The History of Shaving

The History of Shaving

The evolution of shaving began during prehistoric times and continues to develop to this day. From plucking hairs out with shells to using electric shavers, shaving has undergone many changes.

It is believed that prehistoric man would pluck out hairs using two shells. Quite inefficient, these would eventually be replaced by flint razors, which proved to be much sharper. Unfortunately for ancient men, flint razors were not very durable.

Consequently, the use of metal razors eventually developed. Approximately five thousand years ago, copper razors became moderately widespread in regions of Egypt and India. The ancient Egyptians proved to be rather extreme in the use of their shavers. It was considered unsophisticated in that society to possess any visible hair at all. To have such hair would indicate that a person was a barbarian or a criminal. This trend went to such an extreme that the entire head was shaved, resulting in the use of wigs. It is believed that such practices were begun due to hygiene, as a lack of hair deterred lice infestation and cooled down a person.

Later, in the time of Alexander the Great, shaving became more widespread, reaching Greece and eventually Rome. It was said that Alexander was so conscious of his appearance that he would not enter battle without a preliminary shave. Subsequently, for many, a short haircut and a smooth face were considered necessary as well as aesthetically pleasing.

shaving cream

Shaving once again regained popularity in the middle ages with the advent of elaborate headdresses for women. Many shaved off their hair as well as their eyebrows in order to accommodate such accessories. Men, meanwhile, were expected to possess neatly trimmed facial hair or none at all.

The shaver itself evolved noticeably since the middle ages. In the early 1800s, a straight razor was extremely popular. Somewhat resembling a pocketknife, the blade folded into the handle. This proved to require much maintenance and skill to use, prompting its fall to the shaver we know today. In the later half of the 1800s, the blade became perpendicular to the handle, making the product easier to use. Eventually, disposable blades became available and have proven popular ever since.

Over the past few hundred years, shaving has evolved into its modern form. The mass marketing of shaving products has exploded over the past century, partly through the growth of the media. Women, for instance, began shaving their armpits in 1915, following an advertisement in the United States displaying a woman's shaved arms. Shocking at first, this soon caught on, prompting women to shave their armpits, a trend continuing to this day in much of the western world.

shaving brush

Undoubtedly as trends change, shaving will undergo more modifications. As it stands, however, shaving is an ingrained practice in all societies and is likely to become more sophisticated over time.

Shaving Techniques

• Prewash the skin using warm water in order to open pores and to soften the skin's surface. This is best performed following a bath or shower, which naturally warms and moistens the skin's surface.
• Do not use excessive amounts of shaving foam or gel. Additionally, it is best to use those which benefit the skin. Foams and gels containing vitamins for the skin, which help repair shaving damaged are available.
• Shave using a razor, not an electric shaver, for best results. Electric shavers typically operate on dry skin for best performance. They are not as accurate as a sharp razor and may more easily abrade the skin's surface.
• Be sure to use a sharp razor. Regardless of the brand, if it is not sufficiently shape, it won't produce as effective a result. In fact, the odds for damaging the skin increase significantly with an older, blunt blade.
• Shave in the direction of hair growth to reduce the blade's friction with the skin. Otherwise the blade is likely to cause damage to the skin in the form of a cut or a rash-like abrasion. An exception to this is for women shaving their legs (see women's information).
• Be sure to rinse the blade several times per shave in hot water. This will keep the blade clean and improves its performance.
• Rinse the skin with warm (not hot) water when complete. This washes away the foam or gel used and helps to restore the skin's moisture level.
• Do not use aftershave when finished. Aftershave contains alcohol, which closes the skin's pores and dries out the skin. Since the act of shaving removes skin oils, it is not a good out to dry out the skin any further. Instead, use shaving oils to replenish the skin's moisture.

Women, Heart Disease, and High Cholesterol

Heart Disease

Coronary heart disease (CHD) is the leading cause of death in American women, causing more deaths annually than all forms of cancer combined. Approximately 25% of American women have high cholesterol levels. In addition to treatment of high blood pressure and maintaining a healthy lifestyle (including proper exercise, a nutritious diet, weight management and avoidance of smoking), the American Heart Association (AHA) recommends aggressive treatment of high cholesterol to prevent heart disease in women.

Excess cholesterol in the blood collects on the walls of certain blood vessels, decreasing their ability to provide proper blood flow to the tissues fed by these blood vessels. For example, a heart attack occurs when the heart receives insufficient blood flow. High levels of cholesterol also increase the risk of high blood pressure, stroke, and circulation problems.

Cholesterol can be affected by consuming foods high in fat, but the body also synthesizes cholesterol. Some people that adhere to a low fat diet still have high cholesterol levels because their body synthesizes an excess amount. There are several forms in which cholesterol is present in the body, LDL (the harmful form) and HDL (the helpful form). Depending on the relative levels of these forms, along with the concentration of triglycerides (another type of body fat), certain drugs are more effective then others in correcting the abnormalities. For example, a person with elevated LDL levels and normal triglycerides may be treated with different medications than someone with only elevated triglycerides.

As with all medications, cholesterol lowering drugs have a risk of side effects, so it is important for a physician to routinely monitor people receiving these drugs. Sometimes a combination of drugs is used. In addition to cholesterol, it is important for women to have their HDL and triglyceride levels monitored because these appear to be stronger risk factors for heart disease in women than men.

This rise in the incidence of CHD at the time when estrogen levels decline has led to the common use of hormone replacement therapy (HRT) at menopause and thereafter. Estrogen has been shown to lower cholesterol levels, one of the risk factors for CHD. The use of estrogen alone can increase a womans risk for endometrial cancer, however the risk is almost eliminated when estrogen is taken in combination with progestins, compounds similar to the hormone progesterone. Women who have had hysterectomies can take estrogen alone.

In postmenopausal women without a history of heart disease, HRT appears to offer a protective effect for the heart, but in the presence of established heart disease, it doesn’t appear to prevent heart attacks. Aggressive treatment of elevated cholesterol levels with drugs other than or in addition to HRT or other substances with estrogenic activity is currently recommended.

Findings from trials currently under way will be useful for providing conclusions about the long-term use of HRT in the prevention of CHD. Currently, the use of HRT for the treatment of menopausal symptoms is often indicated. The decision to use HRT for the prevention of heart disease should be made on an individual basis, taking into account the history of the individual or their predisposition for experiencing a side effect from the therapy.

