There are more than 100 types of Human Papillomavirus (HPV) out there, and it’s a VERY common virus that affects both females and males.

How common?

About 75% of sexually active Canadians will have at least one HPV infection during their lifetime.

And we have to remember that it’s not just intercourse that spreads HPV – any sexual contact can potentially cause an infection. Luckily, most people who are exposed to a strain of HPV clear the virus without any lasting effects. However, some people don’t, and the effects can be devastating.

As doctors, we care a lot about HPV, and here’s why: HPV causes not only genital warts, but cancer as well.

In women, HPV can cause cervical cancer, and in men, it can cause throat and anal cancer.

I have personally seen young, otherwise healthy people diagnosed with these cancers. Yikes. Cervical cancer is the second most common cancer in women aged 20-44, and in Canada, almost 400 women die each year from it. Young women. Our daughters, sisters, mothers, friends.

Thankfully, a safe and very effective vaccine exists against the most problematic strains of HPV – the ones that cause the majority of cancers and warts. In Canada, two vaccines exist to protect us from HPV – Gardasil and Cervarix. Gardasil protects against strains that cause warts AND cancer; Cervarix protects against two strains known to cause cancer only. Health Canada has recently approved Gardasil 9, which protects again 9 strains of HPV. These 9 strains are known to cause 90% of cervical cancers, 75% of vaginal and anal cancers, and over 90% of warts. Wow – in vaccine talk, that is a very effective vaccine! This vaccine is approved for females aged 9-45 and males aged 9-26.  There are three doses and it is important to complete all three. As always, talk to your own doctor to see if these vaccines are right for you, given your personal medical history.

And an important point to remember: being vaccinated does not take place of regular Pap tests to screen for early changes of cervical cancer. These are still a very important part of your health.

As a family doctor, this vaccine excites me. A vaccine against cancer – how amazing! Gardasil underwent years of testing before hitting shelves. It is safe. My own children will absolutely be getting vaccinated ASAP. Happy 9th birthday, kids!! Research is ongoing, but it is thought that the vaccination is most effective when given before the age of 15. But it’s still effective anytime in the above stated age ranges.

A website I like to direct my patients to for more information is www.hpvinfo.ca. Educating yourself and your children is a powerful thing. Protecting your children from harm is never going to be a mistake. Telling them to wear a seatbelt does not make them want to drive recklessly. Ensuring they wear a bike helmet does not guarantee they will be signing up for BMX races. Talking to them about safer sex and vaccinating them against HPV does not mean they will want to be sexually active early or often. It means that when they do become sexually active, they will be protected from the worst strains of HPV.

The post The Vaccine That Prevents Cancer appeared first on Talia Zenlea.

What You Need to Know About Post-Partum Depression

Recently many celebs, such as Hayden Panettiere and Drew Barrymore, have opened up about their battles with Post-Partum Depression (PPD). However, despite the “awareness” raised by their stories, most of us still don’t know when the line is crossed from being a hormonal, sleep deprived new mom, to being a woman suffering from a serious mental health condition.

Even doctors are only just beginning to understand what post-partum depression is.

What many people don’t understand is that very often, PPD can begin during pregnancy. It can affect women of any age, regardless of their mental health or prior reproductive history. Furthermore, we know very little about other debilitating conditions, such as anxiety disorders, that can happen during this very vulnerable time as well.

Here are 5 warning signs that you, or any new or soon-to-be mother, should consider seeing a mental health professional:

Another “bad day.” Sure, the early stages of parenthood are prone to frustration, but if you are finding yourself constantly sad or irritable, overwhelmed, or have trouble enjoying hobbies, food or your new bundle of (would-be) joy, then take note and monitor your feelings. If weeks go by and you still feel the same or worse, seek help.

Counting sheep. Sleep deprivation is almost universal among new parents, but in most situations is due to the wee one’s tendency to rely on mom and dad for soothing in the early hours of the morning. However, if you are counting sheep while your little lamb is fast asleep, then there may be a problem.

The world is blue. We often seek solace in that first month of motherhood in the hope that the screaming, purple-faced little ball of flailing fists will soon become a babbling, cooing and smiling little joy in the coming months. We also at the end of the day are able realize that we are doing the best we can. But if you find yourself dwelling on the negatives when it comes to the past, the future, and especially yourself, this could be a sign that you need help. This extends far beyond what many of us would experience as simple “mommy guilt” when we let the crying go on a little too long while we unload the dishwasher. Depressed moms can become hopeless and self-loathing.

