Transcript: Dermatology | Jan 17, 2002

(music plays)

A title appears inside the shape of a house: More to Life. Words spin against a red and orange background: Health, Family, Home, Money, Fitness, Life. Fast clips show images related to the previous concepts, such as a dollar bill, a wheat field, and strands of DNA.

In animation, the title appears inside the shape of a house: "More to life."

Then, Mary Ito sits in a studio with textured yellow walls and the logo of the show in the background, which reads "More to life."

Mary is in her late thirties, with short black hair and bangs. She's wearing a black blazer, an animal print blouse, and a pendant necklace.

Mary says HELLO. I AM MARY ITO. WELCOME TO MORE TO LIFE. EARLIER THIS MONTH, A YOUNG TEEN TAKING A ACNE MEDICATION DROVE THE PLANE INTO THE SIDE OF A FLORIDA SKY SCRAPER. WAS THE MEDICATION PARTLY TO BLAME FOR HIS DEPRESSION? HERE TO DISCUSS THE SAFETY OF THIS DRUG AND SHED LIGHT ON SKIN ISSUES IS DR. NOWELL SOLISH. HE WORKS OUT OF WOMEN'S HEALTH SCIENCES CENTER. HE WILL TAKE YOUR CALLS ON SKIN PROBLEMS.

Nowell is in his forties, with short curly brown hair. He wears a brown suit, pale blue shirt and green tie.

Mary continues HOW DO YOU COPE WITH WINTER DRYNESS? IS THERE A FOUNTAIN OF YOUTH IN A BOTTLE? CALL WITH YOUR QUESTIONS.

A caption reads "416-484-2727. 1-888-411-1234."
Then, it changes to "moretolife@tvo.org"

Mary says HELLO, DR. SOLISH.

Nowell says HI.

Mary says LET'S TALK ABOUT THAT TRAGIC STORY. THAT BOY WAS ON ACTAIN. HOW SAFE IS THAT DRUG?

The caption changes to "Doctor Nowell Solish. Dermatologist."

Nowell says Z AS A DRUG, ITS A FANTASTIC DRUG. WITH ANY DRUG THERE ARE SIDE EFFECTS. BUT THE DRUG IS LIFE SAVING IN THE SENSE THAT IT CAUSES A DRAMATIC IMPROVEMENT, IF NOT COMPLETE REZ LUGSZ, MEANING THAT YOU CAN CURE ACNE. I TOOK THE DRUG WHEN IT FIRST CAME TO CANADA AND I WAS WAITING FOR IT TO BE APPROVED. IT WAS IN ENG LANDS FOUR YEARS BEFORE IT GOT HERE.

Mary says HOW LONG AGO?

Nowell says ABOUT 17 YEARS AGO. IT WAS DRAMATIC BECAUSE MY SKIN WAS HORRIBLE. I HAD REALLY QUITE DRAMATIC ACNE, SO BAD THAT THERE WERE DAYS WHEN YOU DIDN'T WANT TO GO OUTSIDE. WITHIN FOUR TO SIX MONTHS, YOU KNOW, IT WAS PRACTICALLY PERFECT. THAT IS THE KIND OF RESULTS YOU CAN GET. ITS A FANTASTIC DRUG.

Mary says DID THAT HAVE SOME EFFECT AS TO YOUR CHOICE OF PROFESSION?

Nowell says NO. NOT REALLY. IN A WAY IT DID BECAUSE WHEN I WAS GOING THROUGH MEDICAL SCHOOL YOU GET CHOICES OF WHAT YOU WANT TO TRY. SO I SAID, I'M GOING TO TRY SOME TIME WITH THE DOCTOR THAT PUT ME ON THE MEDICATION. IF I DIDN'T KNOW HIM OR WASN'T THERE, I MAY NOT HAVE TRIED DERMATOLOGY. MAYBE IT HAS SOMETHING TO DO WITH IT.

Mary says WHAT ABOUT THIS LINK THAT HAS BEEN MADE WITH ACCUTANE AND DEPRESSION. IS THERE A VIABLE LINK THERE?

Nowell says THAT IS A GOOD QUESTION. WHEN THE COMPANY RICK NIZES THERE IS A POSSIBILITY OF INCREASED RISK OF DEPRESSION, WHEN YOU LOOK AT THE AMOUNT OF DEPRESSION IN PEOPLE ON THE MEDICATION VERSUS PEOPLE THE SAME AGE NOT ON THE MEDICATION, THERE IS NO REAL DIFFERENCE. YOU HAVE TO REMEMBER THAT SOME PEOPLE DO GET DEPRESSED. A LOT OF PEOPLE TAKE THIS MEDICINE. KIDS THAT ARE ON OR ADULTS ON ACCUTANE USUALLY HAVE QUITE SEVERE ACNE. THAT ITSELF CAN BE DEPRESSING. I SEE MANY PEOPLE THAT ARE... THAT WANT TO GO ON THE MEDICATION AND SEEN THEIR AFFECT, MEANING THEY ARE NOT SMILING, BEFORE THEY ARE ON IT. SO IT CAN BE DEPRESSING, LOOKING IN THE MIRROR EVERY DAY, SEEING ACNE. SO ITS HARD TO KNOW IF ITS THE DRUG OR NOT.

Mary says BUT IT IS A STRONG DRUG.

Nowell says RIGHT.

Mary says WHAT OTHER SIDE EFFECTS COME WITH THE DRUG?

Nowell says THE MAIN ISSUE WITH THE DRUG IS WOMEN TAKING THE DRUG. IF A WOMAN IS ON THE DRUG AND SHE GOT PREGNANT WHILE ON THE DRUG, SHE WOULD HAVE CHILDREN WITH SEVERE BIRTH DEFECTS. THERE IS A WRITTEN CONSENT FORM THAT EVERY DOCTOR SHOULD GIVE TO THE PATIENT TO SIGN GOING THROUGH EXACTLY, IF YOU ARE A WOMAN BE CAREFUL ABOUT BIRTH CONTROL. IT RUNS THROUGH EVERY RISK. RECENTLY THEY ADDED DEPRESSION BECAUSE OF THIS EVENT AND OTHER EVENTS THAT HAPPENED. THE COMPANY SAID, WELL, LET'S WARN EVERYBODY AND IF THEY ARE FEELING SAD, SEE THEIR DOCTOR. SO THAT HAS BEEN THE MAIN ISSUE WITH THE DRUG.

Mary says WHAT CAUSES ACNE? I HAVE HEARD CONFLICTING THEORIES. DIET, NOT DIET.

Nowell says FOR SURE ITS NOT DIET. THERE ARE STUDIES WHO BACK IT UP. PEOPLE SAY I HAVE CHOCOLATE, I BREAK OUT. BUT THERE IS NO DATA. THE ONLY DIET-RELATED THINGS, THERE HAVE BEEN REPORTS OF PEOPLE WHO WORK IN A KIPEN IF YOU ARE WORKING ON A GRILL AND YOU ARE FRYING UP MEAT AND STUFF, OILS SPILL ON YOUR FACE AND CAN CLOG YOUR PORS. BUT DIET, PER SE, ALL THE MOTHER SAYS. RIGHT.

Mary says DIET AFFECTS EVERYTHING, RIGHT? IT DOES AFFECT THE SKIN. THE NATURAL EXTENSION OF THAT IS WOULDN'T THAT BE ACNE?

Nowell says Z BUT ITS NOT. THERE ARE TWO PROBLEMS WITH THE SKIN. ONE IS THE HORMONES. THEY CAUSE CHANGE IN OILS AND FATS UNDERNEATH THE SKIN. THOSE THEMSELVES CAUSE ACNE TO A LARGE DEGREE. AS WELL THERE IS A BACTERIA THAT LIVES IN OUR SKIN. THAT BACTERIA IF IT ACCUMULATE LAITS GETS MORE INTO ACNE. THAT IS SORT OF THE DEEPER PIM APPROXIMATELIES OR WHITE HEADS. THEN THERE IS THE ACNE THAT IS CLOGGED PORES. THAT IS EITHER HORMONES OR SOMETHING EXTERNAL IN THE SKIN, PUTTING LIKE GREASE ON. IF I PUT ON VAST LEAN EVERY DAY, I WOULD BREAK OUT FOR SURE.

Mary says IF SOMEONE HAS ACNE OR PIM APPROXIMATELIES... PIMPLEZ, WHAT SHOULD BE THE DAILY ROUTINE. I THINK WE ARE LED TO BELIEVE WE HAVE TO WASH, WASH, WASH.