Other compounds with estrogenic activity may be used in postmenopausal women to help prevent elevations in cholesterol levels, however their effects are weak in comparison to cholesterol lowering drugs such as the statins. The selective estrogen receptor modulators (SERMs) act like estrogen in bone and cardiovascular tissue and block estrogenic effects in the breast. They do not appear to increase the risk of breast cancer that is associated with some of the traditional HRTs. SERMs decrease LDL and cholesterol levels, but the overall effectiveness in protecting the heart have not been established. Like traditional HRT, these drugs can increase the risk of blood clots.

Phytoestrogens

Women, Heart Disease, and High Cholesterol

Similar in action to the SERMS, phytoestrogens are plant substances that have weak estrogenic activity in some tissues and block the effects of estrogen in others. They are found in herbs and plant foods, especially soybeans. Soybeans are rich in isoflavones, particularly genistein and daidzein. The FDA stated that foods containing soy protein included in a diet low in saturated fat and cholesterol may reduce the risk of CHD by lowering blood cholesterol levels. For a beneficial effect, at least 25 g of soy protein should be consumed each day. Soy protein is present in soy milk, tofu and soy flour. In comparison to estrogen, these compounds have weak estrogenic effects. They appear to reduce total and LDL cholesterol and triglyceride levels but they are unlikely to be effective in treating high cholesterol when used alone. Their inclusion in the diet offers many potential benefits in addition to reducing cholesterol such as reducing the risk of certain cancers, improving menopausal symptoms including hot flashes, and promoting increased bone density. It is not known if isoflavone containing supplements have the same effects as consuming soy protein. Some plant products such as flaxseed contain other phytoestrogens that appear to have many similar effects as the isoflavones. This is an area of current research interest.

Statins

The statins are a class of drugs frequently used to reduce cholesterol. Some examples of statins are Lipitor®, Mevacor® and Baycol®. They are the most potent cholesterol reducing drugs that are currently available. An additional benefit to postmenopausal women of these drugs is that they may reduce the risk of osteoporosis and resultant fractures by stimulating bone growth. The statins are currently the most potent drugs available for lowering cholesterol levels.

Other drugs, such as Questran® and Colestid®, lower cholesterol by causing the body to increase the conversion of cholesterol to bile acids that are subsequently excreted. The B vitamin niacin may also be used to lower cholesterol, but due to its high tendency to cause severe flushing and itching, many people cannot tolerate it. Even though it is a vitamin it can have some serious side effects at the doses needed to lower cholesterol, so people receiving niacin should be supervised by a physician.

Evolve® and Cardiem® are two OTC supplements made from rice bran oil that lower cholesterol. They contain a tocotrienol that has activity similar to vitamin E. They act like the statins in decreasing the synthesis of cholesterol by the body. Although they appear to be effective, long-term studies are needed to prove their safety and effectiveness.

Garlic

Many alternative medicine advocates or folkloric remedies recommend garlic to lower cholesterol. In the U.S. all nutraceuticals (food substances used for their pharmacological or drug effects), such as garlic supplements, are not regulated as drugs so scientific data supporting claims are not always available. Rigid quality control standards are not required for nutriceuticals and marked variability can occur in the potency and the purity of these products.

Although garlic seems to inhibit cholesterol synthesis by the body, recent studies suggest that garlic supplements may not lower cholesterol. Garlic is composed of many sulfur containing compounds, including allinin. When garlic is crushed, allinin is converted to allicin and it is the allicin that effects cholesterol synthesis. In addition to the variability of allinin content, supplements do not contain all of the compounds found in fresh garlic. Therefore, it is not known if consumption of fresh garlic is required to have a cholesterol lowering effect.

Garlic used for cooking is generally safe, but large amounts in supplements can increase the effects of anticoagulants (blood thinners), therefore increasing the tendency for bleeding and can also interfere with blood sugar control in diabetics. Further studies are required before conclusions can be made.

Fiber & Whole Grains

The FDA allows health claims to be placed on foods that contain at least 51% whole grains (whole wheat, whole oats, corn, barley, and rice) stating that they reduce the risk of heart disease. The fiber in the grain appears to provide the benefits. Psyllium acts by inhibiting absorption of dietary cholesterol. The effects on cholesterol levels are generally modest. Oat bran acts in a similar manner but is more effective at lowering cholesterol than psyllium.

Vitamin E

Vitamin E has been used for its cardioprotective effect due to its ability to prevent oxidation (antioxidant) reactions. Part of the damage to blood vessels associated with high cholesterol is due to the oxidation of LDL and the action of oxidative enzymes. Vitamin E is thought to be able to slow or reverse this process.

Several recent studies have not seen a cardioprotective effect of vitamin E, but this may be due to the dose used or the possibility that combination antioxidants may be needed to see this effect. For example, vitamin C may be necessary to keep the vitamin E in an antioxidant form. Vitamin E is well tolerated, but at high doses it can increase the risk of bleeding associated with anticoagulants (blood thinners).

Homocycteine

High Cholesterol

In addition to cholesterol, elevated homocysteine levels are also associated with an increased risk for heart disease. Homocysteine is an amino acid that is formed from protein that appears to damage the lining of blood vessels and can result in atherosclerosis, a condition where fat deposits in the arteries, making them stiff and interfering with blood flow. Atherosclerosis can cause heart disease. Folic acid can decrease homocysteine levels. Vitamin B6 and B12 can also be helpful.

Homocysteine levels may be an inherited trait, or may be associated with renal failure, psoriasis, certain leukemias, folate, B6 or B12 deficiencies or certain drugs. The AHA recommends consuming at least 400 mcg of folic acid per day. People with elevated homocysteine levels will require higher amounts. Adequate folic acid consumption is important in pregnancy in order to decrease the chances of the baby developing neural tube defects. People with elevated homocysteine levels will require higher amounts.

Sexually Transmitted Diseases (STDs)

Sexually Transmitted Diseases (STDs)

Some 56 million Americans have an STD other than AIDS and many more are infected each year. The causative bacterial, viral, or parasitic agents are spread primarily by sexual contact, but may also be spread by the use of infected needles. Some STDs are chronic infections, but many can be cured. Quick diagnosis and treatment are often the keys to cure.

The only 100% prevention is abstinence. Maintaining faithful monogamous relations with one's spouse is effective, provided both partners are free of STDs. Safe sex (use of a condom) with a monogamous partner is the next best protection against STDs. Always remember that prevention is better than therapy.

Bacterial:

Gonorrhea

Gonorrhea ("clap"), a common disease worldwide, is caused by the bacterium Neisseria gonorrhoeae. There are over 650,000 new cases in the U.S. each year. 82% of cases of gonorrhea occur in teenagers and young adults, and females are twice as likely to become infected after one act of intercourse with an infected male as males are after one act of intercourse with an infected female. Gonorrheal infections may be asymptomatic in both sexes.