It’s all too much. It is natural to feel wiped out by sleep deprivation, but most of the time we are able to attend play groups, take out the stroller for a walk and throw together dinner (even if it is just PB and J). It is not normal to consistently be too exhausted to play with your little one, or to get out of the house. This can especially be a problem if you are putting off going to the doctor because you are simply too tired to get off of the couch or too anxious to leave the house.

Mega Mommy brain. As a new mom, nobody would expect you to write a novel, but if you just spent an hour watching Grey’s Anatomy and really can’t remember who Dr. McDreamy is currently dating, then take it as a sign that something is brewing. People with depression often feel too foggy and exhausted to focus, while those with anxiety sometimes feel too frazzled or distracted by other thoughts and worries.

And remember to trust yourself. If you feel something just isn’t right, and you’re concerned you might have post-partum depression, don’t hesitate to seek help. You’re doctor is there to help you, and you aren’t alone.

The post More Than Just the Baby Blues? appeared first on Talia Zenlea.

Good bone health is essential for all women. Osteoporosis and osteopenia, or low bone density, are diagnosed based on a bone mineral density (BMD) test.

Low bone density increases the risk of fractures and is very common in women, increasing in risk as we age.

Fortunately, bone loss is not inevitable.

Here are 5 ways you can ensure good bone health.

DRINK YOUR MILK: Calcium is a necessary building block for healthy bones, and builds bone density. In people who do not have enough calcium, the body will actually take calcium from the bones to meet its needs. It is very important for all women to make ensure that their diet is high in calcium. Children, postmenopausal women, and women who are pregnant have the highest calcium requirements. The best sources of calcium are dietary and include dairy products, leafy green vegetables and fish.  A general rule is that one serving of calcium-rich foods contains approximately 300 mg of calcium. Current recommendations are for 1000-1200 mg of calcium daily, either in the diet, as a supplement, or both, for all women over the age of 50.

GET OUTSIDE: Vitamin D is necessary for healthy bones because it helps your body absorb calcium. The best source of vitamin D is from sunlight. Low levels of vitamin D are common in many women, especially women who live in colder climates and spend less time outside in the sun. (In case your wondering, sunscreen probably does act as a barrier, but it’s not a good reason not to slather it on!). Dietary sources of vitamin D include fish, eggs, and foods fortified with vitamin D, such as certain cereals. Vitamin D can also be taken as a supplement, but because Vitamin D requirements can vary from person to person, ask your doctor to check your levels before starting on a supplement.

KEEP MOVING: Any activity that places weight on your bones stimulates bones to increase in density. I always encourage my patients to focus on activities that they already like to do, like running, walking, dancing, playing tennis, yoga, and Tai chi. Resistance exercises, like using free weights or weight machines are another great option. It is a good idea to speak with your doctor about which exercises are good for you.

DON’T SMOKE: In addition to all of the other terrible side effects of smoking, it can also worsen your bone density. The bottom line is, if you smoke, stop. If you need help stopping, reach out to your doctor as there are lots of options available to help you.

KNOW YOUR HISTORY:  It is important to understand if there are other family members with osteoporosis, as family history can be a risk factor. All post-menopausal women should be screened for osteoporosis with a bone mineral density test (also called a DXA scan) regardless.

The post What You Need to Know About Strong Bones appeared first on Talia Zenlea.

Neonatal Eye Ointment and the Canadian Controversy

Local mommy groups are abuzz this week after Canadian news outlet, Global, reported that the mandatory application of prophylactic eye ointment to newborns was “ineffective, outdated and unethical.” What followed were two camps: happy hippies, and a lot of pissed off doctors. All of this suggesting to me that a lot has been misunderstood.

Here’s why this is a really big deal.

Antibiotic eye ointment is mandatory in many states and Canadian provinces. In some places, parents who refuse it on behalf of their newborns can be reported to Child Protective Services. In Texas, medical staff who fail to give it can be criminally charged for a class B misdemeanor. That sends a pretty clear message to the public and to the medical community that antibiotic eye ointment is considered REALLY IMPORTANT, and that the benefits must inarguably outweigh the risks. Unfortunately, not everyone agrees.
Now often in matters of health and wellness, we have people who disagree, even with messages as clear as this one. But this time, it’s not just anybody (cough, cough Jenny McCarthy). This time, it’s the Canadian Society for Pediatrics. In March 2015, they came out with a position statement quite clearly stating that erythromycin eye ointment should not be routinely recommended. Have the Canadians gone completely insane?