Nowell says RIGHT. I THINK THAT A LOT OF... ALL THAT STUFF REALLY DOES ALMOST NOTHING. IF YOU ARE IN A ENVIRONMENT THAT IS DIRTY OR GREASY, THAT CAN CONTRIBUTE TO ACNE. JUST GOING BY EVERY DAY LIFE, ITS IMPORTANT TO CLEAN YOUR SKIN ONCE OR TWICE A DAY BUT THAT IS NOT GOING TO MAKE THE ACNE THAT MUCH BETTER OR WORSE. A LOT OF MOTHERS SAY TELL MY CHILD THAT HE HAS TO WASH HIS FACE FOUR OR FIVE TIMES A DAY. I SAY, ITS NOT TRUE BECAUSE I DON'T BELIEVE IT IS. I THINK THAT IF YOU HAVE ACNE AND EVERYONE HAS DIFFERENT ACNE, THEY SHOULD BE ON A RENN MIN BUT YOU TAYLOR IT TOWARDS THE KIND OF ACNE THE INDIVIDUAL HAS, WHETHER ITS CLOGGED PORES, YOU USE SOMETHING TO PEEL THE SKIN. IF THEY HAVE BACTERIA, PUT THEM ON ANTIBIOTIC. IF THEY HAVE SEVERE ACNE OR SCARRING ACNE, ESPECIALLY, THEN YOU THINK OF ACCUTANE.

Mary says HOW OFTEN SHOULD WE WASH OUR FACE?

Nowell says MOST PEOPLE, TWICE A DAY. THAT IS USUALLY MORNING AND NIGHT. IF YOU ARE DOING EXERCISE OR YOU ARE IN AN ENVIRONMENT WHERE ITS NOT THAT CLEAN, ITS GOOD TO CLEANSE THE FACE. THE IMPORTANT THING ABOUT CLEANING THE FACE THAT I REALIZE IS THAT YOUR FACE DOESN'T HAVE TO BE DRY TO BE CLEAN. IF YOU USE SOAP YOU GET A TIGHT FEELING AND YOU THINK IS MY SKIN CLEAN. WHAT IT DOES IS STRIP THE OILS OFF. YOU CAN USE A CLEANSER TO WASH YOUR FACE THAT HAS NO SOAP AT ALL. YOU HAVE TO GET USED TO IT BECAUSE YOU DON'T FEEL TIGHTENING AND THINK I'M NOT CLEAN. ALL YOU NEED IS A MILD CLEANSER TO TAKE OFF THE EXPOSURE TO POLLUTION AND DIRT. I BROUGHT ONE WITH.

He shows a bottle of cream with a dispenser and says
I FIND THIS HELPFUL FOR PEOPLE IN THE WINTER. I GET REALLY, REALLY DRY HANDS, ESPECIALLY BECAUSE I WASH MY HANDS EV AFTER EVERY PATIENTS. I USE THIS FOR MY FACE TOO. I USE THIS CLEANSER TO TAKE OFF THE DIRT BUT IT WON'T LEAVE ME DRY. WHEN I FIRST STARTED USING IT, I THOUGHT I AM NOT CLEAN BUT YOU ARE.

Mary says Z IT SAYS INSTEAD OF SOAP. WHAT DO WE MEAN BY SOAP. ISN'T THAT GENTLE NERIC?

Nowell says Z IT IS. WHAT A SOAP DOES IS THAT THE CHEMICALS IN SOAP MIX WITH THE OILS ON YOUR SKIN. STRONGER ONES REMOVE MORE. SO THEY CAN BE QUITE STRONG AS REMOVING OILS. SOMETIMES YOU DON'T NEED THAT, YOU JUST NEED SOMETHING TO TAKE OFF THE SURFACE. WE ALL HAVE OILS ON OUR SKIN. IF YOU ARE AN OILY PERSON, YOU WOULD LIKE SOAP BECAUSE IT WILL STRIP THE OIL AND YOU LIKE IT. IF YOU ARE MORE TOWARDS DRY SKIN, YOU COULD CHOOSE A SOAP SUBSTITUTE SO YOU CAN WASH YOUR FACE AND NOT NEED A MOISTURIZER AFTER.

Mary says BUT GENERALLY, WOULD THESE OILS THAT WE NATURALLY HAVE, GENERALLY, THEY ARE A GOOD THING?

Nowell says RIGHT. IF I TOOK SOAP AND TOOK IT OFF, MY BODY REPLENISHES THE OILS. YOU ARE DRY UNTIL THEY REPLENISH. MOISTURIZES HELPS GIVE YOU BACK THE MOISTURE. BUT IF YOU ARE ALREADY DRY, WHY USE SOMETHING TO STRIP AWAY THE OIL YOU HAVE LEFT?

Mary says WHAT DOES THAT SAY ABOUT THINGS LIKE FACIALS?

Nowell says I THINK FACIALS ARE GOOD PAMPERING. THEY MAKE YOU FEEL NICE. THEY ARE NICE. IF YOU HAVE A LOT OF CLOGGED PORES, THEY CAN OPEN THEM AND REMOVE THEM. DO I THINK THAT YOU ARE GOING TO HAVE YOUNGER-LOOKING SKIN FOR LIFE BECAUSE OF FACIALS? NO. DO I THINK ITS NICE AND ENJOYABLE? YES. THAT IS MY PHILOSOPHY ON THEM.

Mary says THE LINES ARE FULL. LET'S TAKE CALLS. TERRY?

The Caller says HELLO. YES. HI, MARY. SO GLAD YOU HAVE THE DOCTOR ON. I HAVE A PROBLEM OF SUPER DRY SKIN. I HAVE GONE TO A DOCTOR BECAUSE I GET A BREAKOUT OF ECZEMA, RED SPOTS HERE AND THERE. ITS ONLY IN MY FACE. EVERY TIME I GO TO THE DOCTOR, HE GIVES ME CORTISONE WHICH DON'T WORK. I GO TO THE TANNING BOOTH AND I TAKE CARE OF IT. IS THE HEAT THE SOLUTION? I'M REALLY UPSET ABOUT IT BECAUSE ITS ALWAYS IN MY FACE.

Nowell says WELL, I DON'T KNOW IF IT IS ECZEMA OR NOT. THAT WOULD BE A THING A DOCTOR WOULD LOOK AT TO KNOW RIGHT AWAY. TANNING ITSELF IS USUALLY NOT SOMETHING WE RECOMMEND FOR TREATING SKIN PROBLEMS. WE DO FOR SOME THINGS BUT TANNING ITSELF HAS ITS OWN PROBLEMS AND COMPLICATIONS.

Mary says WHICH ARE?

Nowell says PREMATURE AGING BUT MORE IMPORTANTLY, SKIN CANCER. THE TANNING BEDS, THE ULTRA VIOLET-A IS NOT SAFE. EVERYONE THINKS ITS SAFE.

Mary says IS IT THE SAME AS THE SUN?

Nowell says THE BEDS ARE UVA. THEY SAY ITS THE B THAT CAUSES CANCER BUT MANY STUDIES SHOW A AND B CAUSES CANCER. THOSE PEOPLE WANT YOUR BUSINESS. I ALWAYS SAY, IF YOU GO TO A TANNING BED, ITS BETTER FOR ME BECAUSE I HAVE A BIG PRACTICE OF SKIN CANCER. BUT I WOULD SAY DON'T GO. THEY ARE NOT SAFE. IF THE STEROIDS ARE NOT WORKING, IT MEANS THE DOCTOR DIDN'T GIVE THE APPROPRIATE STEROID OR MAYBE IT ISN'T ECZEMA AND NEEDS SOMETHING ELSE. IF IT IS ECZEMA, THERE IS A NEW CREAM OUT FOR ECZEMA. THE TRADE NAME IS PROTOPIC. THIS IS A DRUG THAT WAS AVAILABLE THAT WE USE INTERNALLY FOR PEOPLE WITH TRANSPLANTS SO THEY DON'T REJECT THE TRANSPLANT. WHAT IT DOES IS TAKES THE IMMUNE SYSTEM AND TONES THE IMMUNE SYSTEM DOWN SO THAT YOUR BODY WON'T JEKT THE ORGAN. WELL THEY FOUND THE SKIN WAS BETTER. WE KNOW THAT ECZEMA IS RELATED TO THE FACTS OF THE FACTORS, THINGS THAT CHANGE, IF YOU CAN LOWER THOSE, THE ECZEMA GOT BETTER. THIS TARGETS IT WHERE WE WANT IT. SO THEY WERE ABLE TO PUT IT IN A CREAM FORM. THERE IS A VERY, VERY LITTLE AMOUNT OF THE CREAM THAT IS ABSORBED SO ITS VERY SAFE. THE PROBLEMS WITH STEROIDS, THINNING THE SKIN, SOME PEOPLE DON'T LIKE THAT. THIS DOESN'T OCCUR WITH THE CREAM. SO IF YOU TRULY HAVE ECZEMA AND ITS NOT GETTING BETTER, THIS MAY BE SOMETHING THAT MAY BE THE PERFECT ANSWER. I THINK ITS PHENOM NATURAL, ESPECIALLY WITH PEOPLE WITH SEVERE ECZEMA.

