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to your Address Book or Safe List. Learn how here. | September 22, 2011 | |  |  | New Treatments for Old Acne Scars | | | Beyond The Four Agreements: The Hidden Force That Controls Your Most Important Relationships | | | When Mom Gets on Your Nerves | | | Drug-Free Diabetes Cure | | | Fascinating Facts | | | |  |  | |  | |
 | | New Treatments for Old Acne Scars Were pimples a problem in your long-distant past but the scars are still with you today? Now’s a good time to do something nice for your skin—because the latest techniques can reduce or erase even decades-old acne scarring. The best treatment option for you will depend on the extent and depth of your acne scars, said Paul M. Friedman, MD, a dermatologic laser surgeon in Houston and New York City and coauthor of Beautiful Skin Revealed: The Ultimate Guide to Better Skin. Individual factors such as skin tone must be considered, too, so of course you’ll want to talk with your dermatologist. If you have... Mild scarring—those rolling acne scars that give the skin’s surface a wavelike appearance due to their width and shallow depth. Treatment to consider: Hyaluronic acid dermal filler. Injected beneath each scar, this filler acts like an inflated cushion to support the skin’s structure and even out its surface... and because it absorbs water, it also helps skin look fresh and supple, Dr. Friedman said. Some patients do fine without anesthesia and others opt for topical numbing medication. After treatment, patients may have some mild swelling or bruising for up to 10 days. Results are seen immediately and may last up to a year. Hyaluronic acid filler can be used alone, or it can be combined with the laser techniques described below. Cost: About $600 per session, depending on the areas treated and the depth of the acne scars. Moderate scarring—the so-called "boxcar scars," which are round or oval in shape... have angular, well-defined edges... may be superficial or deep... and usually are on the temples and cheeks. Treatment to consider: Non-ablative fractional photothermolysis. This type of laser treatment uses miniscule columns of light to heat the dermis, the second layer of skin beneath the surface layer. It stimulates the synthesis of collagen (the connective tissue that holds skin together) and promotes skin remodeling, a process in which old scar tissue is replaced with healthy new collagen fibers. "This improves depressed scars and overall skin texture and also may shrink pores, so a resurfacing effect is achieved," Dr. Friedman said. The procedure is done using topical anesthesia and takes about 15 minutes. Afterward, patients may experience mild-to-moderate redness and swelling, which typically resolve after two to three days. Risks: It may create temporary dark spots with sun exposure (so sun avoidance is necessary for three months after treatment)... and it may reactivate herpes simplex in patients prone to cold sores. Results are permanent, though for an optimal outcome, patients generally require several treatment sessions spaced about four to six weeks apart. Cost: About $800 to $1,100 per session. Deep scarring—the "ice pick" scars that are narrow and deep... form pits in the skin... and are most common on the cheeks. Treatment to consider: CO2 ablative fractional resurfacing. This laser treatment partially removes the epidermis (surface skin layer) and part of the underlying dermis. It tightens the skin... promotes collagen synthesis and skin remodeling... and triggers formation of new elastin, a vital protein that maintains the structure and elasticity of the skin, giving it a smooth quality. The procedure is done with IV sedation or nerve block injections. During recovery, which takes a week, patients experience moderate-to-severe inflammation, redness and peeling. There is a very low risk (1% to 2%) for infection or hyperpigmentation (darkened areas of skin). This treatment is not appropriate for dark-skinned individuals. Several sessions may be needed for best results. Cost: About $2,000 to $5,000 for a single session, depending on the areas treated. Referrals to practitioners: American Society for Dermatologic Surgery (visit www.asds.net/find.aspx and click on "acne scar correction" under the Procedures box)... or American Society for Laser Medicine and Surgery (visit www.aslms.org and click on "consumer resources"). Source: Paul M. Friedman, MD, is director of the Dermatology & Laser Surgery Center in Houston. He also is a clinical assistant professor of dermatology at both the University of Texas Medical School in Houston and Weill Cornell Medical College in New York City. Dr. Friedman is the coauthor of Beautiful Skin Revealed: The Ultimate Guide to Better Skin (Sandow). www.DermLaserSurgery.com