Back up. Why do we give infants eye ointment, anyway?

The reason we give infants eye ointment is to prevent something called ophthalmia neonatorum. Ophthalmia neonatorum is an eye infection that occurs in babies in their first month of life, and generally, it’s no big deal. Except for when it’s caused by an organism called N gonorrhoeae (the same bug that causes gonorrhea). In those cases, it very often progresses rapidly to a devastating eye illness and eventually blindness. The way a baby would get gonorrhea in their eye would be from passing through the birth canal of an infected mother, or even from a Cesarean delivery where the bugs crawl up the cervix into the uterus. Because a woman doesn’t always know if she is infected with N gonorrhoeae, and because it used to be pretty common, it was a no-brainer to give all babies ointment to prevent an infection that could otherwise lead to blindness.

So what’s the issue?

In the past, gonorrheal infection was a lot more common than it is now. Nowadays, the vast majority of cases of ophthalmia neonatorum (like, 99% of them) are caused by other organisms. Though erythromycin eye ointment may very well kill some of those other bugs, it’s not really necessary since those other bugs don’t cause a severe illness or blindness, the way N gonorrhoeae does.
The issue brought to light by the Canadian position statement is that it’s not really clear that erythromycin eye ointment actually works to prevent ophthalmia neonatorum caused by N gonorrhoeae, which is sort of the whole point of using it. The reason for this is that emerging strains of N gonorrhoeae are resistant (about 25%).  Does overuse of erythromycin eye ointment breed this resistance? Unclear. And just to add more murk to these waters, one recent meta-analysis, which is a study that looks at the quality and findings of all the other studies on this topic, showed that the quality of all of the evidence pretty much sucked, and the prophylactic agents (like erythromycin eye ointment) had significant failure rates at preventing the disease they were being given for.  So I know when I said that the vast majority of cases of ophthalmia were not caused by N gonorrhoeae anymore, many of you probably thought—well duh, that’s because we give prophylactic eye ointment now. But this argues against that—it argues that it’s not doing much at all.

But my 3 kids got erythromycin eye ointment and they’re fine.

So here is where many of the media reports missed the point. This wasn’t a discussion about the safety of erythromycin eye ointment. Some groups argue that it could blur vision and interfere with mother-baby bonding. It can also cause eye irritation in rare cases. But that wasn’t the point of the position statement. They didn’t argue that we should stop using it because it’s harmful. They argued that we should stop using it because it doesn’t work.

So why not just use it anyway? I’d take the risk of some minor eye irritation to prevent a devastating infection and blindness.

According to the Canadian Pediatrics Society (and by the way, also Denmark, Norway, Sweden and the United Kingdom, who haven’t mandated universal ocular prophylaxis in decades), there’s no reason to do something that doesn’t work. It’s like saying why not just stand on your head when you have a flat tire.
Now, the other thing they aren’t saying is that we just suck it up and deal with a small percentage of blind babies. The Canadians, like Texas, agree that gonococcal ophthalmia is really, really important. The whole point of their article was to find the best, most effective way way to prevent its devastating consequences. They went on the suggest strategies that might be better at preventing gonococcal ophthalmia, like more aggressive maternal and infant screening strategies, more aggressive medical prophylaxis for at-risk babies, early aggressive treatment when infection is identified, education, and close follow-up.

OK, so we’re good with the new plan then?

Well, not really. And this is where I think a lot of the confusion lies, and a lot of the backlash.
It’s all well and good to suggest, as the Canadian Pediatrics Society did, that we screen pregnant women for gonorrhea and treat them, and this way you’re actually preventing N gonorrhoeae from being where it shouldn’t be. The real problem is that we have no idea if this is actually an effective strategy AND it raises a whole slew of other problems.
Some people refuse testing because they don’t believe they’re at risk. But, as any doc can tell you, we’ve all seen the pregnant nun in the office, or the little old happily married lady with syphilis.  Some sexual partners lie, and unfortunately, you often don’t know until something bad happens. Like your baby going blind from a gonorrheal eye infection. Also, sexually transmitted infections like gonorrhea are gifts that keep on giving. You have to treat ALL the partners. Meaning that poor pregnant lady whose partner would never cheat on her needs to be treated, but so does her husband who swears he picked it up on a public toilet seat. And probably also the women he’s adamant he’s not sleeping with.
See how this can get really tricky? So even if you manage to identify and treat the pregnant mom, you can’t control that they won’t get reinfected the next day. You know the great old wives tale of the best thing you can do to bring on labour? Well, you can even contract gonorrhea then (and no, I’m not talking about jumping up and down. Or about Flamin’ Hot Cheetos, though I’m 99% sure those worked for me.)

