Such exciting developments on the skin care front! You've likely seen Carmina McGee's posts here at inCYST. Carmina is a registered dietitian as well as a licensed esthetician, and she loves to teach about skin care from inside out. If you haven't heard her interview on PCOS Challenge, and you want to know more about everything from acne to acanthosis nigricans to skin tags…I highly recommend it.
Speaking of skin, we're soon to have a new inCYST member with some great new information for you! Dr. Susan Van Dyke is a board certified dermatologist in Paradise Valley (near Phoenix), Arizona, who has a special interest in PCOS. She's got a great new laser technique called Duet LightSheer Laser, which is only available in select locations in the United States. You can read about Dr. Van Dyke and her procedure at this link, and you can join her Facebook group at"Van Dyke Laser and Skin".
I am learning from all of you how important it is to understand the emotional issues surrounding the appearance changes PCOS induces, and it's important to me that we provide support for you in those areas as well as in areas where we're currently very actively discussing.
I love what Carmina is doing and I'm absolutely thrilled Dr. Van Dyke is joining our group. I hope it's only the beginning of new, helpful information and services we at inCYST can offer to our readers.
I recently purchased a Clarisonic and it seems to be helping my acne. What do you think about Clarisonic for PCOS-related acne?
Dr. Van Dyke's answer:
It would be great, it doesn't spin so you don't get"abraded". It oscillates causing vibration that drives the cleanser into the pores to clean them out. I like using a glycolic cleanser with it (Vivite is good).
Dr. Van Dyke
************************************************************************************ If you're not familiar with Clarisonic, cllick here for more information.
Have a skin question? Send it along and we'll get Dr. Van Dyke's perspective!
I am not a skin expert, at all, but since we have so many women we work with who have skin problems, I am very interested in skin health. We are grateful to have Susan Van Dyke, MD, board-certified cosmetic dermatologist, as a resource when we do have questions about skin.
I am not a naturopath, either, but we do work with a lot of women who have decided they would rather treat their PCOS using complementary techniques when possible, rather than traditional Western medicine. And that is why we are grateful to have Susan Lundgren, ND, a naturopathic physician with an interest in women's health, in our network.
I do a lot of Tweeting, and because I interact with both Dr. Van Dyke and Dr. Lundgren in that network, I have come on to the radars of quite a few beauty/skin and natural medicine companies. So the other day, when a company sent me information about a new"natural botox", I knew exactly what to do. Ask the experts!
The new botox, called Natox, is being marketed as the natural alternative to Botox. According to its website, it is a skin cream with"100% natural ingredients". It has not been animal tested, it is paraben free, and it is"eco-emission" friendly (translate: comes in a glass bottle). The product claims to be scientifically proven, and one study has been provided, conducted in South Africa. However, the sample size in this study, the dose of cream, and the length of treatment were not provided. This is pretty basic information and its absence is suspect. No before/after photos (unretouched or otherwise) are provided. It is said to work by using"high energy discharges at specific frequencies to create uniquely structured resonating particles" OK, whatever.
I sent the information to the docs and here is what they said.
Dr. Van Dyke:
Marketing, nothing like Botox. BTW: Botox in natural (botulinum toxin is God-made).
Good point! We tend to think that Western doctors don't use nature, at all, and that is not true!
Dr. Lundgren:
It does not give any real science" microscopic, electromagnetically charged particles to relax nerve endings." That doesn't say how it relaxes the nerve endings- I want to contact them to find the exact mode of action. Also I found it funny that they said botox is not natural- those little botulism bacteria are very natural I just would not want them in my body: )
So there you have it. Both doctors, from different perspectives, agree, there is not a lot of valid scientific information supporting the claims this product makes. That's what happens when it's good science. It doesn't matter what the training, there will be a recognition of facts.
About a month ago, Dr. Susan Van Dyke did a great webinar for inCYST on the many aspects of PCOS that can be helped by working with a dermatologist. One of the conditions she spoke about was melasma, a skin patchiness/darkening that can be caused by hormonal changes and the use of birth control pills.
Coincidentally, a few days later, a friend casually mentioned that she had noticed the skin on her head was darkening even though she was diligent with sunscreen. What she showed me looked just like what I'd seen in Dr. Van Dyke's slides…and when I asked, she mentioned that the skin change actually did appear after she changed birth control pills about a year earlier.
I saw her last night, and she shared that she had been to see a dermatologist after we spoke and it turned out that she DID have melasma.
I had originally posted the photo you see in this post on our inCYST Facebook page and several women commented they had similar skin changes but had no idea they could be caused by birth control pills. I was very surprised these women did not know this, since so many women with PCOS have been prescribed them!
So I wanted to expand the audience that this message got to, to be sure that all women know, if you are on birth control pills, and your skin starts to look different, there may be a connection. And there are options for addressing it.
I'm really grateful to have Dr. Van Dyke on our team, she is just a wealth of information! I am working on editing a guest post she's done for us, it will be up later today. If you'd like to have a copy of her webinar (which includes Power Points), click here to order.
I spent some time with Susan Van Dyke, MD, yesterday, a board certified dermatologist interested in PCOS, who will soon be in our network. She demonstrated a new laser hair removal technique, LightSheer DUET, which is quicker and less painful than older laser techniques.
I know virtually nothing about what dermatologists do; in fact, the only thing I knew about laser treatments before yesterday was that people I know who have had them hated them because they were so painful. So I was curious to find out what this new procedure offered to inCYSTERs.
