Many of my patients come in for the same common skin concerns. They are typically unaware of what their problem is called or how easily it can be treated. The four most common include Poikiloderma, melasma, broken capillaries or ingrown hairs. 

Poikiloderma is basically a combination of blood vessels, redness and discolorations that commonly occur secondary to sun exposure either on the face, neck or chest areas. This extra pigmentation of the skin is usually displayed in a variety of shades and associated with widened capillaries in the affected area.  Effective treatment methods include intense pulsed lights/IPL and fractional laser technologies.  

Melasma, another frequent problem, is a skin condition presented as brown patches on the face. In many cases, both sides of the face are affected and most often seen on the cheeks, bridge of the nose, forehead, and upper lip. Unfortunately for women, melasma occurs mainly in females, as only about 10 percent of men are affected. This condition is also more prevalent among Hispanics, Asians, Indians, and people from the Middle East and Africa.

Also known as the “mask of pregnancy,” melasma can be secondary to pregnancy, or in women who are genetically predisposed and go on hormone therapy.  While it is made worse by excessive sunlight exposure, it can be treated in the dermatologist’s office using Retin-A, hydroquinone compounds, superficial chemical peels or new-generation Q-switched and fractional laser technologies.  It is most important to be sure to protect yourself everyday using a broad-spectrum sunblock when you go out because this condition will recur if you do not use adequate sun protection. 

Broken blood vessels are a common problem on the face, nose, chest and arms.  They usually occur either on a genetic or a sun-induced basis. New generation pulsed dye and KTP lasers can easily and painlessly remove these unwanted vessels in a single session and are cost effective.

Finally, we come to ingrown hairs. From women who get ingrown hairs in the bikini area or on their chin, to African-American men who are more susceptible to ingrown hairs – this condition plagues many individuals. The bright side is that these ingrown hairs, and the subsequent inflammation, can be treated by combinations of topical antibiotics and hydrocortisone lotion derivatives. 

If it is a recurrent problem, new generation advanced hair removal laser technologies including at-home laser technologies such as the no!-no! or Tria and Silk’n™ can also be very effective to decrease the inflammation. Keeping your face and body moisturized and exfoliated can help to dramatically reduce the occurrence of ingrown hairs, as well as using specialized soothing products such as Barc Skincare’s Barc Bump Down.

Although a high percentage of the population is affected by these common skin problems, we are fortunate to live in a time where there are so many advanced alternatives to treat them.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

Dear Yvonne,
I heard it’s possible for a woman to have an orgasm while giving birth. Is this fact or fiction?
-Anna Maria

Dear Anna Maria, 
Yes, females can indeed experience climax during natural childbirth, a reaction Dr. Danielle Harel coined an “unexpected birthgasm.” In researching this phenomenon, Harel learned some women have experienced a rather surprising orgasm at the moment of birth without sexual stimulation or fantasy. Understandably, given the circumstances, this response is not interpreted by these women as sexual. It has been speculated that one of the reasons for this reaction is due to the baby’s head putting pressure on the pelvic and hypogastric nerve system as it descends, inducing orgasm.

In learning about birthgasms, couples have actively sought to have a woman experience such a “passionate birth.” Research indicates that the primary factors that allow for such are that:

- The woman has a good sex life and understands everything that birthing entails.
- A woman and her partner incorporate massage, kissing and masturbation as part of the birthing experience.
- The woman is not given anesthesia during childbirth and uses sexual stimulation to ease contractions.
- The woman is in a safe, private environment for the birth.
- The woman’s partner is supportive, for example, he or she holds her. 
 
For information on how a woman can have an orgasmic pregnancy, please check out my newly released book “Your Orgasmic Pregnancy: Little Sex Secrets Every Hot Mama Should Know.”

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

What is fiber?

Fiber is a substance found only in plants, such as fruits, vegetables and grains.  Fiber is not found in any animal products, including meat, fish, poultry, eggs or cheese.  The part of the plant fiber that you eat is called dietary fiber and is an important part of a healthy diet.  Dietary fiber is made up of two main types—soluble and insoluble.
 
What is the difference between insoluble and soluble fiber?

Soluble fiber forms a gel when mixed with liquid, while insoluble fiber does not.  Insoluble fiber passes through your digestive tract largely intact.  Both types of fiber are important in the diet and provide benefits to the digestive system by helping to maintain regularity.  Soluble fiber has some additional benefits to heart health.

What are the benefits of fiber?