Symptoms of exposure include urethral or vaginal discharge and frequent and painful urination. Bacterial culture confirms diagnosis. Gonorrhea requires antibiotic to resolve, so see your doctor for appropriate diagnosis and treatment. Penicillin used to be the drug of choice but many strains have become resistant. Sexual partners should be treated and intercourse avoided until the infection is cured. Untreated gonorrhea can damage the heart or cause a form of arthritis.

Chlamydia

Chlamydia is caused by the bacteria Chlamydia trachomatis. Infection with chlamydia is often concurrent with gonorrheal infections. Chlamydia is the most frequently reported and fastest spreading STD in the United States. More than 3 million men and women in the U.S. are diagnosed each year. Infection without symptoms and latent disease are not uncommon.

Males typically experience painful and frequent urination and a urethral discharge 7-21 days after exposure. Females often do not have any symptoms and the infection is discovered in conjunction with a gonorrheal infection. Chlamydia requires antibiotics to resolve. A physician should be consulted for appropriate diagnosis and treatment. Sexual partners should be treated and intercourse avoided until the infection is cured.

Pelvic inflammatory disease

Sexually Diseases

Pelvic inflammatory disease is a complication of gonorrhea or chlamydia. It is an infection that generally involves the uterus, fallopian tubes, or pelvic area. Symptoms vary but usually include abdominal pain and tenderness, fever and vaginal discharge.

This is a very serious infection and requires antibiotics to treat and may also require hospitalization. A doctor should be consulted for appropriate diagnosis and treatment. If untreated or inadequately treated, it may result in infertility and/or sterility.

Syphilis

There are more than 70,000 new cases of syphilis each year in the U.S. caused by the spirochete bacteria Treponema pallidum. The risk of infection with syphilis after a single exposure is ~50%. Syphilis has four clinical stages -- primary, secondary, tertiary and congenital (passed from mother to baby). The primary stage occurs between 10 and 90 days after infection and causes an ulcer at the site of infection. The primary stage is highly infectious. Secondary syphilis occurs about 6 weeks after the primary stage and causes a rash all over the body, fever headache, loss of appetite and joint pain. The tertiary form of syphilis has many different forms and may present without any external signs or symptoms. If untreated, the third stage, can affect the heart, brain or other vital organs.

Syphilis is usually diagnosed by a blood test, The disease can cause many problems in all areas of the body including the heart, brain, skin, bone, upper respiratory tract and liver. Syphilis requires antibiotics to resolve. Consult a doctor for appropriate diagnosis and treatment.

Bacterial vaginosis

This is a vaginal bacterial infection caused by several bacteria that are normally harmless. Signs and symptoms include malodorous vaginal discharge, but you may or may not be symptomatic. This infection requires antibiotics to treat. Consult a doctor for appropriate diagnosis and treatment.

Protozoal:

Trichomoniasis

Trichomoniasis is a readily curable infection caused by the protozoa Trichomonas vaginalis. Common signs and symptoms include a mild to severe malodorous vaginal discharge, intense itching and painful urination; males may not have any symptoms.

Trichomoniasis requires antibiotic therapy, so see your doctor for appropriate diagnosis and treatment. The drug of choice is metronidazole (Flagyl®). It is very effective but may produce several side effects. Both partners should be treated.

Viral:

Genital Herpes

Genital Herpes Information

Human Papilloma Virus (HPV)

Sexually Transmitted Diseases

Some 5.5 million new cases of HPV infection are reported each year in the U.S.. Twenty million Americans, men and women alike, are infected with this virus. HPV is a double stranded DNA virus that is the causative agent of genital warts. There are more than 65 types of the virus. Infection with specific types of HPV can lead to neoplastic changes in genital epithelia. The lesions are usually papules or plaques that may be hard to see. In women, the infection may be intravaginal or cervical. If the cervix becomes affected, cervical cancer can result. Because of the contagious and possibly neoplastic nature of the infection, treatment is necessary.

Destructive treatment includes removal of the warts by the use of lasers, freezing or burning. Some medications may be applied by a physician (podophyllin, trichloracetic acid) or the patient with proper training (podofilox, imiquimod), but there are some side effects. These include pain, burning, inflammation, skin erosion, scarring, erythema and the medications should not be used during pregnancy. There is no cure and the warts may recur at any time. Patients with genital warts are also at risk for other STDs.

Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)
HIV is the virus that causes AIDS. Some 900,000 Americans are estimated to be infected with HIV with 40,000 being added each year. Half of these cases are in those under 25 years of age. The most common risk factor for this disease is male homosexual intercourse. In addition, the virus can be spread by heterosexual intercourse or by blood transfusions, although these are less common. Thus HIV infections are preventable.

HIV is a virus that affects the human immune system, specifically T-helper cells that have a CD4+ marker on their surface. These T-helper cells normally function to protect against infection.

When HIV enters one of these cells, it is protected by a capsule. This capsule breaks open and a single strand of RNA is released along with an enzyme called reverse transcriptase. Reverse transcriptase than converts the single strand of RNA into a double strand of DNA. This DNA is then incorporated into the normal cellular DNA. The rest of the immune system does not respond because the virus is inside the cell. The HIV virus has taken over the cellular machinery and forcing the immune system to make millions of copies of the HIV virus. Infected persons frequently succumb to opportunistic infections.

Clinically, HIV presents with flu-like symptoms, and then the symptoms go into dormancy but the virus continues to replicate. As the amount of HIV virus in the body increases, the immune system is further impaired and opportunistic infections become more common. Some of the most common infections include thrush (fungal infection), Kaposi's Sarcoma (cancer), pneumonia, recurrent herpes infections, and in later stages severe bacterial, protozoal or fungal blood stream infections.

There are many medications available to help slow the progression of HIV, however no cure is currently known and many infections are drug resistant. Clearly prevention of infection is rational and desirable. If you have questions and also for appropriate diagnosis and treatment, talk to a doctor.

Allergies and Allergic Reactions

Allergic Reactions

Allergies come in different forms and affect people with varying degrees of severity.  An allergic reaction, also known as a hypersensitivity reaction, is a reaction caused by the immune system in response to a foreign substance, or allergen.

Cells within the immune system have the job of sampling their environment to determine what belongs what does not. Some of these cells act as garbage disposals. Macrophages and other antigen presenting cells swallow and chew up the foreign substance and present the resulting ("digestion products"), small peptides (antigen) to another cell type (B lymphocyte) that then becomes a plasma cell and makes an antibody to the antigen. The plasma cell begins to make and release a specific antibody (IgE) into the bloodstream. Plasma cells life span is roughly 10-20 days. The memory of the antigen rests in B memory cells that respond rapidly to an additional antigen exposure.

