Skin Problems
May 31st, 2024 by Dr. Hannah Sivak
Everything we see seems to indicate that Ozempic and drugs with a similar mechanism of action are here to stay. It’s not “just” for obesity but also for diabetes, and outcomes for heart and renal disease seem to improve. These medications took a long time to arrive, and many patients who benefit from them are older and have been overweight for many years and even decades. You will be able to wear nicer clothes, knee and foot pain may go away, and you can see your body as it used to be when you were younger and thinner. But your skin is now showing its wrinkles, and your arms are…
April 2nd, 2024 by Dr. Hannah Sivak
Older skin is different from baby skin, not just in texture but also in color. Or, let’s say, colors, like in plural? Older skin looks almost like a map, with different spots reminding you of all the ays we mistreated our skin as we grew up. That burn while we were boiling water in the kettle? The time we stayed way too long in the sun after the sea had rinsed away the sunscreen. How about broken capillaries? They produce bruising that changes color with time and may take months to disappear. You may also get those pin-size red spots. Many illnesses require the use of anticoagulants: heart arrhythmia, cancer,…
February 28th, 2024 by Dr. Hannah Sivak
Aging is a complex physiological process characterized by progressive degradation, loss of function, and reduced repair capacity of an animal’s tissues and organ systems. A better understanding of these mechanisms may help extend the average lifespan and healthier life expectancy (years spent free from age-related illness). Research on aging is intense, but it’s important to understand that it will take decades before the knowledge scientists acquire makes it practical application, if ever. Why? Each aging mechanism is complicated in its own way, and the complexities and difficulties are only found when we try to use them on living creatures. For example, a microRNA may influence a gene related to aging…
February 2nd, 2024 by Dr. Hannah Sivak
Always look at the ingredient list to find out what a product can (or cannot) do for you. What’s available? Add Tremella fuciformis, a.k.a. snow mushroom, and Zinc PCA. Follow the links to posts describing their benefits. The secret to controlling acne without damaging your skin is in the ingredients. Fight the bacteria and the skin condition, not your body. Don’t supress your skin’s immune system or the barrier. This, for example, is a good product . Water, Potassium Azeloyl Diglycinate, Seakelp (Lactobacillus/Kelp Ferment Filtrate) Bioferment, Sodium PCA, Camellia Sinensis (Green Tea) Hydrosol Water, Propanediol, Hamamelis Virginiana (Witch Hazel) Water, Nobiletin, Zinc PCA, Tremella fuciformis (Snow Mushroom) Extract, Porphyridium Polysaccharide,…
January 27th, 2024 by Dr. Hannah Sivak
Pleiotropic: producing more than one effect. Does it matter that an ingredient you use on your skin displays pleiotropism? Yes, of course. It means that you can expect more than one desired (advertised!) effect; you have to be observant and make sure that the ingredient doesn’t have a side effect that you don’t want. The mechanisms of pleiotropism vary. Pleiotropy describes the genetic effect of a single gene on multiple phenotypic traits. The underlying mechanism is genes that code for a product that is either used by various cells or has a cascade-like signaling function that affects various targets. Retinoic acid exerts its pleiotropic effects primarily by controlling the expression…
November 19th, 2023 by Dr. Hannah Sivak
The cons of menopause and aging In part I, I listed the benefits of menopause, but let’s not ignore reality: menopause and aging change the body in ways that are not pleasant. I know there isn’t a remedy for every malady brought about by menopause (or aging); there isn’t. But there have been enough scientific advances to improve life and let you enjoy the pros. Skin First, let’s celebrate the definitive departure of acne. You may get a spot here and there, but that’s not acne. If you get too many, maybe you should check the ingredient lists of the products you put on your skin: coconut oil is a…
September 16th, 2023 by Dr. Hannah Sivak
Just in case you haven’t heard about it, a new kind of weight-loss/diabetes medication has revolutionized how we see obesity. And that is a great thing. Obesity is a health problem because it causes a lot more than “just” mental distress for people who are obese. I could list the health problems that follow long-term obesity, but they are familiar to many and are also easily found online. If obesity was ever a sign of wealth, this association has long been gone from first-world societies. Nowadays, it’s a sign of “low class,” lack of willpower, or whatever. Obese girls are not cool. You don’t have to agree with these opinions…