Did anyone ask the experts?

So, it’s cool that Global news asked a midwife what she thought. But what about the people who actually treat babies with gonococcal eye infection? Turns out, they think the Canadian Pediatrics Society’s position statement is a load of crap. The President of the Canadian Association of Pediatric Ophthalmology and Strabismus published a letter to the editor of the Canadian Journal of Ophthalmology, in which he expressed his feeling that the statement failed to recognize that gonococcal ophthalmia is a lot more common than we think because it often goes unreported, and that c trachomatis (aka chlamydia) can also cause serious problems when it finds it way into a newborn’s eye and can also be prevented with eye ointment. Additionally, it fails to consider the risks of stopping prophylactic eye ointment, and fails to present any evidence that the proposed alternatives are effective. Most importantly, it fails to adequately review the evidence. Meaning that that meta-analysis I told you about? They eye doctors interpreted the findings to say the exact opposite of what the pediatricians reported. So basically, the eye doctors think the report is a giant failure in all aspects. The author ends the letter by urging the Canadian Pediatrics Society to reconsider their position statement, and retract their recommendation to stop eye prophylaxis. Oh, and they suggested that next time the pediatricians write a position statement about eye prophylaxis, they talk it over with the eye doctors first.

Here’s the story behind the story.

What the Canadian Pediatrics Society is ACTUALLY suggesting is not to avoid the evils of Western medicine, but rather to aggressively prevent and treat infection in at-risk babies with a shot or infused antibiotics; and aggressively screen and treat pregnant moms.
As you can see, the alternative to eye ointment is fraught with a lot of potential problems, not the least of which being that the eye doctors don’t agree that it’s even necessary. I don’t know what the “right answer” is here, nor was my goal to force my opinions onto you. The purpose here was just to make sure we’re all on the same page about what the Canadians actually said. So now you know, eh?

The post Oh, Canada: The Controversy Over Neonatal Eye Ointment appeared first on Talia Zenlea.

Roughly 75% of women will develop stretch marks during pregnancy. They can appear on the belly, sides, thighs, breasts, arms and buttocks. They can also happen during puberty, or at times of rapid weight gain, as well as from some medications or medical conditions.

Given how common they are, it’s not surprising that in my daily practice as a cosmetic dermatologist, I see a lot of women with stretch marks, and most are looking for a “magic bullet” to get rid of them. So here are my thoughts on stretch marks.

What are stretch marks?

One may think of stretch marks, or striae, as we dermatologists like to call them, as a scar, due to a tear in the dermis, or middle layer, of the skin. This results in loss of some of the proteins that give skin its elasticity, resulting in that classic wrinkly reddish or purplish line. With time, these tend to fade on their own into flesh-colored or white lines.

Can you prevent them?

Before you invest in those yummy smelling tummy-butters, think twice. There are many remedies marketed to eliminate or fade stretch marks, but a large review looking at over 800 women using difference topical preparations including vitamin E, cocoa butter, and alphastria, concluded these creams do not prevent stretch marks.

Can you get rid of them?

Unfortunately, stretch marks are notoriously challenging to treat. Since they are scars, it is impossible to completely cure or eliminate them. That being said, several treatment options exist that can diminish their appearance and have them blend in with the surrounding skin, typically using laser and light devices. In my consultations, I always start off by asking my people what end-result they are looking for with their stretch marks, and try to guide them to a very realistic expectation. I have found in my practice that the earlier you treat the stretch mark the better the result. Treatments are typically quick and comfortable.

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Losing sleep over lost hair?

Hair loss, also called alopecia, is one of the most troubling conditions for women. There’s so much social importance placed on a long and luscious mane.

And alopcia can be really frustrating for your doctor, too.

Unfortunately, because hair loss can go on for a while before your really start to notice it, it can be hard for the doctor to get an accurate history. On top of this, there can often be more than one reason for a woman to lose her hair.

Even when a cause is found, though it can be a relief to have identified the culprit, not all forms of hair loss are reversible. And sometime, particularly when the hair loss is what we call “scarring alopecia,” is doesn’t always grow back.