IgE has a great affinity for receptors on cells in the blood (basophils) and tissue (mast cells) that contain histamine, heparin, and other anaphylactic agents. The antibody sits on the surface of those cells waiting to encounter the antigen that inspired its production. When the antigen is encountered, the cells are stimulated to release their inflammatory products and an allergic reaction ensues.

How Do You Get an Allergy?

Allergies and Allergic Reactions

Allergies may develop with first a mild, then an increasing sensitivity over time, or they may come upon you suddenly. For example, you might find that, after your first bee sting, you are severely allergic to bees. Or, you might find that it took years in a pollen-heavy environment (such as a valley in which the main industry is grass-seed farming), to gradually develop a reaction of increasig severity to that pollen.

Childhood allergies to food and drugs are common.  For example, common childhood allergies include allergies to cow's milk, wheat, citrus, peanuts, and carrots. Most people outgrow these allergies by the time they reach puberty. In general, a child does not inherit allergies from the parents--therefore, most allergies are established within an individual due to environmental exposure to allergens.

It is a common myth that people do not acquire allergies when older--for example, greater than 50 years of age. However, you can acquire an allergy at any time in your life, regardless of your age, and you can lose an allergy, or become tolerant, just as abruptly and unexpectedly.  A 92-year-old woman may suddenly find herself with an allergy to strawberries, while a 24-year-old man may suddenly discover he is no longer allergic to wheat.

Inherited Allergies, or Atopic Disease

Some allergies are the result of inherited sensitivities to a particular allergen.  These allergies are called atopic disease, and can include: allergic rhinitis (inflammation of the nasal passages -- also called hay fever or seasonal allergies), allergic asthma, and eczema. Eczema is atopic dermatitis--commonly called dry skin.  Eczema is an inflammation of the skin characterized by redness, itching, and oozing lesions that eventually scab over.

Atopic diseases are distinguished by their tendency to produce allergic reactions to normally harmless inhalants and other substances, such as pollens, molds, animal dander, dust mites, and nuts.

signs of allergies

Water Soluble Vitamins

best vitamins for women

Water-soluble vitamins consist of members of the vitamin B complex and vitamin C. They are generally found together in the same foods with the exception of B12 which is present only in meat and dairy foods. The others are found in whole grain cereals, legumes, leafy green vegetables, and fruits. The water-soluble vitamins generally function to assist the activity of important enzymes such as those involved in the production of energy from carbohydrates and fats. They are often referred to as "cofactors". Other roles may be defined with further research. The water-soluble vitamins are not stored to a great extent in the body so frequent consumption is necessary. When present in excess of the body's needs, they are excreted in the urine. Because they are readily excreted, they are generally non-toxic, although symptoms have been reported in some individuals taking megadoses of niacin, vitamin C or pyridoxine. The lack of water soluable vitamins most greatly affects tissues that are growing or metabolizing rapidly such as skin, blood, the digestive tract and nervous system. These molecules present in fruit, vegetables and grains are all unstable in the presence of heat so that processing and cooking methods can greatly affect the amount of vitamin actually available in food.

Vitamin B Complex – The vitamin B complex is traditionally made up of 10 members (listed below) that differ in their biological actions, although many participate in energy production from carbohydrates and fats. They were grouped together into a single class because they were initially isolated from the same sources, liver and yeast.

Thiamine (Vitamin B1) is important for energy metabolism and in the initiation of nerve impulses. A deficiency of thiamine causes a condition known as beriberi. In certain parts of the world where the diet consists largely of polished rice, this condition is frequently seen. In these countries, a deficiency in mothers can cause a deficiency in infants and may lead to death. In the US, thiamine deficiency is most commonly seen in alcoholics, although it can occur in the presence of several diseases. Pregnancy increases thiamine requirements slightly and when a pregnancy is associated with a prolonged period of vomiting and/or poor food intake, thiamine deficiency may result.

The major symptoms of the deficiency are related to the nervous system (i.e. sensory disturbances, muscle weakness, impaired memory) and the heart (i.e. shortness of breath, palpitations, and heart failure). Wernicke’s syndrome is a serious complication of alcoholism and thiamine deficiency that may manifest as impaired muscle coordination, impaired ability to move the eyes, and marked confusion. It may lead to Korsakoff’s psychosis, a chronic disorder in which memory and learning are impaired.

Thiamine is used to treat thiamine deficiency. There are many unproven uses of thiamine including a treatment for poor appetite, canker sores, motion sickness, poor memory, fatigue and as an insect repellant. The RDA for women over 18 years is 1.1 mg; for pregnant women, 1.4 mg; for lactating women, 1.5 mg; and for men over 14 years, 1.2 mg.


Riboflavin (Vitamin B2) is important in promoting the release of energy from carbohydrates, fats and proteins. It also aids in maintaining the integrity of red blood cells. Riboflavin deficiency can occur most frequently in people with long-standing infections, liver disease, and alcoholism. A sore throat and sores at the corners of the mouth are generally the first symptoms of a deficiency. This can be followed by a swollen tongue, seborrheic dermatitis, anemia and impaired nerve function. These manifestations are commonly seen in other diseases, including many vitamin deficiencies. The RDA for women over 18 years is 1 mg; for pregnant women, 1.4 mg; for lactating women, 1.6 mg, and for men over 14 years, 1.3 mg.

A deficit of cellular energy metabolism may play a role in migraine headaches. A recent study indicated that high-dose (400 mg/day) riboflavin was effective in decreasing the frequency of migraines. Further studies are needed to confirm this effect. High dose riboflavin can cause a yellow-orange fluorescence or discoloration of the urine.


Nicotinic acid (Niacin, Vitamin B3) is important for the release of energy from carbohydrates and fats, the metabolism of proteins, making certain hormones, and assisting in the formation of red blood cells. Niacin deficiency causes pellagra, a condition that affects the skin (dermatitis), GI tract (i.e. diarrhea, nausea, vomiting and swollen tongue) and nervous system. (i.e. headache, depression, impaired memory, hallucinations and dementia). Frequent causes of a deficiency include a poor diet, isoniazid therapy (used in the treatment of tuberculosis) and carcinoid tumors. Rarely a deficiency can occur in the presence of hyperthyroidism, diabetes mellitus, cirrhosis, pregnancy or lactation.