August 27th, 2023 by Dr. Hannah Sivak
Scars and sports injuries can be sensitive when the rain comes or the weather changes in other ways. For many people, pain can flare up in the cold of winter. So, how does cold weather affect pain, and what can be done about it? The causes There are several theories behind this familiar problem, including: Lower temperatures cause tissues to contract, putting pressure on nerves. Different tissues contract at different rates, for example, scar tissue. This is why the site of a previous injury could experience pain in cold temperatures. Pressure changes – air pressure in winter drops. With this drop, the gases and fluids in joints expand, putting pressure…
April 13th, 2023 by Dr. Hannah Sivak
Reevaluating Ozempic The data are in and it looks like Ozempic-type medications benefit several health conditions, including diabetes, high blood pressure, and kidney and heart problems. Since these are serious conditions, it looks like the Ozempic type of medicine is here to stay. What is Ozempic? It’s the brand name for a synthetic chemical, semaglutide, a chemically modified peptide, that can fool a receptor for the natural peptide. The receptor is called glucagon-like peptide receptor, or GLP-1, and semaglutide will make your body “think” that you just had a huge meal. Semaglutide, sold under the brand names Ozempic, Wegovy and Rybelsus, is an antidiabetic medication used for treating type 2…
January 6th, 2023 by Dr. Hannah Sivak
…and it’s a resolution you’ll find easy to keep! You see your face in the mirror every day, and you may have made some New Year’s resolutions about your face. But your long-term health and comfort depend on some often forgotten parts of your body. Think of your hair and scalp. Deciding to take care of your scalp will prevent future “crises” and “emergencies”. For example, it is relatively easy to keep a healthy scalp biome, but if you let things get out of control, then you may need to use antifungal medications to stop a “sudden” dandruff event. Don’t let it progress that far, Skin Actives has the tools…
December 6th, 2022 by Dr. Hannah Sivak
Rosacea skin is characterized by dysregulated inflammatory (perivascular or pilosebaceous infiltrate), vascular dilation, lymphatic dilation, glandular hyperplasia, and fibrotic processes, a mixture of symptoms that reflects the complexity of the underlying mechanisms. What is going on? We all prefer simple answers, especially for very complex situations. A simple answer for rosacea has been proposed. Nitric oxide is a gas produced naturally in nearly all of the body’s cells and is used as a signal by the nervous, immune and cardiovascular systems. Because nitric oxide is known to make blood vessels dilate, it was hypothesized that it might play a role in rosacea. But, so far, and despite intense research on…
September 5th, 2022 by Dr. Hannah Sivak
If Winter is harsh on your skin because of the heating and the dry air, Summer is undoubtedly tougher. Add the UV radiation of those days at the beach (or on your recliner in the backyard) to the dryness of air conditioning. Not all is bad news. Our skin is NOT a wall, for better and for worse. If you give it a chance, skin can heal itself and will do even better if we help it. We should have been protected with sunscreen and applied more after swimming removed most of it. We should have been applying moisturizers of some kind. But even if we did, we still have…
July 2nd, 2022 by Dr. Hannah Sivak
What happened to our bodies after more than two years of a pandemic? Covid 19 took so much away from us (and it keeps taking). I am thankful that with the aid of vaccines and boosters, hundreds of masks, and a lot of luck, I managed to avoid (so far) this terrible illness that killed one million Americans and countless others worldwide. Some things have changed: I am now less enthusiastic about kissing and hugging acquaintances. I am (still) wearing a mask to the supermarket (I am in that age group) and haven’t been to a party or the movies. I also have a couple of what superficially may seem…
July 1st, 2022 by Dr. Hannah Sivak
What is alopecia areata? Severe alopecia areata (AE) can cause a total loss of body hair, including eyelashes and eyebrows, nose hair, and hair in the ears. How does this happen? AE is one of the many autoimmune diseases where our immune system malfunctions and doesn’t recognize molecules in our bodies, treating them as foreign and dangerous. What is JAK? The Janus kinase family of enzymes is involved in signal transduction by cytokines. Cytokines control cell growth and the immune response by binding to specific receptors. Once activated, these receptors are phosphorylated by Janus kinases, and the modified receptors recruit transcription factors that modulate gene transcription. Block these kinases, and…