One important distinction I try to clarify from my patients is whether they’re experiencing hair “shedding” or hair “thinning.”  People who have shedding usually describe many hairs on the pillow, hairs all over their clothes, hairs in their food, hairs on the kitchen counter after preparing a meal…you get the idea.  People who are experiencing thinning describe a wider hair part over time, a smaller ponytail, and hair that just appears “finer.”

When women come to see me with alopecia, it’s really important for me to get a good look at their scalp and hair.

I look for signs of rash or irritation on the scalp, as this can suggest an inflammatory alopecia, which is less common, but needs treatment so that scarring does not occur.  I examine the hair’s overall density (how much hair is there?), relative density (for example, width of the part at different part s of the head), hair shaft abnormalities, and do a “hair pull test” where I see how easily hairs come out.

Often times, I can’t find a reason for the hair loss just from the history and physical exam, so I sometimes need to do blood tests or even a biopsy.

The most common cause of hair loss in women that I see in my clinic is Female Pattern Hair Loss, also called Androgenetic Alopecia. This is progressive, meaning it gets worse over time, and unfortunately, is related to genes and hormones.  The good news is that there are treatment options, including medications you either apply directly to the scalp or take orally, and if that doesn’t work, even hair transplantation!

Hair loss in women is a frustrating and scary problem.

Whether it’s fixable or non-fixable, the first step is an evaluation – call your dermatologist today!

The post Losing It! Getting to the Root of Female Hair Loss appeared first on Talia Zenlea.

5 Tips for Heart Healthy Living

Did you know that in Canada, every 7 minutes, some one dies from a heart attack or stroke? In the US, some one dies from cardiovascular disease each minute.

You probably don’t think about preventing heart disease because you are, like most of us, busy taking caring of everyone else.  Taking care of yourself is often a last though, if you even think of it at all.

But it’s too important to ignore.

There are some things we can change, and some things we can’t. Genetics, aging, and the increased risk in women are sadly things we can’t change.

But there’s a lot you can do to prevent heart disease.

Here is my prescription for heart healthy living.

1.  If you smoke, stop. Now. After quitting for one year, the risk of dying from heart disease is reduced by half and in 15 years, your risk of dying will be as though you never smoked.  Make sure your children understand the hazards of smoking.

2.  Limit your alcohol intake. Women, no more than one alcoholic beverage in a 24-hour period. And, no, you cannot save up Monday through Thursday for Friday night. (Men, your limit is two drinks in a 24 hour period.)

3. Get your heart rate up. Put it on your schedule, make an appointment, to be physically active for the purpose of getting your heart rate up and improving your cardiovascular fitness. Aim for 30 minutes a day, as many days of the week as you can.  You don’t have to go out and train for the Toronto Marathon, just break a sweat. Make it something you enjoy and recruit your friends.

4. Make healthy eating choices. Think about your nutritional intake as something similar to your household budget. You cannot have more money going out than you have coming in (you can – but not for long!) and if you want to save, you need to put some aside. You cannot eat more calories than you are burning and if you want to loose weight, you have to reduce the calories. There are several great tools for “budgeting” your calories: try this site, or this one.

5. Know your ABCs. When you visit your doctor, ask about ABCs. Aspirin if you are at risk, Blood pressure check, Cholesterol check, and help to Stop smoking.

You work hard. You have many demands in your life. And you deserve to take care of yourself.

Reward yourself with heart healthy living!

The post The Heart of the Matter appeared first on Talia Zenlea.

Now that the weather’s cooling off, if you live in a cold climate you may be thinking about winterizing your pipes, your car, your garden… and your skin??

Dry itchy skin (xerosis cutis) is a common reason for visit in a dermatology clinic, especially here in Alaska. For the most part, dry skin is never going to hurt you or affect your overall health, but it can certainly be a nuisance.

There’s no magic bullet, but here are some tips for dry, itchy, winter skin:

Moisturize! You may think I’m stating the obvious here, but I’m shocked at the number of patients who come in for complaints related to their dry skin, who aren’t using a moisturizer daily.  There is no one brand of moisturizer that’s better than the others, but I do have one rule: your moisturizer needs to come in a tub or jar.  I’m talking about the kind of moisturizer that you scoop out with your hand to apply.  If you can pump your lotion out of a bottle, or squeeze it out of a tube, then it has too much alcohol in it to properly moisturize your skin.

Dial down the shower heat.  This is the request that elicits the most groans from my patients.  Everyone loves a hot shower!  Unfortunately, that hot shower water (while it feels great on a cold winter day) is not doing nice things for your dry skin.  Limit bath/shower time to 10 minutes, and go for lukewarm water instead of steaming hot.  Pat dry afterwards and then moisturize.