Dietary niacin and niacin formed within the body from the amino acid tryptophan are converted to niacinamide. Niacinamide (nicotinamide) is the biologically active form of niacin and it may be preferred as a supplement because it lacks the flushing effects of niacin. The RDA for women over 14 years is 14 mg; for pregnant women, 18 mg; for lactating women, 17 mg; and for men over 14 years, 16 mg.

Water Vitamins

Niacin is used for the treatment of niacin deficiency but at large doses is also used to treat high cholesterol and triglycerides. High doses should only be taken under the supervision of a physician because there is a risk of developing serious side effects such as liver dysfunction. There are also several medical conditions that may be worsened by its use at the high, therapeutic doses. It can cause the release of histamine resulting in increased gastric acid, therefore it is generally not used in the presence of an active peptic ulcer. Large amounts can also decrease uric acid excretion, possibly precipitating a gout attack in people predisposed to this condition, and it can impair glucose tolerance, interfering with blood sugar control in diabetics. In the treatment of high cholesterol the simultaneous use of niacin with drugs that inhibit cholesterol formation, known as the HMG-CoA reductase inhibitors (i.e. Lipitor®, Baycol®, Mevacor®, Zocor® and Pravachol®) increases the occurrence of serious muscle disorders.

Due to common side effects (flushing, nausea, dizziness, itching, low blood pressure), many people do not tolerate high doses of niacin, even though some may lessen in intensity with continued usage.


Pyridoxine (Vitamin B6) is necessary for the proper function of over 60 enzymes that participate in amino acid metabolism. It is also involved in carbohydrate and fat metabolism. A deficiency in adults mainly affects the skin (seborrhea-like lesions around the eyes, nose and mouth), mucous membranes, peripheral nerves and blood forming system. Convulsive seizures may also occur. Deficiencies can manifest in people with kidney disease, cirrhosis, alcoholism, impaired gastrointestinal absorption (malabsorption), congestive heart failure and hyperthyroidism.

The RDA for pyridoxine in women from 19-50 years of age is 1.3 mg; women over 50 years, 1.5 mg; for pregnant women, 1.9 mg; for lactating women, 2 mg; for men 14 to 50 years of age, 1.3 mg; and for men over 50 years, 1.7 mg. Prolonged doses in excess of 200 mg. per day have been associated with neurotoxicity. Pyridoxine may be effective in lowering high levels of homocysteine, a risk factor for heart disease, decreasing the symptoms of premenstrual syndrome, as an adjunct to other treatments for improving behavior in autism, and for reversing some of the side effects of flurouracil in cancer patients. It is also used in treating some metabolic disorders.

Several drugs can increase the pyridoxine requirement, such as hydralazine, isoniazid and oral contraceptives. Simultaneous use of pyridoxine with amiodarone can increase the risk of drug-induced sensitivity to sunlight, and pyridoxine can decrease the effects of phenytoin and phenobarbital.


Pantothenic acid (Vitamin B5) is the precursor to coenzyme A that is vital for the metabolism of carbohydrates, the synthesis and degradation of fats, the synthesis of sterols and the resultant steroid hormones, and the synthesis of many other important compounds. A deficiency has not been seen in humans on a normal diet because it is so widely distributed in foods, however it is often included in multivitamin preparations.

There is insufficient information to establish RDAs for pantothenic acid. The Committee on Dietary Allowances provides provisional recommendations for adults of 4 to 7 mg. per day.


Folic acid (Vitamin B9) plays a major role in cellular metabolism including the synthesis of some of the components of DNA. It is necessary for normal red blood cell formation and adequate intake can reduce damage to DNA.

Folic acid deficiency is a common complication of diseases of the small intestine that interfere with the absorption of folic acid from food and the recycling of folic acid from the liver back to the intestines. Alcoholism can result in folic acid deficiency. Folic acid activity can also be reduced by several drugs including large doses of nonsteroidal anti-inflammatory drugs (NSAIDs), methotrexate, trimethoprim, cholestyramine, isoniazid, and triamterene. The simultaneous ingestion of folic acid supplements may, in theory, interfere with the effectiveness of methotrexate cancer treatments, however their combined use in the treatment of rheumatoid arthritis and psoriasis has resulted in lessened side effects from methotrexate.

Although the anemia that results from folic acid deficiency is not distinguishable than that resulting from B12 deficiency, folic acid deficiency is rarely associated with neurological abnormalities (see Vitamin B12). Excessive doses of folic acid may mask the anemia that results from B12 deficiency, preventing diagnosis of the deficiency and allowing progression of neurological damage.

Adequate folic acid intake is associated with a reduced risk of neural tube birth defects. It is recommended that all women of childbearing age consume at least 400 micrograms of folic acid each day. Folic acid supplements are also used to lower elevated homocysteine levels, a known risk factor for heart disease. Recent studies have suggested that folic acid supplements may be effective in lowering the risk of colon cancer. Topical folic acid formulations are used for gingival hyperplasia that result from phenytoin therapy and for gingivitis associated with pregnancy.

The RDA for folic acid for adults over 13 years, 400 micrograms; for pregnant women, 600 micrograms; and lactating women, 500 micrograms.


Vitamin B12 (Cyanocobalamin) is important for the proper functioning of many enzymes involved in carbohydrate, fat and protein metabolism, synthesis of the insulating sheath around nerve cells, cell reproduction, normal growth and red blood cell formation. It is essential for proper folic acid utilization. A deficiency results in anemia, gastrointestinal lesions and nerve damage. Many drugs can interfere with the absorption of vitamin B12 including drugs commonly used to treat ulcers (such as cimetidine, omeprazole), and drugs used to treat seizures (such as phenytoin and phenobarbital).

A protein called intrinsic factor is secreted by the stomach and is required for vitamin B12 absorption from the lower part of the small intestine. Signs of B12 deficiency often occur in the presence of adequate B12 intake, but result from impaired absorption. Conditions that are associated with this include some gastric surgeries, pancreatic disorders, bacterial overgrowth or intestinal parasites, and damage to the intestinal cells.

The RDA for vitamin B12 for adults is 2.4 micrograms; for pregnant women, 2.6 micrograms; and for lactating women, 2.8 micrograms. Approximately 10 to 30% of people over 50 years of age have difficulty absorbing food-bound vitamin B12, so they should eat foods fortified with the vitamin or take a supplement.

Vitamin B12 and folic acid have a close relationship. A deficiency in either one results in abnormal synthesis of DNA in any cell in which cell division is taking place. Tissues such as the blood forming system are most severely affected, therefore an early sign of deficiency of either vitamin is a type of anemia termed megaloblastic anemia.