• Fiber is scientifically proven to reduce serum cholesterol levels which may help to reduce your risk of heart disease.
• Fiber increases stool bulk, allowing for regular defecation (alleviating constipation) and decreasing the risk of colon cancer.
• Fiber slows down gastric emptying, allowing you to feel fuller for a longer period of time after a meal.  High fiber foods have little effect on increasing serum glucose levels (an important fact for diabetics and people trying to lose weight).
• Since fiber is indigestible, it adds no calories to your diet.  Adding fiber-rich foods to your meals bulks them up (think larger, more filling portions), without adding excess calories.  Fiber allows you to feel fuller and more satisfied even on fewer calories, making weight loss easy to achieve.

Overall how much fiber should I eat?

The American Dietetic Association recommends that Americans eat 20-35 grams of fiber per day.  The average American currently eats 9-12 grams of fiber a day, leaving much room for improvement.  Studies show that diets high in fiber reduce serum cholesterol levels, risk of heart disease, adult-onset diabetes, and certain forms of cancer.

For more information on Fiber, check out my website www.ffactordiet.com.

Tanya Zuckerbrot, MS, RD is a nutritionist and the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.

What have we learned from previous year’s Halloween celebration? It can be done safely and wisely with kids enjoying their special day (or night).  One of the most important things to do for this holiday (as well as anytime) is to be a LABEL DETECTIVE! That’s right as a parent you must read each and every label of packaged foods.  Many snack foods and candy may contain peanuts, nuts, egg and milk (among the most common food allergens in kids).   

Learn more about safe food allergen labeling and consumer information which will simplify whether a food contains one of the top 8 food allergens to protect consumers with food allergy @  http://www.cfsan.fda.gov/~dms/alrgqa.html. 

So here is a partial list of ways I have found to enjoy a safe Halloween.

·     The American Academy of Allergy, Asthma and Immunology have a great check- list of things to do for a safe Halloween at:  http://www.aaaai.org/patients/elements/1008/08halloween_checklist.stm

·     Go shopping with your child and pre-purchase safe foods and snacks that do not contain suspect allergens before the “trick-or-treating” begins

·     Attend a Halloween party with your child to ensure that you can monitor to keep your child safe and resolve any food allergy concerns

·     Bake safe foods and treats at home and bring them with you to parties and during trick-or-treating on Halloween (if your child has gluten intolerance or celiac disease, this will be particularly important)

·     If your child is allergic to egg and egg products watch out for the appearance of “shiny” food products that may signal egg coating on bakery foods

·     Keep your child’s emergency medication on hand, such as an epinephrine auto injector, if they have prescribed for potential use if a food induced allergic reaction should occur

·     Consider non food items such as stickers, crayons,  in lieu of snacks, candy and food

Check out www.foodallergy.org (The Food Allergy and Anaphylaxis Network) for more food allergy safety tips to keep it safe and an enjoyable holiday for your family 

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition. 

The National Institutes of Health recently published an interesting study in the “BMJ,” where they approached 1,200 internists and rheumatologists about what they called “placebo treatments,” where patient expectations rather than an expected physiological response was the rationale for the treatment. Only 679 physicians responded, which limited the conclusions, along with the design of the study itself, as this type of survey is a weak form of science. Nevertheless, the results were disturbing – about half of the responding doctors indicated they prescribed these kind of treatments on a regular basis, and more than 60 perecent believed there was no ethical problem in doing so. It has long been known that cures and responses to treatment can be affected by a patient’s mental attitude and expectation, and that healing itself involves suggestion as well as chemical intervention.

But I find these results deeply disturbing for the following reasons:

1) Most of those surveyed were not using sugar pills or harmless salt water, they were using medicines with potential side effects. These included over-the-counter analgesics (41percent), vitamins (38 percent), sedatives (13 percent), and antibiotics (13 percent).

2) More than 90 percent of upper respiratory infections are viral, yet physicians are knowingly prescribing antibiotics to meet patient expectation.

3) Patients are fueled to ask for pills because of advertising, the Internet and a culture of instant gratification.

4) Physicians are motivated to provide a quick fix rather than a more elaborate explanation which could eliminate the need or urge for the treatment. A study published in the “Annals of Family Medicine” published in 2005 concluded that physicians only spend 55 percent of their time in face-to-face patient care. In this environment of 5 to 10 minute office visits, it is often easier for doctors to provide a quick placebo treatment rather than a more elaborate diagnosis and explanation.

