monday, 4 July 2005, 15:00 CDT

Q. In the back of my women's magazines, I see ads for Triluma, which is supposed to reduce the appearance of age spots. Is this a good product to spend money on? Does anything help age spots?

A. "Age spots" look like big freckles: They are flat and brownish but wider than a centimeter across. They are commonly found on sun- exposed areas, such as the face, hands, and lower arms. While freckles appear in children and can darken with the sun, age spots are due to a cumulative exposure to sunlight, do not change in color, and usually occur after age 40. Sometimes they are called "liver spots," but they have nothing to do with the liver.

You do not need to treat age spots. However, if you don't like the looks of them, there are several options. Your doctor or dermatologist may freeze them with liquid nitrogen. You may buy a bleaching lotion containing hydroquinone (often labeled "fade cream") at your local pharmacy, or your doctor may prescribe hydroquinone at a higher concentration.

Janet Fairley, a professor and dermatologist at the Medical College of Wisconsin, tells me that Triluma can be beneficial. It combines hydroquinone, tretinoin (a medicine that treats acne under the brand name RetinA), and a cortisone cream. This product, like any product containing hydroquinone, must be used with sunscreen to be effective. Sunscreens are also a useful way to prevent new age spots, but they will not lighten present ones.

Q. I am a 55-year-old woman with facial hair. Originally, I used depilatories (like Nair), but they irritate my light, sensitive skin. I don't think shaving is practical and I'm concerned that electrolysis would be painful. What do you suggest?

A. Thick, dark hair above a woman's lip or on her chin can sometimes run in families. However, this nuisance should first be distinguished from abnormal hair growth due to a medical problem such as polycystic ovary syndrome or a testosterone-producing tumor. Treating the underlying medical problem, when it exists, will treat the excess facial hair.

If you have a benign form of hair overgrowth, Fairley lists several options: shaving, tweezing, waxing, chemical removal such as depilatories, and permanent removal (electrolysis or laser). A prescription cream called Vaniqa (eflornithine) can also chemically inhibit hair growth. Before applying any product to the skin, test it on a small area to be sure you do not have an allergic reaction or display hypersensitivity. Always follow the package directions.

Electolysis applies electric current to individual hairs and destroys the hair root.

However, because sometimes the electrolysis needle isn't on target, you often need several treatment sessions to completely remove all hair in a particular area.

For a small area like your face, electrolysis may be an option. Make an appointment to discuss what your treatment plan would be. Choose an electrologist wisely to minimize risks of infection and scarring. In Wisconsin, electrologists must be licensed by the State Board of Cosmetology, but there are no national standards. Look for members of the International Guild of Professional Electrologists, the American Electrology Association or the Society of Clinical and Medical Electrologists.

Q. My doctor diagnosed me with plantar fasciitis several months ago and it still bothers me. Will it ever go away?

A. Plantar fasciitis is aptly named: It is an inflammation of the plantar fascia, the thick band of tissue on the bottom of the foot running from the heel to the base of the toes. As you know only too well, the inflammation results in pain in the heel, typically worse with the first morning steps or after extended periods of sitting and then dissipating after walking a bit, but it may progress throughout the day.

He notes plantar fasciitis is more common as we age, in those who are overweight, after an episode of strenuous walking or running, in individuals with tight heelcords, flat feet, or high arches, and when shoes fit poorly or have lost their support, according to Richard Marks, an orthopedic surgeon and the director of the division of orthopedic foot and ankle surgery at the Medical College of Wisconsin.

Marks tells me that, very likely, your plantar fasciitis will go away, although it may take eight to 16 weeks. He employs a number of different therapies: stretching exercises, change of footwear, specific training techniques for the athlete, and sometimes initial rest from activities. Often, he prescribes an anti-inflammatory medication such as ibuprofen (Advil or Motrin) or a night splint. Physical therapists can help teach the stretching exercises, which should be performed four to five times per day. Occasionally, a shoe insert is helpful. In severe cases, he injects cortisone or plans a surgery to remove the degenerated fascia.

Next week: Paul Norton

Julie Mitchell is an assistant professor of medicine at the Medical College of Wisconsin. Send questions to her at: Medical College of Wisconsin Physicians & Clinics, 9200 W. Wisconsin Ave., Milwaukee Wis. 53226 or via e-mail at drjulie@mcw.edu.

Copyright 2005, Journal Sentinel Inc. All rights reserved. (Note: This notice does not apply to those news items already copyrighted and received through wire services or other media.)

Source: Milwaukee Journal Sentinel

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