Mary says SO YOU WOULD SEE YOUR DORM TOLL JIST FOR THIS DRUG?

Nowell says ABSOLUTELY.

Mary says LET'S TAKE ANOTHER CALL. JILL?

The Caller says HI. GOOD AFTERNOON. I SUFFER FROM PSORIASIS, I HAVE FOR YEARS AND YEARS. I HAVE IT ON MY STALL P AND THE PLAQUE SPOTS ON MY BODY. I CURRENTLY USE A MEDICATION WHICH WORKS GREAT ON MY SCALP BUT NOT ANYWHERE ELSE. I AM WONDERING... I HAVE TRIED EVERYTHING. THE TANNING BEDS SEEM TO HELP A WE BIT BUT THERE IS... I'M SCARED OF THE TANNING BEDS WITH THE CANCER AND PREMATURE AGING. I'M WONDERING IF YOU HAVE ANY IDEAS OR ANY NEW CREAMS FOR PSORIASIS?

Nowell says THERE IS NOTHING BRAND-NEW. THERE ARE A LOT OF AVAILABLE CREAMS FOR PSORIASIS AN A LOT OF TREATMENTS. THERE IS A HUGE LIST. USUALLY THE BIGGER THE LIST THE POORER WE ARE AT TREATING IT. WHEN SOMETHING WORKS AMAZING, WE SAY DO THIS.

Mary says THAT MAKES SENSE ABOUT A LOT OF CONDITIONS.

Nowell says YES. THERE IS NO MAGIC CREAM. WITH PSORIASIS, THE OTHER PROBLEM IS WHEN YOU FIND SOMETHING THAT WORKS FOR YOU, AFTER A WHILE, THE CREAM STOPPED WORKING SO YOUR BODY GETS USED TO IT. WITH PSORIASIS, YOU GO TO A DIFFERENT DOCTOR AND YOU TRY THIS, MIRACLE, THREE MONTHS LATER, ITS COMING BACK. TRY DIFFERENT THINGS. IF ITS NOT WORKING, HAVE YOUR DOCTOR SWITCH TO SOMETHING ELSE. KEEP ROTATING AMONG THINGS. THERE ARE A LONG LIST OF OPTIONS FOR YOU, ALL OF WHICH ARE NOT PERFECT. THERE IS NO AMAZING THING. THEY HAVE BEEN WOSHING WITH DIFFERENT THINGS AND THERE ARE TRIALS OR STUDIES GOING ON LOOKING AT DIFFERENT THINGS. THE BEST THING HAS NOT COME OUT YET. MANAGE WITH WHAT YOU HAVE AND KEEP TRYING NEW THINGS AS THEY COME.

Mary says DO CONDITIONS SUCH AS PSORIASIS GET WORSE IN THE WINTER?

Nowell says THEY DO, ESPECIALLY ECZEMA. WE ARE DRY IN THE WINTER. THE DRIER WE ARE, THE WORSE THE ECZEMA IS. PSORIASIS CAN FLARE IN THE WINTER BECAUSE THE SUN ITSELF CAN TAME DOWN THESE CONDITIONS SO THAT GIVES A LITTLE BIT OF IMPROVEMENT. VERY COMMONLY, LIKE MY KIDS, TWO OF MY THREE HAVE ECZEMA. I NEVER SEE IT UNTIL WINTER. ITS THE BEGINNING. WHEN THE WEATHER GOES COLD AND YOUR SKIN HASN'T HAD TIME TO CHANGE, IT COMES OUT.

Mary says WHAT DO YOU SUGGEST ABOUT GENERAL WINTER DRYNESS? THEIR SKIN GETS ITCHY AND FLAKY.

Nowell says ITS COMMON IN CANADA AND WHERE ITS COLD AND DRY. FIRST THE GENERAL THINGS IN THE HOME, HELP THE ENVIRONMENT. I HAVE A HUGH MID FIRE BECAUSE WE GET DRY. BUT THAT IS NOT ENOUGH, SO WHAT DO YOU SPEND YOUR TIME IS SLEEPING. IN THE BEDROOM WE HAVE SMALL HUH MID FIERS TO HELP THE HELP THE AIR. AFTER YOU WASH, APPLY A MOISTURIZER. GET IN THE ROUTINE OF PUTTING IT ON EVERY DAY.

Mary says DOES IT DEPEND WHAT KIND OF MOISTURIZER?

Nowell says YEAH. THERE ARE A MILLION.

Mary says YES.

Nowell says NO MAGIC ONE. SOME ARE RICH AND OILY. SOME ARE NOT. IF YOU DON'T KNOW IF YOURS IS OILY, TAKE SOME, PUT IT ON YOUR HAND, RUB IT ON. IF THERE IS OIL, THE HEAT FROM YOUR FINGERS WILL MAKE IT WARM. IF ITS MOSTLY WATER, IT WILL FEEL COOL. ONES WITH WATER ARE GOOD FOR THE FACE BUT FOR YOU BODY YOU MAY NEED SOMETHING RICHER. THE MORE CREAMY IT IS, THE RICHER. SO FIND ONE YOU LOOK AND DO NOT SPEND MORE THAN 20 dollars. THERE IS NOTHING WRONG WITH THE INEXPENSIVE ONES. THERE IS ONE 100 dollars BUT THERE IS NO NEED TO SPEND THAT KIND OF MONEY. IF THOSE DON'T WORK... I TOOK THESE FROM MY HOUSE.

He shows another bottle of moisturizer and says
THIS ONE I LIKE. IT DOESN'T MATTER BUT I FINE IT NICE FOR MY SKIN. THAT DOESN'T MEAN ANYTHING. THIS IS A REGULAR MOISTURIZER WHICH IS OIL, WATER.

Mary says THAT IS AVAILABLE ANYWHERE?

Nowell says ANY DRUG STORE. YOU CAN BUY ANY. IT DOESN'T MATTER. IF THESE ARE NOT DOING THE TRICK, THEN YOU NEED ONE THAT IS TARGETED FOR DRY SKIN. THOSE USUALLY HAVE ACID IN THEM. THE ACID ITSELF WILL BIND WATER SO IT WILL STICK WITH WATER AND PUT WATER INTO THE SKIN. THESE MAKE A LAYER TO STOP EVAPORATION. THERE ARE A COUPLE AROUND. I BROUGHT ONE. A SMALL BOTTLE.

He shows a small bottle of cream and says
THIS IS AVAILABLE OVER THE COUNTER. ITS PRESCRIPTION IN THE STATES, I DON'T KNOW WHY. THIS IS LACTIC ACID. THESE ARE GOOD IF YOU ARE REALLY DRY. THE PROBLEM WITH THESE IS THE FIRST COUPLE TIMES YOU PUT IT ON, THEY STRING. SO THEY CAN STRING SO SOMETIMES I PUT THIS ON AND PUT ANOTHER CREAM ON TOP. SOME PEOPLE CAN'T USE IT. THAT HAPPENS IF FIRST COUPLE DAYS, BUT AFTER ITS REALLY GOOD.

Mary says OKAY. I AM GETTING CONFUSED BECAUSE I HAVE HEARD SO MANY ACID NAMES. RIGHT? YOU MENTIONED LACTIC ACID?

Nowell says RIGHT.

Mary says WHAT ABOUT THE OTHER ACIDS?

Nowell says THOSE HELP A LITTLE BIT AS WELL. THOSE ARE TARGETED FOR ANTIAGING BECAUSE THEY FOUND THE IRRITATION THEY HAVE OF THE SKIN CAN REMOVE SOME OF THE BROWN MARKS FROM OUR SKIN AND PLUMP THE SKIN UP. THOSE WORK BETTER FOR ANTIAGING PURPOSES. THE TWO MAIN ONES FOR DRYNESS ARE UREA. BUT THE ANTIAGING ONES HELP.

Mary says THESE ONES FOR DRYNESS.

Nowell says RIGHT.

Mary says Z LOOK FOR THAT IN THE LIST OF INGREDIENTS.

Nowell says RIGHT. USUALLY ITS THE TOP THING. IT SAYS RIGHT ON IT. LACTID ACID, 12 percent, THAT IS AS LONG AS YOU CAN GET. IT SAYS RIGHT HERE. THEY ARE TARGETED FOR THAT.