5) This is a survey of doctors, but it is highly doubtful to me that patients would be satisfied with this approach. I suspect that a similar survey of patients would reveal that less than 10 percent of patients believe that it is okay for placebo treatments to be given for deceptive reasons, with false expectations. I suspect that most patients would like an interaction with their doctor to be completely honest and based on full disclosure.

Do my readers agree?

VIDEO: Watch Dr. Siegel Talk About The Placebo Problem

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News Medical Contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: the Truth About the Epidemic of Fear” and “Bird Flu: Everything You Need to Know About the Next Pandemic”. Read more at www.doctorsiegel.com

Dear Yvonne,
Please help me find classy porn that my wife will also enjoy. I can’t seem to find it and my wife is showing interest in the idea.
- Alan

Dear Alan,
Typically, “classy” and “porn” don’t go in the same sentence. If you’re looking for something erotic, but still maintains a bit of class, you might do better renting racy European flicks that push the envelope with nudity, sex and other sensual acts. If you and/or your wife are set on porn, however, you may want to consider those geared toward female interests. There are a couple of major resources to look into. First, Candida Royalle’s sensually explicit “Femme Productions” flicks are geared specifically at women. Royalle describes her videos as involving more story line, good original music and more real characters of all ages. They’re also less graphic than traditional, male-oriented porn flicks. Also, Tristan Taormino recently released a line of female-oriented, sex educational videos through Vivid Entertainment’s Vivid-Ed line, sure to give you and your wife tons of pleasure-play ideas.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

Edamame are a great source of protein, fiber, soy and essential amino acids. Edamame can be found shelled or in the pod and are often sold frozen in bags. They have become so popular that they can be found not only in Asian markets and health food stores, but in the freezer section at most local supermarkets. Edamame are delicious steamed in the pod and salted, or shelled and tossed into soups or salads. Seapoint Farms now sells packets of dry roasted edamame that makes a delicious and crunchy snack, and unlike salted peanuts, edamame are much lower in fat and higher in fiber.

Ingredients:
• 1 bag shelled edamame
• 1 cup water
• 1 tablespoon minced fresh ginger
• 1 tablespoon low-sodium soy sauce
• 2 teaspoons sesame oil

Directions:
1. In a saucepan, combine the edamame, water, and ginger.
2.  Bring to a boil over high heat. Reduce heat to low, cover and cook for 10 minutes.
3. Drain edamame and place in a bowl.
4. stir in the soy sauce and oil and serve.

Serves 8
Nutrition Contents:
Per serving: 95 calories, 7g carbohydrate, 3g fiber, 7g protein, 5g total fat, 1g sat. fat, 83mg sodium

Tanya Zuckerbrot, MS, RD is a nutritionist and the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.

As most women are aware, October is Breast Cancer Awareness month. According to the National Cancer Institute, more than 200,000 women are diagnosed with some form of this disease each year.  Although some risk factors you cannot control, like your sex, age or family history, there are changes that can make a difference. The National Cancer Institute and the American Cancer Society recommends a well balanced diet along with exercise may significantly reduce your risk of developing the disease.

Below you can find tips on how to lessen your possibility of developing breast cancer.

1. Fiber: According to the Journal of Clinical Oncology a diet including 20 to 30 grams of fiber per day can lower blood estrogen levels. Estrogen stimulates the early growth and development of breast cancer. Therefore, the less estrogen you have in your body, the lower your cancer risk. Another theory is that if you eat more fiber, you tend to eat less fat, and a diet high in fat appears to increase the risk of breast cancer. Add low-fat sources of fiber such as whole grain breads, crackers and cereals.

2. Fruits and vegetables: Eating a variety of fruits and vegetables don’t only boost your fiber intake, but are full of powerful antioxidants which help protect the cells against free radical damage. In addition they contain vital nutrients essential for health maintenance. Researchers at Cornell University concluded that there are strong epidemiological studies that eating more produce decreases a women’s risk in developing breast cancer. Aim to eat a variety of at least five servings daily.

3. Calcium: Consuming two or three servings of dairy products daily is linked to lower breast cancer risk, according to American Cancer Society that studied postmenopausal women only. Calcium cleanses excess estrogen from the liver, making this nutrient vital in preventing breast cancer.

4. Omega-3 fatty acids: Omega-3 fats have demonstrated a number of physiological and biological effects through which they may reduce the risk of breast cancer and other cancers. Some studies indicate that cells containing omega-3 fats are converted into prostaglandin hormones which decrease the rate of cell division. Fish high in omega-3 fatty acids include salmon, herring, mackerel and sardines.