Choline is traditionally not a vitamin, however it was identified as part of the vitamin B complex and has several important functions. Choline is a component of many biological membranes and fat transport molecules in the blood. It is able to stimulate the removal of excess fat from the liver. Choline serves as the precursor to many substances including a the transmitter of the parasympathetic nervous system, acetylcholine. Some athletes use choline to delay muscle fatigue because acetylcholine is involved in muscle contraction, but this effect has not been proven. A deficiency is uncommon except among people receiving long-term IV nutrition. It is added to infant formulas to approximate the amount found in human milk.

The Daily Reference Intake (DRI) is 550 mg for adult males and lactating females; 425 mg for adult females; and 450 mg for pregnant females. Oral choline supplements have not been proven to be effective in treating memory loss, Alzheimer’s disease, dementia and schizophrenia.


Inositol is an important part of cell membranes and is part of a signaling mechanism that transmits information from the outside to the inside of cells. Some evidence suggests it participates in the movement of fat out of the liver and intestinal cells, and that it may reverse desensitization of serotonin receptors, however this remains to be confirmed. Although it may be effective in treating panic disorders, depression and obsessive-compulsive disorders, these uses remain to be verified.

A dietary need for inositol has not been established, probably due to its production by gut bacteria, the existence of tissue stores following absorption from food, and possible synthesis in some organs. It may be added to infant formulas to approximate the content of human milk.


Biotin has an important role in carbohydrate and fat metabolism. It can be synthesized by gut bacteria and recycled. A deficiency rarely occurs in humans. If raw egg whites are consumed in large quantities, a biotin deficiency can occur. Signs of a deficiency include dermatitis, muscle pain, loss of appetite, slight anemia, an inflamed tongue, and weakness. There is no RDA for biotin.


Vitamin C (Ascorbic Acid) has many important functions in the body. It is a powerful antioxidant, protecting against oxidative damage to DNA, membrane lipids and proteins. It is involved in the synthesis of numerous substances such as collagen, certain hormones and transmitters of the nervous system, lipids and proteins. It is necessary for proper immune function, a fact that has led many to use vitamin C to prevent or treat colds, although this has not been supported by current studies. It may, however, shorten or reduce the severity of a cold.

Water Soluble Vitamins

Vitamin C deficiency causes scurvy that is characterized by capillary fragility resulting in bruising and hemorrhaging, inflammation of the gums, loosening of the teeth, anemia and general debility that can lead to death. The RDA for adults 15 years and older is 60 mg; for pregnant women, 70 mg; and for lactating women in the first six months, 95 mg decreasing to 90 mg for the second six months. There may be increased vitamin C requirements for people taking estrogens, oral contraceptives, barbiturates, tetracyclines, aspirin and for cigarette smokers. Large doses of vitamin C can interfere with many laboratory tests. Side effects from large doses include nausea, vomiting, heartburn, abdominal cramps, headache and diarrhea.

Diets containing 200mg or more of vitamin C from fruits and vegetables are associated with a lower cancer risk, particularly for cancers of the colon, lung, mouth, esophagus and stomach. The consumption of dietary supplements have not been shown to have the same effect. It may block the formation of N-nitrosamines, cancer-causing agents from certain foods. Ascorbic acid alone does not appear to prevent heart disease, however the combined use with vitamin E may reduce the risk of heart disease.

Nutraceuticals and Herbal Remedies

Nutraceuticals and Herbal Remedies

A nutraceutical (or nutriceutical) is any food or food ingredient considered to provide medical or health benefits, including the prevention and treatment of disease. Food and food substances can qualify for health claims only if they meet FDA requirements, which require that the claims be supported by sufficient scientific evidence. However, nutraceuticals are not regulated as strictly as drugs. Significant variability can occur in both the potency and the purity of these products. Many dietary supplements will not contain claims of a particular use on the label because there is not scientific evidence of this claim. However, unproven claims can be made elsewhere, for example, in a health newsletter.

Some FDA-approved supplements and preventions or treatments include calcium and osteoporosis, fiber-containing grain products, fruits and vegetables and cancer, and folate and neural tube birth defects. Listed below are some foods or food ingredients that are commonly marketed for their medical benefits.

OLIVE OIL

The typical Mediterranean diet, rich in olive oil, has been found to be associated with lower levels of cholesterol and triglycerides, and lower blood pressure then many other diets. Diets enriched with oleic acid, the main fatty acid in olive oil, have been shown to significantly reduce both total cholesterol and the harmful form of cholesterol (low-density lipoprotein, LDL) as well as total triglyceride levels, while the beneficial form of cholesterol (high-density lipoprotein, HDL) levels remain unchanged or are slightly increased. Oxidation of LDL cholesterol is involved in the formation of fat deposits in the arteries and ultimately atherosclerotic lesions. These lesions appear to hinder the ability of the blood vessels to dilate or relax upon certain signals. The high content of oleic acid in olive oil causes LDL cholesterol to become enriched in this fatty acid, making them more resistant to oxidation.

Additional benefits have been associated with consumption of olive oil or oleic acid. Diets containing high amounts of monounsaturated fatty acid (MUFA) including oleic acid have been shown to protect against mental decline in old age. A change from consumption of polyunsaturated to monounsaturated fats in the diet of certain diabetics increased their sensitivity to insulin and allowed easier control of their blood sugar levels. Preliminary results indicate a beneficial effect in the prevention of blood clots and in the lowering of high blood pressure.

In addition to oleic acid, other beneficial compounds are present in olive oil. Several phenolic compounds have antioxidant activities. Olive oil contains high amounts of squalene, a compound that inhibits a key enzyme in cholesterol synthesis and also may have tumor-inhibitory activity by inhibiting cancer signaling through the ras oncogene. Mutated ras oncogene activation may be important in many cancers, including cancer of the breast, colon and pancreas.

OAT BRAN

Herbal Remedies

Oat bran contains both soluble and insoluble fiber. The soluble fiber in oat bran helps decrease the risk of cardiovascular disease by decreasing cholesterol, fatty acid, and bile acid absorption. Fiber may change the blood concentration of hormones or short-chain fatty acids that affect fat metabolism. Beta-glucan contained in oat bran increases the time needed for food to be absorbed into the blood and therefore it decreases the peak of blood sugar (and insulin) that occurs following a meal. This is particularly beneficial for diabetics. The American Heart Association recommends a total dietary fiber intake of 25 to 30 g/d from foods, not supplements, to maximize the cholesterol-lowering impact of a low fat diet.