Mary says OKAY.

As he shows a larger bottle, Nowell says TWO OTHER QUICK THINGS. IF YOU BATH OR SHOWER, KIDS GET PROBLEMS. PUTTING OIL IN THE BATH ALLOWS THE OIL COAT TO GO THE SKIN WHICH HELPS KEEP DRYNESS AWAY IN THE SKIN. THE NICE THING ABOUT THIS IS IT DOESN'T RUIN THE BATHTUB. OTHER OILS STICK AND MAKE IT HARD TO CLEAN. THIS ONE DOESN'T. THE THING WE FORGET IS OUR LIPS. A LOT OF PEOPLE GET DRY LIPS. YOU CAN USE ANY MOISTURIZER. I BROUGHT ONE IN THAT I HAD AT HOME BUT IT DOESN'T MATTER. THEY ARE ALL A DOLLAR OR TWO DOLLARS.

He picks up a tiny round container and says
THEY USUALLY HAVE MENTHOL, SOMETHING TO SOOTHE THE SKINS. A LOT OF PEOPLE GET CRACKED SKIN, ESPECIALLY IF THEY SKI OR ARE OUT ALL DAY. REAPPLYING PUTS A LAYER OF PROTECTION ON THE SCREEN.

Mary says IT SAYS FOR COLD SORES.

Nowell says DOESN'T WORK FOR COLD SORES. ITS HOW THEY MARKET IT. IT SOOTHS THE PAIN OF A COLD SORE BUT DOESN'T MAKE IT GO AWAY. I LIKE IT BECAUSE ITS GREASY AND IT WORKS WELL ON LIPS. FOR COLD SORES, FORGET IT.

Mary says WHAT CAN YOU DO WITH COLD SORES? THAT IS A WINTER PROBLEM.

Nowell says YEAH, YEAH. COLD SORES, THERE ARE A FEW THINGS. THERE ARE MEDICATIONS YOU CAN GET A PRESCRIPTION 50 dollar CREAM TO PUT ON. BUT THAT ONLY SHORTENS THE LENGTH OF THAT COLD SORE BY A DAY.

Mary says IS IT BECAUSE ITS A VIRUS?

Nowell says CORRECT. ITS HERPES. IF YOU TAKE PILLS TO KILL THE VIRUS, THEY HELP MORE. IF YOU GET A LOT OF COLD SORES, EIGHT, TEN A YEAR, PEOPLE GO ON THESE PILLS EVERY DAY AND DECREASE THEIR SORES TO ONE OR TWO A YEAR. ITS A VERY SAFE DRUG. PEOPLE WITH RECURRENT COLD SORES, I SAY GO ON THE PILLS. WE LOWER THE DOSE UNTIL WE FIND THE MINIMUM AMOUNT NEEDED AND THEY ARE HAPPY.

Mary says LET'S GET ANOTHER CALL. TERESA? HI.

The Caller says HI. THANKS FOR TAKING MY CALL. THE QUESTION IS MY HUSBAND DEVELOPED A RASH THREE MONTHS AGO. HE WAS DIAGNOSED AS LIPTENPLANT IS. I'M WONDERING IF THERE IS HELP.

Mary says THERE ARE THINGS TO MAKE IT FEEL BETTER. THERE IS NO CURE THAT YOU CAN GIVE PEOPLE SOMETHING AND IT WILL GO AWAY. LIKEN, PLANT IS.
ITS A VERY UNUSUAL RASH IN THE SENSE ITS NOT A COMMON THING. UNDER THE MICRO SKROP THEY HAVE A CLASSIC LOOK TO THEM SO WE KNOW WHAT IT IS. THE SKIN GETS INFLAMED, ITCHY AND YOU GET BUMPS ON THE WRISTS OR ANKLES. THEY ARE ITCHY AND RED. STEROID CREAMS HELP TO THE ITCH AND REDNESS. ITS NOT GOING TO LAST FOREVER. YOU CAN MAKE IT GO, SOMETIMES IT COMES BACK. IT CAN HANG AROUND FOR A YEAR OR SO BUT AT LEAST ON THE CREAMS, YOU CAN MAKE THE SYMPTOMS GO AWAY. IF A PERSON HAS NO SYMPTOMS, WE DON'T TREAT IT BECAUSE ITS GOING TO GO AWAY ANY WAYS. BUT ITS NOT DANGEROUS, DEFINITELY VERY STRONG CREAMS WILL MAKE IT BETTER.

Mary says LET'S TACKLE THE ANTIAGING AREA. I AM CURIOUS, WHAT PERCENTAGE OF THE PEOPLE YOU SEE ARE COMING TO SEE YOU FOR ANTIAGING TECHNIQUES?

Nowell says MY PRACTICE IS UNUSUAL. AT LEAST 60 percent OF MY PRACTICE IS THAT. THE OTHER PART OF MY PRACTICE IS SKIN CANCER. THAT IS MY MAIN TWO THINGS THAT I DO. ANTIAGING IS A HUGE THING, TLI DAYS A WEEK FOR ME.

Mary says WOW. WE TALKED EARLIER ABOUT ACIDS. I DON'T KNOW WHEN IT WAS IT CAME OUT, WAS THAT THE 80s?

Nowell says LATE 80s, EARLY 90s.

Mary says THEN WE SAW HUNDREDS OF PRODUCTS. RECENTLY A COUPLE YEARS AGO, I REMEMBER READING EVIDENCE. THE RESEARCH WAS SAYING IN FACT THESE ALPHA HIGH DROX E ACIDS MAY AGE THE SKIN MORE THAN HELPING THE SKIN. WHAT DO YOU THINK? IS IN A JUDGMENT ON THAT?

Nowell says THEY ARE NOT AGING THE SKIN. THERE WAS A WORRY OF DRYING THE SKIN AND CHANGING THE COMPOSITION BUT REALLY THEY ARE ANTIAGING IN THE SENSE THAT THEY MAKE THE TEXTURE OF THE SKIN BETTER. YOUR SKIN GETS MORE SHINY, GLOWING. THE BROWN SPOTS OR ROUGH SPOTS ARE SOOTHER. ALL AHAS WILL DO IS GIVE YOU A SHINE, A GLOW. THEY WILL MAKE YOUR SKIN MORE VIBRANT. THE TRENDS ARE, SOMETHING NEW WILL COME ALONG AND THEY WILL PUT A TWIST ON IT AND THAT LASTS A YEAR, THEN ANOTHER THING COMES. FIRST IT WAS AHA, THEN BETA, THEN RETNOL BS, YOU CAN BUY THAT WHY A CREAM AND IT GOES ON WELL, ITS CONVERT ND THE SKIN TO TINY AMOUNTS OF RETNA.

Mary says VITAMIN A?

Nowell says CORRECT. EVERYONE THOUGHT THEY WERE BUYING THAT BUT IT WAS A TINY AMOUNT. GREAT MARKETING THING. IT WORKS A LITTLE SO THEY ARE NOT LYING TO YOU. THAT CAME OUT, SO, YOU KNOW, SOMETHING NEW COMING ALONG. ALL THESE CREAMS HELP A LITTLE BIT.

Mary says DO YOU MEAN SUPERFICIALLY?

Nowell says CORRECT. JUST THE UPPER LAYERS OF THE SKIN. YOUR MAKEUP GOES ON EASIER AP YOU FEEL EVEN BUT THEY ARE NOT GOING TO MAKE WRINKLES DISAPPEAR. THEY WILL JUST MAKE YOU LOOK MORE RESTED, SORT OF, REFRESHED.

Mary says GOING BACK NOW WITH THIS RETINOL, IF WE WENT TO THE REAL STUFF, RETINA, WHAT ABOUT THAT?

Nowell says THAT IS GREAT. ITS NOT GOING TO MAKE DEEP LINES GO AWAY. THERE HAVE BEEN HUGE STUDIES, TWO YEAR STUD IS WHERE THEY TOOK A PIECE OF PEOPLE'S SKIN AND LOOKED AND THEY HAD THEIR SKIN FROM TWO YEARS PRIOR AND YOU HAVE AGED TWO YEARS AND THE SKIN LOOKS YOUNGER. IT HAS MORE COLLAGEN, BETTER ELASTIC TISSUE THAN IT HAD. SO YOU ARE LOOKING AT SKIN TWO YEARS OLDER WHICH LOOKS YOUNGER THAN IT DID BEFORE. I PUT A LOT OF MY PATIENTS IF THEY CAN TOLERATE IT ON THAT BECAUSE IT WILL EVEN OUT THE COLOR, SHINE THE SKIN, BETTER JOB OF GETTING RID OF FINE LINES. A LOT OF PEOPLE SAY I DON'T THINK ITS DOING ANYTHING, BECAUSE ITS GRADUAL. BUT I ALWAYS SAY, WELL, YOUR SKIN HAS NOT AGED MUCH IN TWO YEARS AND YOU ARE TWO YEARS OLDER. YOU THINK, YOU KNOW WHAT, THAT IS SORT OF RIGHT.