5. Exercise: Researchers found that women who exercised regularly reduced their risk of developing breast cancer by 20%.  Regular exercise can help you maintain a healthy weight and, therefore resulting in lowering your threat of developing breast cancer. Exercise reduces fat levels in the body, which lowers hormone levels, diminishing chances for abnormal cell-growth in the breasts. Working out reinforce s your immune system, which might prevent viruses, bacteria and cancer cells from developing in your breasts or lymph nodes. Today there are endless amounts of workout methods; between walking, running, spinning, yoga, and pilates find the one that suits you best. You should aim to work out between 30-45 minutes four times a week.

Research into the effects of diet on the risk of breast cancer is still in the early stages. But considering that 1 in 8 women alive today will get this disease, and one-third will die from it, making simple dietary changes now is a smart move. To make it even easier to start adding some of these foods into your diet today, I have provided you with easy and nutritious recipes that are filled with either fiber, calcium, antioxidants or omega-3 fatty acids! Enjoy!

Recipes to Help you Reduce the Risk Factors for Breast Cancer:

Blueberry Bran Muffins

A typical store bought-muffin can deliver close to 500 calories and no fiber.  These muffins are only 158 calories and have a whopping 6g of fiber plus the blueberries are loaded with cancer-fighting antioxidants.  And the best part is, they taste better than anything store bought!

1 ¼ cup whole-wheat flour
¼ tsp. salt
1 Tbl. baking powder
½ teaspoon cinnamon
½ teaspoon nutmeg
1 ½ cup All Bran Extra Fiber cereal
1 ¼ cup skim milk
½ cup honey
2 egg whites
¼ cup canola oil
1 tsp. grated lemon peel
1 cup blueberries

1. Preheat oven to 400 degrees.
2. Stir together flour, salt, baking powder, cinnamon and nutmeg.
3. In a large bowl, mix cereal and milk.  Let the mixture stand for two minutes to allow for the cereal to soften. 
4. Beat egg whites and add to cereal mixture.  Add oil and lemon peel and stir to combine.  Add the blueberries and then the dry ingredients and stir only until mixed.
5. Pour batter into muffin pan and bake for 20 minutes.

Makes 12 muffins

Nutritional Content:
Per Serving: 149 Calories, 26g Carbohydrate, 6g Fiber,4 g Protein, 5g Total Fat, 0g Sat. Fat, 205mg Sodium

Vegetable Soup

The many vegetables in this soup make it incredibly filling and loaded with antioxidants and fiber.   Feel free to add your favorite vegetables or leave out ones you don’t like. 

1 onion, diced
2 cloves garlic, minced
2 cups peeled baby carrots, cut into bite-sized pieces
1 head of celery hearts, cut into bite-sized piece
1 box button mushrooms, sliced
2 zucchini, diced into bite-sized pieces
1 16-oz crushed tomatoes
4 cups chicken broth
1 teaspoon dried basil
1 teaspoon dried oregano
Salt and pepper
2 cups frozen broccoli florets
2 cups frozen spinach
Parmesan cheese

1. Heat a large stockpot over high heat. Spray with cooking spray.
2. Add the onion and sauté for 2 minutes.  Add the garlic and sauté for 2 minutes more.
3. Add the carrots, celery, mushrooms, zucchini, tomatoes, chicken broth and spices.  Season with salt and pepper. 
4. Bring the mixture to a boil and then simmer for 15 minutes. 
5. Add the broccoli and spinach and cook for 5 more minutes.
6. Serve and top with grated Parmesan cheese.

Serves 8

Nutritional Content:
Per Serving: 124Calories, 21g Carbohydrate, 7g Fiber, 8g Protein, 2g Total Fat, 1g Sat. Fat, 602mg Sodium
Poached Chicken Salad with Raspberry Vinaigrette

Spinach and raspberries are chock filled with fiber and antioxidants and olive oil contains omega 3 fatty acids.  This salad makes a wonderful weekend lunch or a light summer supper.

4 cups canned chicken stock (preferably nonfat)
1 pound boneless, skinless chicken breasts
1 (14-ounce) can artichoke hearts, drained
1 tablespoon olive oil

2 tablespoons raspberry vinegar
1 tablespoon water
1/2 pint fresh raspberries
8 cups mesclun greens

1. In a medium sauté pan, bring chicken stock to a simmer and add chicken breasts.  Poach the chicken for about 6 minutes, turning to cook through.  Remove chicken from pan with a slotted spoon and set aside to cool.
2. Slice the artichokes hearts into bite size pieces.
3. Cut the cooled chicken into strips.
4. In a blender, combine olive oil, vinegar, water and 1/4 cup raspberries, and puree until smooth.
5. Divide mesclun greens, chicken, artichokes, remaining raspberries and dressing among 4 plates.