When combined with water, oat bran swells and forms a gum, which increases stool weight and may provide a bulk-forming laxative effect. Sufficient water must be consumed along with the oat bran to prevent constipation or blockage of the bowel.

LECITHIN

Lecithins are a type of phospholipid that are important components of cell membranes and are involved in fat digestion in the intestine. The protective sheaths surrounding the brain and nerve cells also contain these phospholipids. Lecithins are composed of a phosphate group, a choline group and two fatty acids (such as linoleic acid and linolenic acid). Since the two fatty acids can vary, different forms of lecithin exist.

Food sources of lecithins include soybeans, egg yolks, liver, wheat germ, and peanuts. Lecithins are often added to pharmaceutical, cosmetic and food industries to serve as stabilizing and emulsifying agents, allowing two different substances, like oil and water, to blend together.

Choline is a building block of acetylcholine, in important transmitter of signals among certain nerves in the brain and throughout the body. Lecithin supplements have been used in an attempt to increase brain acetylcholine and improve mental function in conditions such as Alzheimer’s disease. Clinical trials have failed to verify this benefit. Studies have also failed to demonstrate a significant benefit of lecithin supplements on certain movement disorders.

When applied to the skin, lecithin preparations are effective as moisturizing agents and are used in the treatment of dry skin. The benefits of oral supplementation remain to be proven. Although some studies have suggested lecithin supplementation may help lower high cholesterol levels, other studies disagree. However, the plant sterol sitostanol emulsified in a lecithin preparation appears to reduce cholesterol absorption in humans. Another study in mice indicated lecithin had a preventive effect against lung cancer. Lecithin supplements are generally well tolerated, however in some individuals they can cause diarrhea, nausea, abdominal pain and fullness. Persons on calorie-restricted diets should consider their high caloric content.

GREEN TEA

Tea is made from the dried leaves and leaf buds of the shrub Camellia sinensis. Black tea is prepared by drying and fermenting the leaves and is consumed in many parts of the world. Oolong tea is partially fermented and is mainly consumed in China and Japan. Green tea, which is not fermented, is made by steaming or pan-frying tea leaves and then drying them. It is mainly consumed in China and Japan, where it has been used for its medicinal properties for about 5000 years.

Dried tea leaves contain polyphenols, including flavonols such as catechins, flavonoids and flavondiols. The leaves also contain the stimulants caffeine, theobromine and theophylline. The composition of green tea varies with the geographic origin of the leaf, the time of harvest and the manufacturing process. Fermentation of black tea lowers the concentration of polyphenols, and thus may decrease the health promoting effects associated with green tea. For this reason, there has recently been an increased interest in green tea consumption in the western world.

Many of the studies linking green tea to anticancer activity have highlighted a role in the prevention of certain types of cancer. Green tea consumption has been associated with a potential to decrease the risk of developing certain precancerous polyps in the colon, esophageal cancer in women, and pancreatic cancer. In animal studies it has also been shown to have a preventive effect in lung, liver, duodenal, and breast cancer. Part of the anticancer activity of green tea is thought to be due to the activity of the catechin epigallocatechin gallate (EGCG) and several similar substances. EGCG has antioxidant activity, but it may also deter cancer by inhibiting enzymes involved in cell division and DNA synthesis, or by inhibiting communication pathways in a cell that are required for cell division. These polyphenolic compounds may also prevent activation of certain potential cancer causing compounds that are ingested in the diet. The effect of tea consumption on cancer is likely to depend on the factors associated with a specific cancer. Therefore, a protective effect observed on one type of cancer within a given population may not be seen with cancer of a different type.

Scientific studies have suggested a preventive effect of green tea against the risk of stroke, atherosclerosis (hardening of the arteries), heart disease, high blood cholesterol levels, and high blood pressure. One mechanism by which green tea constituents lower cholesterol is by increasing fecal excretion of cholesterol. Another beneficial mechanism is the prevention of low-density lipoprotein (LDL) oxidation, a process involved in cholesterol deposition in blood vessels leading to atherosclerosis.

Although lower in caffeine content than black tea and coffee, green tea contains approximately 60 mg per cup and multiple cups per day can cause gastric hyperacidity and upset, constipation, diarrhea, restlessness, palpitations and difficulty sleeping. Many studies suggesting the healthful effects of green tea have been conducted in laboratory animals and these findings need to be confirmed in humans. In general, however, green tea is very well tolerated and many people may benefit from adding this beverage to their diet.

FISH OIL

Fish Oil contains the omega-3 fatty acids eicosapentanoic acid (EPA) and docosahexanoic acid (DHA). These substances can compete for the formation of naturally occurring arachidonic acid in the production of several classes of biologically active substances, the prostaglandins, the thromboxanes and the leukotrienes. Some of these substances are involved in blood clotting, inflammation, and dilation of the blood vessels, hence their activities of decreased blood clotting, providing modest symptomatic relief in rheumatoid arthritis, lowering relapse rate in Crohn’s disease, decreasing inflammation in ulcerative colitis, decreasing pain associated with menstruation, and moderately lowering blood pressure. Fish oil supplements also lower blood triglycerides that can play a role in pancreatitis and cardiovascular disease.

Common side effects of fish oil include a fishy taste and belching. Large doses can cause loose stools. Simultaneous use with other drugs and herbs that decrease blood clotting ability such as anticoagulants (blood thinners), aspirin, fever, garlic, red clover and willow increase the risk of bleeding. Fish oil should be avoided in people with aspirin sensitivity as it may interfere with lung function and cause impaired breathing.

GARLIC

Many alternative medicine advocates or folkloric remedies recommend garlic to lower cholesterol. Although garlic seems to inhibit cholesterol synthesis by the body, recent studies suggest that garlic supplements may not lower cholesterol. Garlic is composed of many sulfur containing compounds, including allinin. When garlic is crushed, allinin is converted to allicin and it is the allicin that effects cholesterol synthesis. In addition to the variability of allinin content, supplements do not contain all of the compounds found in fresh garlic. Therefore, it is not known if consumption of fresh garlic is required to have a cholesterol lowering effect.

Garlic used for cooking is generally safe, but large amounts in supplements can increase the effects of anticoagulants (blood thinners), therefore increasing the tendency for bleeding and can also interfere with blood sugar control in diabetics. Further studies are required before conclusions can be made.

SOY

Nutraceuticals

Inclusion of soybeans into the western diet has increased in recent years due to their high fiber and antioxidant components. Soy protein is highly valued for its nutritional value.