Mary says GRADUAL. HOW LONG WOULD IT TAKE?

Nowell says MONTHS.

Mary says OKAY.

Nowell says YOU HAVE TO START IT SLOWLY BECAUSE IT'S IRRITATING.

Mary says YOU SAID IF THEY CAN TOLERATE IT.

Nowell says RIGHT. IF I GAVE IT TO YOU AND YOU PUT IT ON EVERY NIGHT AND YOU PUT ON A LOT, YOU ARE RED, DRY, IRRITATING. YOU SAY I CAN'T USE IT AND THROW IT OUT. THAT IS A COMMON MISTAKE. WHAT WE DO IS START EVERY THIRD NIGHT, A TI ANY BIT. GRADUALLY INCREASE IT. YOU'LL FIND THAT AFTER A WHILE YOUR BODY WILL TOLERATE IT AND YOU CAN USE IT EVERY NIGHT. IT CAN TAKE A MONTH TO GET THERE BUT YOU DON'T START NOTICING CHANGES FOR THREE TO SIX MONTHS. ITS A GRADUAL CHANGE. WE DON'T NOTICE OUR HAIR GROWING DURING THE DAY BUT YOUR HAIR IS GROWING. SIX MONTHS LATER, WOW, MY HAIR IS LONG. SAME WITH YOUR SKIN. SLOWLY GETS BETTER, SO ITS HARD TO NOTICE THE CHANGE.

Mary says YOU SAY THIS IS AN INCREASE IN COLLAGEN?

Nowell says CORRECT.

Mary says SO ITS MORE THAN SUPERFICIAL?

Nowell says RIGHT. ITS BUILDING IT UP. OVER THE COUNTERS DON'T COME CLOSE.

Mary says THAT IS THE FINAL WORD OF EVERYTHING OUT THERE, WHAT DOES WORK AS FAR AS ANTIAGING? IS THIS IT?

Nowell says THE OTHER STUFF WORKS A LITTLE BIT. THIS IS MUCH MORE DRAMATIC. ITS NOT EXPENSIVE. YOU CAN GET DIFFERENT VARIETIES. YOU ARE STILL TALKING MAYBE 40, 50 DOLLARS. A TUBE LASTS LIKE SIX MONTHS. SO IT... WHEN YOU COST IT OUT PER MONTH, YOU ARE STILL LOOKING AT 10 dollars OR LESS A MONTH, WHICH IS REASONABLE. THINK OF THE MONEY YOU SPEND OH ON OTHER THINGS THAT DO NOTHING. PEOPLE PUT MOISTURE ON TO KEEP LOOKING YOUNG. THAT IS NICE BECAUSE IF THEY ARE DRY, THEY HELP. ITS LIKE SHINING SHOES, YOU SHINE THEM AND THEY LOOK GREAT BUT IT DOESN'T MAKE THE LEATHER YOUNGER. BUT FOR A FEW MINUTES, IT LOOKS BETTER.

Mary says LET'S TAKE AN E-MAIL.

Mary reads from a laptop computer and says I AM 45 AND HAVE FEW WHIN KLS BUT I HAVE A FURROW BETWEEN MY BROWS. WHAT IS THE BEST WAY TO ELIMINATE THIS, COLLAGEN OR BOTOX?

Nowell says THIS IS MY FAVORITE TOPIC.
[LAUGHTER]
THERE IS NO QUESTION THAT IF YOU GET A LINE IN HERE THAT BOTOX IS THE TREATMENT OF CHOICE. WHAT HAPPENS, THE REASON WE GET VERTICAL LINES HERE IS FROM FROWNING. I NEVER USED TO BE ABLE TO FROWN. I TRAINED MYSELF IN A MIRROR, NOW I'M WORRIED I WON'T BE ABLE TO STOP IT. IF YOU FROWN ALL THE TIME AND YEARS AND YEARS, YOU WILL GET A CREASE, JUST LIKE FOLDING A BOOK. EVENTUALLY THAT CREASE WILL BECOME PERMANENT. IF I CAN PUT A DRUG LIKE BOTOX IN, I CAN STOP YOU FROM FROWNING. IF I CAN STOP YOU FROM MAKING THE MOVEMENT THAT CAUSES THE LINES, I CAN PREVENT THE LINE FROM GETTING WORSE, NUMBER TWO, I CAN GET RID OF THAT FROWN LOOK WHICH IS USUALLY A NEGATIVE LOOK, WORRY, CONCERN. THREE, I CAN MAKE THE WRINKLES BETTER BECAUSE ITS SO RELAXED THAT THE SKILL FULS BACK. THE MUSCLES THAT BULK UP IN THERE, THEY GET BIG. SO PEOPLE GET BULGES THERE. IF YOU CAN'T MOVE THE MUSCLES, THE MUSCLES GET THIN. JUST LIKE IF ARNOLD DIDN'T WORKOUT, HE WOULD LOOK LIKE ME. SO THE AREA CAN GET SMOOTH. SO THAT IS THE BEST TREATMENT. ITS JUST ABSOLUTELY SO IMPRESSIVE THAT ITS ADDICTING IN THE SENSE THAT YOU LOVE THE RESULTS.

Mary says ADDICTING. THAT SOUNDS SCARY THERE. I CAN SEE PEOPLE... ARE THEY GETTING ADDICTED?

Nowell says IF SOMEONE COMES TO ME AND SAYS ITS MY BIRTHDAY. I'M DOING THIS ONCE. I WANT BOTOX PUT IN. IT'S A BIG PARTY WHATEVER. I SAY DON'T DO IT. WHEN YOU SEE THE RESULTS YOU CAN GET, IF YOU ARE NOT GOING TO BE ABLE TO DO IT AGAIN, YOU ARE GOING TO BE UPSET BECAUSE YOU WILL SAY LOOK AT THE DIFFERENCE, ITS SO AMAZING. IF YOU ARE NOT GOING TO DO IT AGAIN, I WOULDN'T DO IT BECAUSE ITS ADDICTING BECAUSE YOU LOVE THE LOOK. PEOPLE COME BACK AND NEVER LET THEMSELVES GET BACK TO ZERO AGAIN BECAUSE THEY NOTICE IT AND DON'T WANT TO GO BACK THERE AGAIN.

Mary says SO IT IS IN A SENSE LIKE AN ADDICTIVE DRUG? ONCE YOU HAVE DONE IT, YOU HAVE SIGNED ON FOR LIFE. WHY WOULD YOU WANT TO GO BACK?

Nowell says TRUE. JUST LIKE IF YOU TOLD ME THERE IS A CREAM YOU CAN RUB ON MY SCALP TO MAKE MY HAIR GROW BACK, I WOULD SAY GREAT.

Mary says BUT YOU HAVE TO DO IT EVERY DAY FOR LIFE.

Nowell says I WOULD DO IT IF YOU TOLD ME IT WAS 100,000 dollars AND I COULD ONLY DO IT ONCE BECAUSE I WOULDN'T HAVE IT AGAIN. PEOPLE KEEP COMING BACK BECAUSE IT PERFORMS. OTHER THINGS THAT WE DO SOMETIMES DON'T GIVE AS GOOD RESULTS. CHEM KEL PEELS LOOK FRESHER BUT ITS NOT A BIG DIFFERENCE. PUTTING COLLAGEN IN A LINE CAN MAKE A DIFFERENCE. SOME PEOPLE IT MAKES THEM HAPPY AND SOME PEOPLE NOT. SOME THINGS LIKE BOTOX HAVE SUCH IMPROVEMENTS AND IS SO SIMPLE AND SAFE AND EASY THAT IT IS ADDICTING.

Mary says HOW MUCH DOES THIS COST US?

Nowell says THE AVERAGE AREA TO DO, LIKE A FOREHEAD... THE SPURROW WOULD BE 400 dollars TO DO THAT. IT WOULD LAST... THE FIRST TREATMENT LASTS FOUR MONTHS BUT IT GETS LONGER. MOST PEOPLE LAST SIX MONTHS AFTER THEY HAVE DONE IT A NUMBER OF TIMES. IT BECOME AS TWICE A YEAR THING.

Mary says 400 dollars. THIS IS AN INJECTION?

Nowell says RIGHT.

Mary says OF WHAT, LIQUID?