July 1st, 2022 by Dr. Hannah Sivak
What is atopic dermatitis? It’s a common, chronic inflammatory skin disease characterized by skin barrier dysfunction, inflammation, and itch. Steps to control eczema and atopic dermatitis Patch-up skin barrier disruption with topical occlusive products Keep the skin well hydrated. Avoid further disruption: avoid bubble baths, alcohol, abrasion, and prevent scratching at all costs Avoid ingredients that are allergenic like some fragrances and tea tree oil. Unfortunately, some “natural” products supposedly formulated for sensitive skin, contain allergenic ingredients, practically ensuring that eczema will develop or worsen. Avoid UV: this type of radiation promotes inflammation and production of ROS* (reactive oxygen species) Control opportunistic allergens like Malassezia with antifungals and pre-biotics (bee…
June 29th, 2022 by Dr. Hannah Sivak
Atopic dermatitis (AD, eczema is one of its forms) is a common, chronic inflammatory skin disease characterized by skin barrier dysfunction, inflammation, and itch. The exact mechanisms behind the pathogenesis of AD are very complex and still being studied, but we know that its development and persistence require interaction between skin barrier dysfunction, inflammation, and itch. Eczema is a complex, multifaceted skin condition that has a strong genetic component. More than 30 genes have already been identified as implicated in eczema. Knowing the genes involved is not enough to understand the mechanisms involved but progress is being made all the time How does it start? It seems that abnormalities in…
June 19th, 2022 by Dr. Hannah Sivak
A ubiquitous biological material, keratin represents a group of insoluble, usually high-sulfur content and filament-forming proteins, constituting the bulk of epidermal appendages such as hair, nails, claws, turtle scutes, horns, beaks, and feathers. These keratinous materials are formed by cells filled with keratin and are considered ‘dead tissues’. Nevertheless, they are among the toughest biological materials, serving various interesting functions, like scales to armor the body, horns to combat aggressors, hagfish slime as a defense against predators, nails, and claws to increase prehension, hair and fur to protect against the environment. Thinking about keratins familiar to us, it’s hard to think of how they could make an ingredient in skincare,…
May 21st, 2022 by Dr. Hannah Sivak
Ingrown hairs, a.k.a. razor bumps. Very common, almost normal but they can still be problematic. An ingrown hair is one that’s grown back into your skin instead of rising up from it. It can lead to pseudofolliculitis barbae (PFB), which sounds more serious than it is because it’s in Latin. PFB is a chronic, inflammatory reaction characterized by papules and pustules secondary to ingrown hairs. Even in English, PFB is not that pleasant and can get complicated. PFB requires a genetic predisposition, plus a traumatic hair-removal practice; sharp-pointed hair shafts curve back into the adjacent epidermis, causing inflammation, and may lead to an abscess. Curly hair is a major risk…
May 16th, 2022 by Dr. Hannah Sivak
In radiation treatment for cancer, noxious radiation is used in a VERY focused way to kill cancer cells. Using information from PET scans and more, the physician/math/physics expert designs a treatment strategy suitable for the type and location of cancer cells. The objective is to kill cancer cells without harming the healthy tissue around them. This is easier said than done. There will always be damage to healthy tissue, even when using top-of-the-line methodology and equipment. For example, the skin is on the way when targeting breast cancer cells “hiding” within the bones. What will happen? Let’s concentrate on the fact that cancer cells will be destroyed, adding months or…
May 13th, 2022 by Dr. Hannah Sivak
When we were living in caves and fighting wild lions, we didn’t make it to menopause. Now, we do. Estrogen does a lot for our bodies, including our skin and scalp. Estrogen deficiency, like the one that comes with menopause, leads to aging and delayed skin repair. In addition to “normal” menopause (around 50), many women go through early menopause, have to contend with the effects of removal of the ovaries or deal with estrogen suppressants (to control the growth of a tumor that responds to estrogen). How does menopause affect skin and hair? The answer is complicated, so I hope you will bear with me. But first, why is…