Beware of soap.  Most people use too much and too harsh of a soap.  Avoid anything “antibacterial”, and anything with fragrances or dyes.  Or, avoid soap altogether and just wash with water.  Areas that tend to sweat/get dirty can be washed with gentle cleansers.

Watch what you wear. Layers of cotton clothing are best.  Some synthetic fibers and scratchy wool can further irritate dry skin.

Stay out of the sun!  Changes to collagen and other supporting structures in the skin from sun damage make it harder for skin to hold on to water.

Stay hydrated.  While drinking more water won’t fix your dry skin if you’re not also moisturizing it, it’s never a bad idea.
And remember – always talk to your doctor.  You may be dealing with eczema, or the dry skin may be caused by certain medications you are taking. Chronic medical problems like liver or kidney disease, thyroid issues, and diabetes are all associated with dry skin. Your doctor can help you decide what testing, if any, needs to be pursued, or what additional treatment options there are.

The post Dry Skin Tips from an Alaskan Dermatologist appeared first on Talia Zenlea.

Having “an accident” as an adult can be extremely embarrassing – something you might not even feel comfortable discussing with your doctor. Know that you aren’t alone. It’s estimated that about 5% of women over the age of 60 will have experienced an involuntary loss of stool.

This can arise from any number of medical conditions that weaken the body’s ability to hold stool in, such as diabetes mellitus, multiple sclerosis, dementia, and spinal cord injuries, just to name a few.

But did you know that even pregnancies and childbirth that may have happened many years prior can lead to incontinence of stool decades down the road?

You might be especially at risk if you had a vaginal delivery, particularly one with known trauma to the anal sphincter, or one that required forceps. Big babies (especially those over 9.5 pounds) can also put you at increased risk for troubles down the road.

Another surprising reason some women have fecal incontinence is chronic constipation. Though it seems counterintuitive, hard stool sitting in the rectum for prolonged periods of time can actually result in overflow of loose stool, and even relaxation of the sphincter, or muscle that holds stool in, resulting in incontinence of even formed or hard stool.

Depending on the cause of the incontinence, there are various treatment or management options that exist. So don’t suffer in silence, and don’t be embarrassed to bring this up with your doctor. The sooner you do, the better, especially if you are older than 40, or have chronic diarrhea or risk factors for colorectal cancer. Take control of your symptoms before they take control of you.

The post Accidents Happen: A Fecal Incontinence Primer appeared first on Talia Zenlea.

What’s up with preventative Botox?

Botulinum toxin injection (brand names including Botox®, Dysport®, and Xeomin®…I will just say “Botox®” for simplicity!) is one of the most commonly performed cosmetic procedures today – and I like to refer to it as a “gateway drug.”

Botox® relaxes the muscles into which it’s injected, smoothing wrinkles formed from facial expression.

But what about preventing those wrinkles in the first place?

Short of never smiling/frowning/squinting/concentrating, there’s one true way to go – preventative Botox®!

The concept is simple: relax the muscles so certain facial expressions aren’t physically possible (no forehead scrunching or frowning) and a “set-in” wrinkle will never form.

The most common locations for preventative Botox® are the glabella (frown line area between the eyebrows) and the forehead.

Can people look weird if their facial expressions are limited? Well, yes, but not usually if the Botox® is injected properly.

For my patients I have no problem fully relaxing the glabellar area (not so noticeable when someone can’t frown), but I tend to take it easy in the forehead. Not being able to raise one’s eyebrows at all = the “plastic” look everyone dreads.

There was a study published in Archives of Facial Plastic Surgery which illustrated the concept of preventative Botox® well. It was done on sets of twins, where one twin received preventative Botox® injections regularly starting at a young age, the other twin did not. The images speak for themselves, no-Botox® twin on the left and Botox® twin on the right.

Now, before you get too excited. There is another school of thought in the Botox® community that preventative injections can eventually result in atrophy of the muscles, or muscle loss, and, unfortunately, a prematurely aged appearance. While atrophy is possible with long-term use of Botox®, as muscles are gradually trained not to move in certain ways, the idea that it will actually cause worse cosmetic results has not been shown.

Personally, I got my first Botox® injection as a dermatology resident, at age 29.

I wanted to stave off the onset of those worry lines. And today, 5 years later, despite the stresses of medical school and residency, I’m still pretty much wrinkle free!

The post A Wrinkle in Time: Preventative Botox appeared first on Talia Zenlea.