Nowell says RIGHT.

Mary says WHERE IS THE... WHY IS IT 400 dollars?

[LAUGHTER]

Nowell says ITS AN EXPENSIVE DRUG.

Mary says IS IT?

Nowell says EXTREMELY.

Mary says Z SO ITS NOT LABOR.

Nowell says NO. ITS EXPENSIVE. A TON OF RESEARCH HAD TO BE PUT IN BECAUSE IT'S A BUY LODGIC DRUG. ITS NOT LIKE YOU CAN COPY IT. ITS NOT LIKE ASPIRIN. THE PA TENTS WILL NEVER RUN OUT ON THOSE DRUGS. ITS LIKE A VACCINE. PA TENTS DON'T RUN OUT. THEY HAVE TO MAKE NEW BATCHES, PROVE ITS SAFE, DO ALL THE TESTING. SAME THING FOR BOTOX.

Mary says PEOPLE MAY NOT REALIZE ITS FROM A POISON.

Nowell says CORRECT. EVERYONE ASKS CAN I GET SICK FROM IT? THE ANSWER IS I WOULD HAVE TO INJECT SO MUCH IN YOU THAT IT WOULD COST ME... SOMETHING LIKE 15,000 dollars WORTH OF THE DRUG. I WOULD HAVE TO BUY PERSONALLY, INJECT IT INTO YOUR BLOOD. EVEN THEN THE CHANCE IS VERY LOW. I WOULDN'T SPEND THAT MONEY ON CAUSING THAT. YOU DON'T GET THE PROBLEM. THE AMOUNT IS SO SMALL WHEN WE USE IT FOR MEDICAL REASONS, WE WILL USE THREE TO TEN TIMES THE AMOUNT. AGAIN, WITH NO PROBLEMS. SO ITS EXCEPTIONALLY SAFE BUT A LOT OF MONEY GOES INTO MAKING IT. THE DRUG IS EXPENSIVE. BOTOX IN CANADA IS THE ONLY PLACE YOU CAN GET IT IS ONE COMPANY.

Mary says WHAT WOULD BE THE DOWN SIDE OF USING BOTOX?

Nowell says YOU CAN'T DO IT IF YOU ARE PREGNANT OR BREAST-FEEDING. THERE ARE RARE NEUROLOGIC DISEASES, VERY UNCOMMON. IF YOU HAD THE DISEASE YOU WOULDN'T BE COMING INTO THE OFFICE ANY WAYS. OTHERWISE, THOSE ARE THE ONLY REASONS NOT TO DO IT. THE RISKS ARE THAT YOU CAN GET A SMALL BRUISE WHERE YOU PUT A NEEDLE IN. YOU CAN HAVE A DULL HEADACHE AFTERWARDS. ITS NOT COMMON BUT SOME PEOPLE GET IT.

Mary says IT DOES RELIEVE HEADACHES.

Nowell says IF YOU FROWN A LOT, YOU GET TENSION HEADACHES. OTHER PEOPLE GET MIGRAINES FROM SPASMS. SO WE USE IT AS A TREATMENT FOR THAT.

Mary says SO IS IT INJECTED INTO THE MUSCLE?

Nowell says EXACTLY.

Mary says TO RELAX IT.

Nowell says RIGHT.

Mary says IS THERE A RISK IN THAT?

Nowell says NOT REALLY. IF YOU DO THE FROWN AREA... WE DON'T SEE THIS ANYMORE... BUT A WEEK AFTER IF YOU PUT IN THE WRONG AREA OR A LEARN LAY DOWN WITHIN FOUR HOURS, ONE EYE LID COMES DOWN, GOES LIKE THAT, LASTS SEVEN TO TEN DAYS AN GOES BACK UP. THAT HAPPENS, TO ME, ONE IN THOUSANDS. I RARELY SEE IT. I WITH THINK OF ONE OR TWO IN THE LAST FIVE YEARS. THAT IS THE ONLY THING. IT LASTS ABOUT A WEEK. MOST PEOPLE GET IT DONE AND BY THE TIME THEY LEAVE THE OFFICE, YOU WOULD NEVER KNOW BECAUSE YOU CAN'T NOTICE MARKS OR ANYTHING. THERE IS REDNESS FOR 15 MINUTES AND THAT IS IT. IT STARTS TO WORK AFTER TWO OR FOUR DAYS AND GETS BETTER FOR TEN DAYS. SO ITS GRADUAL. ITS NOT LIKE YOU HAD A MAJOR PROCEDURE AND LOOK DIFFERENT. THERE IS NO DOWN TIME TO IT. Z.

Mary says LET'S TAKE ANOTHER CALL. ELEN?

The Caller says HI. I'M WONDERING IF YOU CAN HELP ME. I CAUGHT STEVCAUSECUSTODY I BELIEVE FROM THE HOSPITAL AND I HAVE HAD IT TWO YEARS IN FEBRUARY. I HAVE THE PROBLEM OF I WON'T GO OUTSIDE BECAUSE OF MY FACE. I GET THESE BIG LESIONS. ITS NOT ACNE, SOME OF THEM ARE AN INCH BY AN INCH. THEY POP UP. THEY HAVE A CRUST. MY FACE IS JUST TOTALLY SCARRED. MY SHOULDERS, MY BREASTS. EVERYTHING. DO YOU KNOW, LIKE, WHAT I CAN DO?

Nowell says WELL, I'M NOT SURE IF YOU HAVE STAVE. THAT IS A BACTERIA. YOU CAN GET A BACTERIA INFECTION IN A HOSPITAL FROM A PROCEDURE, FROM SOMEONE DOWN THE STREET. OT SO ONE THING IS THAT SOME PEOPLE ARE CARRIERS. 10 percent OF PEOPLE ARE CARRIERS OF THIS BACTERIA. WHICH MEANS IF I PUT SWABS ON YOUR SKIN, UNDER THE ARMS, IN THE NOSE, I COULD GROW IT IN 10 percent OF PEOPLE. IF THEY HAVE IT ON THEIR BODY NORMALLY AND THEY GET A CRACK IN THE SKIN OR A BREAK, SOMETIMES THAT BACTERIA WILL GO THERE AND OVER GROW AND WE GET INFECTION. BUT IF YOU HAVE EVERY DAY FOR TWO YEARS AND THAT DOESN'T SOUND LIKE STAFF. THAT SOUNDS LIKE SOMETHING ELSE IS GOING ON AND YOU ARE GETTING INFECTIONS WITHIN WHATEVER IS GOING ON. IF YOU ARE TRULY A CARRIER, WHICH IS EASY TO FIND OUT, GO TO THE DOCTOR AND TAKE A SWAB, SEND IT AWAY AND GET AN ANSWER, THEN THERE ARE TREATMENTS TO FIX THAT. I DON'T KNOW IF YOU CAN FIX IT FOREVER. USUALLY IT COMES BACK A BIT BECAUSE YOUR BODY LIKES TO GROW IT. THERE ARE PILLS FOR THAT, SPECIAL ONES. OR CREAMS YOU CAN USE. YOU SOUND LIKE MORE THE KIND OF PERSON THAT SHOULD GO AND SEE A SPECIALIST, SEE A DESHL TOLL JIST TO FIND OUT WHAT IS GOING ON. WHETHER YOU HAVE THIS MAY BE SECONDARY. YOU MAY HAVE SOMETHING GOING ON AND THE BACTERIA IS GOING THERE. SO YOU SHOULD BE CHECKED OUT BY A SPECIALIST.

Mary says OKAY. WE ARE TALKING ABOUT YOUR SKIN TODAY. IT'S THE LARGEST ORGAN IN YOUR BODY. IF YOU ARE HAVING PROBLEMS WITH IT, WINTER PROBLEMS OR YEAR ROUND PROBLEMS, CALL.

The phone numbers and email reappear briefly.

Mary says WE HAVE KAY ON THE LINE. HI.

The Caller says HI. THANKS FOR TAKING MY CALL. I'M WONDERING IF YOU COULD TALK ABOUT ADULT ACNE. I AM IN MY 40s. COULD YOU TELL ME WHAT YOU THINK ABOUT THE COMMERCIAL PRODUCTS? THIS IS ONE THAT I TRIED, I DON'T WANT TO BE AN ADVOCATE FOR IT, IT WORKED WELL. I HAVE HEARD YOU SAY THAT THERE IS NO AMAZING CURE, WHATEVER. THIS WORKED REALLY GOOD. I'M NOT USING IT BECAUSE ITS FROM THE STATES AND WITH THE EXCHANGE ITS EXPENSIVE.

Mary says YOU CAN MENTION THE NAME.