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 | | When Mom Gets on Your Nerves Judy Kuriansky, PhD Teachers College, Columbia University | Of course, most daughters love their mothers—but in the midst of day-to-day interactions, some friction is inevitable. You may find that in your dealings with your mother, certain traits or behaviors of hers can really get under your skin. Maybe her habit of interrupting is a recurring source of irritation or her veiled criticisms of your kids hurts your feelings, which in turn hurts your relationship. Here’s how to take the sting out of prickly parental encounters... | Recognize your fear of "becoming" your mother. What you like least or resent most about your mother may be the very same attributes that you secretly dislike in yourself. Her annoying traits—moodiness, nosiness, bossiness or whatever—are far more troubling to you if you suspect that she is a mirror of what you are becoming or could become. Remember: While you may indeed have inherited some unpleasant personality traits or learned them by example, you are not doomed to repeat your mother’s ways. You cannot change her, but you can choose to change yourself—and once you do, you’ll be able to tolerate Mom’s foibles more calmly and patiently. Cultivate empathy for her past. Your mother, like everyone else, is a product of her own personal history. When she was a child, did her family struggle financially? Realizing this will help you understand why she might fret about your every expenditure. Did her father make her feel that simply by being a girl, she was inferior to her brothers? Not wanting to pass along that hurtful attitude, she may unwittingly go to the opposite extreme by endlessly pressuring you or your daughter to make it big in business. What helps: Ask your mother to share stories from her childhood, then really listen (even if you think you’ve heard them all before). As your understanding and empathy grow, your irritation will diminish. Accept her for who she is. Just as you want your mother to accept you as you are—without demanding that you fulfill her expectations of, say, where you should live or who your friends should be—you need to see her as her own person. She may not join the gym to build her aging bones or start dating again after your father died as you would want her to do, but these are her decisions to make, not yours. Offering occasional encouragement or assistance is OK, but beyond that, let her live her own life—and you’ll see the friction between you ease noticeably. Actively nurture appreciation of her. In Japanese Naikan therapy, a person spends hours in private reciting all the reasons that she is thankful for her mother (and father) for everything that was done for her. Try this, speaking aloud or writing a list and ignoring any mishaps or mistakes your mother has made. Examples: "Thank you, Mom, for helping me with my homework"... "Thank you, Mom, for telling me not to date that boy who treated me badly"... "Thank you, Mom, for caring enough to call me about my mammogram results." You will naturally have more patience for dealing with today’s minor (and not so minor) annoyances when you pause to acknowledge all the efforts she has made for you throughout your life. Source: Judy Kuriansky, PhD, is a clinical psychologist and sex therapist on the adjunct faculty of Teachers College, Columbia University in New York City. She is the author of five books, including The Complete Idiot’s Guide to a Healthy Relationship (Alpha), and is a columnist and advisory board member for HealthyWoman from Bottom Line. www.DrJudy.com
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| | | Fascinating Facts 95%... American women age 40 and older who do not know their own breast density—even though dense-breasted women are more likely to get breast cancer and less likely to have cancer show up on a mammogram. Source: Harris Interactive poll 97%... Emergency department doctors who report that they treat Medicaid patients every day who cannot find any other doctor to accept their health insurance. Source: A survey from the American College of Emergency Physicians 99%... US adults with untreated alcohol abuse disorders who do not believe that they need treatment. For an anonymous assessment test: Visit www.HowDoYouScore.org. Source: US Substance Abuse and Mental Health Services Administration
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 | |  Tamara Eberlein, the editor of HealthyWoman from Bottom Line, has been a health journalist for nearly three decades. An award-winning author or coauthor of four books, she is committed to helping other women in midlife and beyond live healthy, fulfilling lives. Her latest book is the updated, third edition of When You’re Expecting Twins, Triplets, or Quads (HarperCollins). She is also the "chief health adviser" to her husband of 26 years and three college-age children. | |  | | Bottom Line Publications | 281 Tresser Boulevard, 8th Floor | Stamford, CT 06901
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