The FDA has approved the claim that consumption of 25 g/day of soy protein (contained in 2-4 servings of a soy product) in combination with a diet low in saturated fat and cholesterol may reduce the risk of heart disease. Some of the key mechanisms by which soy protein may have a protective effect for the cardiovascular system include prevention of smooth muscle proliferation in the blood vessels, reduction of platelet aggregation (involved in blood clotting ability), blood-pressure reduction, and antioxidant effects on blood lipids. Studies also suggest that soy can lower cholesterol levels by approximately 10%, but this value is highly variable.

The most widely publicized of the biologically active components of soy are the isoflavones such as genistein and daidzein. They are considered phytoestrogens (plant products with estrogenic activity), but in certain conditions they can act as antiestrogens by blocking more potent estrogens. There is much controversy regarding the activity of isoflavones as cancer preventive or cancer stimulating compounds in estrogen sensitive tissues like the breast. It is generally recommended that women who are at an increased risk for breast cancer avoid isoflavone supplements.

Due to their estrogenic activity, the use of soy supplements has been proposed for several other conditions. For example, supplements has been anecdotally recommended for the relief of menopausal associated hot flashes, but several studies have drawn conflicting conclusions as to this effect. Hormone replacement therapy is a much more effective treatment for hot flashes. Preliminary findings suggest that soy protein or isoflavones may have a beneficial effect on maintaining bone density. Genistein may inhibit the bone cells that are responsible for bone breakdown. However, this too needs to be confirmed before it is recommended as solo therapy for the prevention or treatment of osteoporosis.

The preventive effects on many types of cancer are currently being studied in many laboratories. Interest in this area stems from epidemiological studies that show that populations which consume a diet high in soy such as they typical Asian diet, have lower incidences of breast, prostate and colon cancers. But this does not prove that the soy is the cause for this decreased risk. Many other factors are likely to be involved, but there are multiple biologically active classes of compounds found in soy that are associated with anticancer activities, including saponins, phytates, protease inhibitors, and phytosterols.

Much of the research on the effects of soy has investigated the effects of only one component at a time. However, the combined effect of the components of soy may provide additive or even synergistic effects. Therefore, the consumption of soy containing foods, such as soy milk, soy flour or tofu is likely to be more beneficial, and possibly safer than the consumption of its individual components.

Chemical Peels

Chemical Peels

Chemical peels are classified as superficial, medium and deep, depending on the depth of the wounding caused by the agent. Superficial peels damage the outer layer of the skin called the epidermis and mildly stimulate collagen formation in the uppermost part of the dermis. Alpha-hydroxy acids (AHAs) are commonly used. They help smooth rough, dry skin, improve the texture of sun-damaged skin, and even out skin tone. The recovery is rapid, and usually consists of minor flaking and redness for several days. A series of treatments is generally required to obtain the best results. Results of an AHA peel are temporary. Periodic treatments are recommended to maintain the results.

AHAs are often referred to as fruit acids. They include glycolic acid (from sugar cane), lactic acid (from sour milk), citric acid (from citrus fruits) and tartaric acid (from fermented grapes). Glycolic acid is most frequently used for superficial peels and in cosmetic formulations. When used as a peel, the pH (measure of acidity) is low (more acidic) and thus more irritating. Products for home use have been partially neutralized (resulting in a pH closer to that of the normal skin surface, 4.2-5.6) and are less irritating.

Medium Peels

chemical face peel

Medium peels often contain trichloroacetic acid (TCA) (35%), although lower percentages can be used for superficial peels and higher percentages (50-60%) can produce a deep peel. The best candidate for medium peels is an individual with fair skin. It is sometimes combined with other treatments such as tretinoin cream, Jessner’s solution (containing lactic acid, salicylic acid and resorcinol), or dermabrasion, to intensify the results. TCA destroys the epidermis and upper dermis and causes the skin to slough within 5 to 7 days. A mild pain medication may be used to ease the burning and throbbing that occur with the peel. Immediately after the treatment a white frost forms from coagulation of the epidermis. The white frost quickly disappears as the treated area takes on a red, burned appearance, occasionally accompanied by swelling. Within a day the skin is brown in color and after several days a scab or crust forms. The scab generally persists for 7 to 12 days.

Medium peels can be used to treat a number of skin conditions, but they are most often used to treat the effects of sun damage. They also diminish the appearance of vitiligo or leukoderma (conditions marked by the presence of areas lacking pigmentation) by reducing the color contrast of surrounding skin. Deep wrinkles are less responsive and require additional treatments. Frequently a series of medium peels is required to achieve the desired result.

Deep Peels

Deep peels cause similar but more intensified effects than medium peels. These peels, often accomplished by the use of phenol, produce the most dramatic results but are the most painful and require the most post-treatment care. Damage extends to the mid dermis. In addition to treating wrinkles, scars and blemishes, phenol peels may be used to treat precancerous skin lesions. Because phenol peels cause a permanent lightening of the skin they are generally not used in dark-skinned individuals. Sedation is frequently given prior to the treatment. In certain individuals the heart is monitored with an ECG due to the potential for irregular heart rhythms. Pain medication may be prescribed after the treatment.

chemical skin peel

After a deep peel, the area is swollen and raw. The proper post-treatment care is essential to avoid complications and produce the best results. This often involves the use antibiotics, compresses, special soaks and ointments. Normal activities are usually resumed after 2 weeks. After the scab heals, the skin appears red for 2 to 3 months, however cosmetics can be used after an initial period of time to mask the redness. A single treatment is usually sufficient to provide the desired results.

To varying degrees medium and deep peels cause remodeling of the collagen in the dermis and an increase in the elastic fibers. Collagen and elastin (an elastic fiber) are the main structural proteins in the dermis. With aging, the dermal collagen and elastin content decreases as the skin becomes thinner. This is accelerated by sun exposure and is the major factor associated with wrinkling. The changes in the dermis take effect over weeks to months.

Although the use of sunblock is widely recommended, it is especially important for people who have had medium or deep peels because the treated skin is more vulnerable to the damaging effects of the sun. Side effects of the peels vary with the type and depth, and the experience of the operator. Deep peels in particular carry a small risk of infection and/or scarring. Patients with allergies may experience a flare-up of skin allergies. Fever blisters and/or cold sores may also develop. In people prone to fever blisters, antiviral drugs are often prescribed before and after the peel.

A phenol peel generally causes a permanent lightening of the treated skin, which is particularly noticeable in dark-skinned individuals. Infrequently the development of a thick scar occurs after a deep peel. This is more common in Asians, Africans and Indians. Very rarely, a person undergoing a deep peels experiences an abnormal heart rhythm.