The Caller says PROACTIVE. OKAY. IT WORKED WELL. I'M WONDERING SHOULD I GO BACK TO MY DERMATOLOGIST? I HAVEN'T BEEN THERE FOR YEARS. THE LAST THING THEY GAVE ME DON'T WORK AT ALL. ALWAYS NEW STUFF. SHOULD I GO TO THE DOCTOR TO SEE? OR DO YOU KNOW OF ANYTHING COMPARABLE? AND WHY THIS WOULD WORK FOR ME AND WHAT YOU THINK OF THESE THINGS.

Nowell says OKAY. JUST IN GENERAL, ACNE IN ADULTS IS USUALLY A DIFFERENT THING. ITS ACNE BUT THERE ARE DIFFERENT CAUSES. USUALLY MORE COMMON IN WOMEN ADULTS. A LOT OF IT IS HORMONE-BASED. WE KNOW THAT GOING ON MEDICATIONS THAT ALTER THE HORMONES HAVE DRAMATIC IMPROVEMENTS IN ADULT ACNE IN WOMEN. THERE ARE MANY DRUGS. SOME IS A BIRTH CONTROL PILL. OTHERS WE USE, THERE IS A PILL THAT HELP WITH BLOOD PRESSURE THAT CHANGES THE HORMONES A LITTLE. THAT IS THE LINE OF TREATMENT IN ADULT ACNE IN WOMEN. WHAT DO I THINK ABOUT THE COMMERCIALS? FOR THE MAJORITY OF PRODUCTS ON THEM, IF YOU HAVE TO SPEND A LOT OF MONEY TO MAKE A COMMERCIAL AN PUT IT ON T.V. TO SELL YOUR PRODUCT WITH GUARANTEES ALL THAT, IF YOU GO TO THAT EXPENSE TO SELL IT, IT DOESN'T WORK. IT MAY WORK FOR YOU BUT IN GENERAL. THE REASON I SAY THAT, IF THERE IS A DRUG THAT REALLY WORKS VERY WELL AND HAS RESULTS, YOU DON'T HAVE TO ADVERTISE. YOU WILL KNOW. EVERYONE KNOWS ABOUT IT. THE BEST EXAMPLE IS VIAGRA. A DRUG COMES OUT. IN TWO DAYS, THE WORLD KNOWS. STOCK GOES UP, EVERYBODY KNOWS. THEY DIDN'T PAY FOR ADVERTISING. THEY WERE IN EVERY PAPER, MAGAZINE, TELEVISION SHOW. A DRUG COMES OUT AND WORKS. THAT IS A PROBLEM THAT PEOPLE HAVE. ITS A SMALL PERCENTAGE COMPARED TO ACNE. WAY MORE PEOPLE HAVE ACNE THAN PROBLEMS THAT REQUIRE VIAGRA. SO IF THERE WAS... IF THIS PRODUCT, PROACTIVE, WORKED AS AMAZING IN EVERYONE AS THEY SAY AND IT WORKED, EVERYONE WOULD BE GETTING IT. WE WOULD FORGET THE REST OF THE STUFF. I HAVE SEEN MANY PEOPLE WHO SAY I TRIED IT AND IT DID NOTHING. I'M GLAD IT WORKED FOR YOU, THAT IS GREAT. THE INGREDIENTS IN THERE ARE MINIMAL. THERE IS HARDLY ANYTHING THERE THAT DOES ANYTHING. BUT PEOPLE SAY IT WORKS FOR THEMLE THERE IS NOTHING COMMERCIALLY AVAILABLE HERE THAT IS IDENTICAL TO IT. SO IF IT DID DO THE TRICK FOR YOU, THEN MAYBE GET IT. BUT SEEING YOUR DERMATOLOGIST, THERE ARE OTHER ALTERNATIVES YOU HAVE FOR ADULT ACNE.

Mary says IT IS AMAZING WHEN YOU WERE TALKING ABOUT VIAGRA AND, YOU KNOW, HYPE, HOW EFFECTIVE HYPE CAN BE. MEDIA HYPE AT THAT. THINK OF SELLSEEN. WHAT DID YOU THINK OF THAT?

Nowell says IF YOU LOOK AT THAT, IT GOT HUGE HYPE BUT NOW EVERYONE SAYS IT DOESN'T REALLY WORK. IF THERE IS HYPE AND ITS SUBSTANTIATED, IT STAYS BIG. EVERYBODY HEARD ABOUT VIAGRA BUT YOU HAVEN'T HEARD IT DOESN'T WORK BECAUSE IT DOES WORK IN THE VAST MAJORITY OF HYPE. SELL LIGHT IS A LOT OF PROBLEMS AND PEOPLE LIKE TO DO THINGS ABOUT IT. PEOPLE SAY THEY SPENT HUNDREDS AND IT DIDN'T WORK. SO YOU HEARD TONS OF BAD PRESS ABOUT IT. IT GOES TO SHOW YOU THAT EVERYTHING WILL BE SUBSTANTIATED. THERE WAS A DOCTOR WHO A YEAR OR SO AGO THEY SAID COULD CURE CANCER. YOU HEAR THAT ANYMORE? NO. THEY LOOKED AND HIS CURE RATES WERE NOT AS GOOD AS OTHER MEDICINES PRACTICED AND THE GUY PROBABLY DOESN'T WORK ANYMORE. THERE IS A LOT OF HYPE. BUT IT HAS TO BE SUBSTANTIATED. YOU DON'T HAVE TO HAVE A COMMERCIAL. IT WILL GO ON ITS OWN.

Mary says IS THERE ANYTHING FOR CELLULITE?

Nowell says NOTHING. CREAMS WITH MARGINAL IMPROVEMENT, 10 percent MAYBE. UNFORTUNATELY, THERE IS NOTHING GREAT FOR THAT.

Mary says WHAT ABOUT EXERCISE?

Nowell says THE PROBLEM WITH THAT IS ITS FAT. THE FAT IS UNDER THE SKIN BUT IT GETS TRAPPED IN THE SKIN AND MAKES THESE DIMPLES, THEY TRY TO INCREASE FLOOD FLOW AND THEY USE CREAMS WITH CAFFEINE TO DO IT. IT MAYBE MAKES IT BETTER BUT I DON'T KNOW IF IT IS PUFFING UP THE SKIN AROUND IT, MAKING IT LOOK BETTER. BUT THERE IS NO REAL CURE. THERE IS FAT IN THE WRONG PLACE. I DON'T KNOW HOW TO GET THAT FAT OUT OF THERE. I THINK ITS SOMETHING THAT WILL BE A LONG TIME BEFORE WE HAVE A CURE.

Mary says I HAVE HEARD ABOUT CERTAIN TECHNIQUES THEY USE TO KNEAD THAT?

Nowell says YES. THAT IS A GREAT EXAMPLE. ITS LIKE TAKING ROLLERS. THE PHILOSOPHY WAS TO STRETCH IT OUT. INCREASE THE BLOOD FLOW. ITS A GREAT EXAMPLE OF HYPE. I HAVE NOTHING AGAINST THE COMPANY AND DON'T WANT A CALL FROM THEM TOMORROW. WHAT I HAVE BEEN TOLD THEY DID IS PEOPLE WOULD CALL UP AND SAY I NEED A FACELIFT AND I WANT ENDMOLG. THEN A REP COMES WITH A MACHINE. A LOT OF HYPE AND MARKETING. PEOPLE BOUGHT IT. WHEN YOU LOOK AT THE STUDIES, THERE RESULTS WERE MINIMAL. THEY WERE BETTER BUT MAYBE 10 percent. ITS EXPENSIVE. TIME CONSUMING. ITS PAMPERING BUT THE RESULTS ARE NOT GREAT. COLLEAGUES OF MINE SAY THE RESULTS WERE MARGINAL AT BEST. MOST PEOPLE ITS NOT THAT GREAT.

Mary says OKAY. LET'S TAKE ANOTHER CALL. TRACY?

The Caller says I HAVE A QUESTION ABOUT ECZEMA. MY DAUGHTER IS SIX. SHE HAS SEEN TWO DERMATOLOGISTS. ONE TOLL HER TO BATHE EVERY OTHER DAY. THE OTHER TOLD US BATHE TWICE A DAY. CAN I HAVE YOUR OPINION?