Serves 4

Nutritional Content:
Per Serving: 315 Calories, 14g Carbohydrate, 5g Fiber, 43g Protein, 9g Total Fat, 2g Sat. Fat, 1170mg Sodium
Broiled Salmon with Dill

Salmon is rich in omega-3 fatty acids, which reduces the risk of not only breast cancer, but cardiovascular disease.

1 onion, sliced
1 pound salmon fillet, cut into 4 pieces
1 tablespoon olive oil
1 ½ tablespoons lemon juice
1 tablespoon chopped dill
Salt and pepper
1 lemon, cut into wedges

1. Preheat the broiler. 
2. Place onion slices on the bottom of a broiler pan and place the salmon on top, skin side down. 
3. Season the fish with salt and pepper.  Sprinkle the lemon juice and dill on top.
4. Broil for 12-15 minutes, or until the fish is opaque.
5. Serve with lemon wedges.

Serves 4

Nutritional Content:
Per Serving: 173 Calories, 3g Carbohydrate, 0g Fiber, 23g Protein, 7g Total Fat, 1g Sat. Fat, 115mg Sodium
Cheesecake Parfait with Blackberry Sauce

I love cheesecake but at over 500 calories a slice, it’s an infrequent indulgence.  This recipe will satisfy your craving for the creamy taste of cheesecake—at a fraction of the fat and calories! And the calcium in the cheese plus the fiber and antioxidants in the berries make it a healthy, cancer fighting treat.

Ingredients:
½ cup low-free ricotta cheese
4 oz. fat-free cream cheese
4 Tbl. Splenda, divided
2 cups raspberries (leave a few aside for garnish)
2 cups blackberries
2 Tbl. water

1. In a blender or food processor, combine the ricotta cheese, cream cheese, 2 tablespoons Splenda, vanilla and raspberries until smooth.  Transfer to a bowl.
2. Rinse out blender or food processor; add blackberries, water and 2 tablespoons Splenda.  Pulse to chop blackberries.
3. Using half of the raspberry-cheese mixture, divide among 4 dessert goblets.  Top with half of the blackberry sauce.  Add remaining raspberry mixture and top with remaining sauce.  Sprinkle with remaining raspberries.  Chill for at least an hour in the refrigerator.

Serves 4

Nutritional Content:
Per Serving: 137 Calories, 20g Carbohydrate, 8g Fiber, 8g Protein, 3g Total Fat, 2g Sat. Fat, 193mg Sodium

Tanya Zuckerbrot, MS, RD is a nutritionist and the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.

Lasers can do great things. They can remove hair and reverse the signs of aging. They can also dissolve fat as part of a liposuction procedure. But when placed in the wrong hands, they can lead to severe damage.
 
You can liken lasers to heat weapons. If too much energy is applied, bad things like skin burns and scarring can happen. If you are going in for any type of laser procedure, you definitely want to be in trained hands.  You want a physician, a licensed physician assistant, a nurse practitioner or registered nurse doing your procedure. Also, don’t have laser treatments when you are tanned because the laser light is picked up by darker skin pigmentation. Lasers are much less effective on removing unwanted hair or diminishing wrinkles on tanned skin.

During the treatment, if the laser treatment is extremely painful, tell your doctor so he can lower the settings. If after the treatment, your skin is  persistently red or there is blistering, be sure to go right back to your doctor to be treated with the proper healing and lubricating agents to minimize the chance of scarring.

You can consult the American Society of Laser Medicine and Surgery , the American Academy of Dermatologic Surgery, American Academy of Cosmetic Surgery  or the American Society of Plastic Surgeons  to find a trained physician who can give you the best results.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

Dear Yvonne,
Can lust turn into love? I’m trying to sort through a situation I’m in…
- Isaac

Dear Isaac,
There are tons of factors that play into whether or not hot sexual chemistry will make for an “in love” relationship, or if a good friendship can turn you into one hot’n’bothered buddy. Research on this matter indicates that while it is possible that feelings can change in feeling lust towards somebody, it’s not guaranteed. Any possibility of the physical turning lovey dovey has to do with the hormones connected to sexual desire possibly triggering the release of oxytocin, the chemical associated with love and romance. This reaction may lead to romantic feelings, turning something physical and casual into a love relationship. Known as the “bonding hormone,” oxytocin is believed to influence a lover’s feelings for his or her lover.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”