Nowell says DEPENDS... QUESTION THAT WE GET ASKED... DEPENDS HOW YOU ARE BATHING OR SHOWERING. IF YOU GO IN A SHOWER A HUNDRED TIMES A DAY, PUT SOAP ON, COME OUT, DRY OFF. YOU WILL GET DRY. YOU CAN USE THE WATER TO YOUR ADVANTAGE. GO IN THE SHOWER OR BATH, PUT OIL IN THE BATH, PAT DRY, LEAVE WATER ON THE SKIN. TAKE AN OILY CREAM, RUB IT ALL OVER AND TRY TO TRAP THE WATER. DO ALL THAT AND THE WATER WOSHS TO YOUR ADVANTAGE. SO IF YOU SHOWER, RUN IN, FAST AS I CAN, HOT SHOWER, SOAP ALL OVER, GET OUT, DON'T PUT CREAM ON, I'M IN A RISH, MY SKIN GETS DRY. WHEN I BATHE MY KIDS, IF THEY ARE DRY, I WILL BATHE THEM EVERY OTHER DAY, OIL IN THE WATER, LOTS OF CREAM. USE THE WATER TO MY ADVANTAGE. SO THE ANSWER IS BOTH. IF YOU ARE USING THE WATER PROPERLY, BATHE THEM TWICE A DAY.

Mary says WHAT ABOUT DEODORANTS?

Nowell says ANTIPERSPIRANTS HAVE ALUMINUM COLOR RIDE IN THEM. THAT SLOWS DOWN SWEAT FROM COMING OUT. FOR THE AVERAGE PERSON, IT WORKS FINE. DEODORANTS ARE JUST TO MAKE THE AREA SMELL BETTER, LIKE PERFUME. A LOT OF PEOPLE BUY THE WRONG THING. MOST ANTIPERSPIRANTS HAVE DEODD RANT IN THEM SO IT HAS A NICE ODOR. IF THAT DOESN'T WORK, IF THAT IS NOT ENOUGH TO STOP SWEATING, YOU CAN THEN BUY THE STRONGER VERSION. YOU HAVE TO ASK FOR IT. ITS NOT ON THE SHELVES. ONE IS CALLED DRYZ O L. TELL THE PHARMACIST AND THEY GIVE YOU THIS LIQUID. ITS A STRONGER VERSION OF THE SAME THING. THE PROBLEM WITH IT IS IT IS A BIT IRRITATING BUT THAT CAN TAKE PEOPLE WHO SWEAT MORE THAN NORMAL AND BRING THEM DOWN TO NORMAL. IF YOU SWEAT BADLY, THERE ARE OTHER THINGS. THE BEST THING IS BOTOX. YOU CAN PUT THAT UNDER THE ARM, EXACTLY WHERE YOU PUT IT, IT WILL STOP THE COMMUNICATION BETWEEN THE NERVE AND SWEAT GLANDS AND YOU WILL ABSOLUTELY NOT SWEAT. I CAN MAKE A VERY, VERY SWEATY UNDER ARM OR HAND, MAKE IT HAD THE A HUNDRED PERCENT DRY. I HAVE A PAY ET SHENT WHO IS AN... I HAVE A PATIENT WHO IS AN OLYMPIC ATHLETES LEET IF YOU HAVE A TARGETED AREA, YOU CAN CAUSE DRAMATIC IMPROVEMENT. SOME PEOPLE HAVE SURGERY DONE, CUT OUT THE GLANDS, YOU GET A SCAR. OR CUT THE NERVE TO THE GLANDS SO YOU DON'T GET SWEATING. BUT THERE ARE PROBLEMS WITH THE SURGERY SO THAT IS A LAST RESORT.

Mary says BUT THAT IS A NATURAL MECHANISM TO THE BODY AND YOU ARE STOPPING THAT.

Nowell says YOU ARE NOT STOPPING IT EVERYWHERE, YOU ARE STOPPING IT IN A SMALL PLACE. THE UNDER ARM IS A SMALL AMOUNT OF THE WHOLE BODY. THE BODY WILL REGULATE OTHER AREAS AND SWEAT MORE ELSEWHERE. WELL, IF YOU HAVE TO SWEAT. IF YOU ARE RUNNING A MARATHON AND NEED TO SWEAT, YOU WILL SWEAT EVERYWHERE. THESE PEOPLE THAT HAVE A LOT OF SWEAT UNDER THEIR ARMS HAVE AN ABNORMAL REACTION. IT CAN BE A FREEZING COLD DAY AND THEY ARE SWEATING UNDER THEIR ARM. THEIR REGULATION IS OFF. THEY DON'T NEED TO SWEAT THAT MUCH. SO, THERE IS NO ISSUE OR PROBLEM WITH THAT. IF I SHUT DOWN YOUR SWEATING OF YOUR WHOLE BODY, THAT WOULD BE PROBLEMS.

Mary says IF YOU BLOCKED IT OFF IN SOMEONE'S ARMPITS, ITS NOT GOING TO GO TO THEIR FEET? TO COMPENSATE?

[LAUGHTER]

Nowell says WITH SURGERY, THEY HAVE FOUND THAT IF THEY CUT THE NER. FS, A SMALL GROUP OF PEOPLE WILL SWEAT SOMEWHERE ELSE.

Mary says OH. OKAY. LET'S GO TO A E-MAIL.

Mary reads from the laptop and says I AM 47 AND I HAVE BROWN SPOTS ON MY ARMS AND BACK. I HAVE LIVER SPOTS ON MY FACE AND NECK. A FEW OF THEM ARE GROWING BIGGER LIKE A MOLE. WHAT CAUSES THIS AND WHAT IS THE TREATMENT?

Nowell says OKAY. OF THE BROWN SPOTS, LIVER SPOTS, HAVE NOTHING TO DO WITH THE LIVER. THERE ARE TWO DIFFERENT BROWN SPOTS THIS PERSON IS DESCRIBING. ONE IS LIKE A FRECKLE, RELATED TO THE SUN. THEY CAUSE TOO MUCH BROWNNESS IN THE SKIN. THE ONES GROWING LIKE MOLES ARE GENETIC. THEY USUALLY, IF YOU LOOK, THEIR PARENTS HAVE THESE. THEY ARE VERY, VERY COMMON. TO TREAT THEM, WE PUT LIQUID NITROGEN ON. IT DESTROYS THE SKIN, FORMS A SKAB AND PEELS OFF. YOU CAN GET A GOOD 80 percent IMPROVEMENT OF THEM.

Mary says OH.

Nowell says BUT ALL THE FLAT BROWN ONES ARE RELATE TODD THE SUN.

Mary says YOU MENTIONED 40 percent OF YOUR PRACTICE DEALS WITH SKIN CANCER. WITH RESEEING ADVANCEMENTS IN THAT AREA AS FAR AS TREATMENTS OR VACCINES?

Nowell says SKIN CANCER IS IN TWO GROUPS. MELANOMA, WHICH IS THE MOST SERIOUS AND THE ONE THAT CAN SPREAD AP WE CAN DIE FROM WHICH FORTUNATELY IS LEAST COMMON. THEN THERE IS NON MELANOMAS, WHICH ARE COMMON. A THIRD OF PEOPLE WILL GET THEM IN LIFE FROM THE SUN. THEY USUALLY HAVE TO BE SURGICALLY REMOVED. THE CHANCES OF THEM CAUSING ANY CONCERN OR LIFE-THREATENING CONCERN IS VERY, VERY, VERY LOW. IN TERMS OF THE MELANOMA, THERE ARE ADVANCES MADE. THERE ARE DRUGS WE USE WHICH HAVE SHOWN TO INCREASE LIFE EXPECTANCY. THEN THEY ARE WORKING ON VACCINES. PEOPLE THINK I WILL GET THE VACCINE AND NOT GET MELANOMA. NO. BY PUTTING BITS OF IT IN THE VACCINE, YOU STIMULATE THE BODY TO TRY TO KILL. THAT IS HOW VACCINES WORK. SO YOU PUT MELANOMA IN, MIXED WITH DIFFERENT THINGS, TRY TO GO GET THE BODY TO KILL IT.

Mary says SO ITS LIVE?

Nowell says YES.

Mary says IT'S LIVE? I DON'T KNOW THE ANSWER TO THAT. I DON'T KNOW HOW THEY PREPARE IT. I KNOW THEY TAKE THE CELLS BUT I DON'T KNOW THE WAY THEY DO IT. BUT THE BODY CAN HELP KILL MELANOMA.

Nowell says THANKS FOR THE INFORMATION, DR. SOLISH. DR. SOLISH IS AT SUNNY BROOK AND WOMEN'S HEALTH COLLEGE AND SCIENCE CENTER.
You can learn more about various skin conditions via the Internet. Go to...

A slate reads "DermWeb, www.dermatology.org."

Mary says And that's it for our skin-deep television today. But please join me each week day, Monday to Friday, for More to Life at 1 o'clock.

A slate reads "The advice given in the preceding program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances."

Watch: Dermatology