The pain from laser treatments comes from the heat in the laser beams. The earlier machines apparently had small surface areas, meaning quite a few laser shots had to be applied in order to cover a skin area. The newer"gun" is quite a bit larger, meaning far fewer"shots" need to be applied in order to do the job. In addition, the older machines were not as precise at hitting their target (the hair follicle), so a lot of the laser heat didn't hit the target and was wasted on surrounding tissue. The newer, more precise technique zaps pretty much what only needs to be zapped, meaning less skin heat…therefore far less pain.
I actually observed a procedure (which happened to be a man's back), a large surface area. The patient was relaxed and talked to us throughout the entire treatment, and a half hour later, had hardly any red skin. A very different experience than what friends of mine have described with the old technique.
When I tweeted yesterday that I was going to observe this procedure, an inCYSTER responded that laser hair removal was a useless exercise, because the hair grows back. That's likely true, if that's all you do! Laser hair reduction is permanent hair removal for currently existing hair, but there is still a need to work to balance hormones in order to alter the environment that promotes hair growth. What Dr. Van Dyke and I would like to do, is work together in a way that hair that is already there is removed with her DUET procedure, and then help these women learn new lifestyle choices that help to discourage the appearance of future hair.
It's going to be fun to work together, as I know this is a very distressing aspect of PCOS that affects self esteem, mood, etc…and that can lead to binge eating, which can only worsen the hair growth. The possibility that a simple dermatological procedure can help break this vicious cycle and jump start PCOS management in a positive direction, is very exciting.
You can learn more about Dr. Van Dyke at this link.
A lot has been talked about when it comes to skin cancer and its cause. Ninety percent of non-melanoma skin cancer is caused by sun exposure. Oddly enough one way we generate a very important vitamin (vitamin D) is from sun exposure! What to do? Expose skin to sun and risk cancer or become housebound avoiding all light from the sun and risk vitamin d deficiency?
Fact: Vitamin D is very good for you.
Fact: Sun is not.
First understand that I think the body is genius in the way it can take sun applied to the skin and start a biochemical process that makes us into little Vitamin D machines. It is photosynthesis like the plants! Without sun the machine does not work.
Without Vitamin D we experience a myriad of negative consequences. Vitamin D is necessary for healthy bones, good immunity and possibly in protecting us from diseases from fibromyalgia to multiple sclerosis, and cancers from prostate to colon. The NIH (National Institue of Health) has reviewed research on Vitamin D and found it to be very complicated. It is not just black and white (or in this case tan and white!). A lot of research is happening, just trying to figure out how much vitamin D we actually need for optimum health is an enormous undertaking (If you like data there is a good scientific review in the Journal of the American Academy of Dermatology, Feb 2006). Believe it or not we are still not sure how much Vitamin D is the correct amount.
We can all agree that we need at least some Vitamin D and we have three ways to get it; sun, food and supplements. Start with food; not a great source unless you eat a lot of fish (tuna, salmon, mackerel and fish liver). Beef liver, cheese and egg yolks have small amounts, but think for the cholesterol! Milk and bread are fortified which is helpful but many Americans still seem to be lacking.
So, supplement or sun? The reality is that if you have light skin and don’t live in a submarine you get about 15 minutes of sun on your hands and face just from living every day. The human body maxes out its Vitamin D producing capacity in 5 minutes (sunny day, hands and face unprotected). Anything more is not helping Vitamin D but is helping skin cancer. Shut-ins and dark skinned people are another story. Rolling grandma out to the sun porch everyday is an option but supplements are more practical. With very dark skin more sun time is needed to penetrate the natural advantage in sun protective color but how much time depends (I know, I hate that answer, too).
Bottom line, sun causes cancer; supplements are available to supply vitamin D, so why risk it? Until we know exactly what we need for perfect Vitamin D health perhaps we should go for the sunscreen and a pill. How much? 200 IU a day, 400 IU for over 50’s and 600 IU for over 70’s.
Note from Monika: One of the aspects of inCYST that I absolutely love is how because of our interdisciplinary team we can look at health issues in new and different ways. Dr. Van Dyke has been teaching me so much about skin issues and how the relate to PCOS. She has been very active this month on Twitter for melanoma month. It seemed like the perfect time to have her write about vitamin D from her specialty's perspective. Thank you so much for taking the time!
For more information on Dr. Van Dyke's practice please visit http://www.vandykelaser.com/. She can be found on Twitter at @drvandyke.
One of my goals in the near future is to pay more attention to skin problems associated with PCOS. They are many, and we have a great resource in our network, Dr. Susan Van Dyke. If you have any skin questions at all, please post them here and I'll forward them to her for answers to post.
The most widely recognized PCOS-related skin problems are acne, hirsutism, and melasmas. However, I've worked with quite a few women also struggling with problems like eczema and psoriasis, both related to diet, in particular, omega-3 fatty acid balance.
This past week I had a new client who wanted help for her eczema. I brought her samples of an Australian homeopathic remedy from the Expo, and she absolutely loves one of them. She shared that this product reduces the itching almost immediately, something the prescription creams she'd tried were not able to do. She also felt the redness started to go away quickly as well.
That's a pretty great testimonial!
I shared the product information with Dr. Van Dyke and she noticed that one of the ingredients in this product listed as"inactive", in Western (non-homeopathic) medicine, gamma-linolenic acid (aka borage oil) has been shown to help eczema. She suggested that it wasn't as"inactive" as the company realized!
Apparently some people with eczema do not convert omega-6 fatty acids well to the gamma-linolenic by-product that the skin needs. So the omega-6's build up and never get into the form that the skin needs.
My client is increasing the omega-3 content of her diet, reducing the omega-6 content, and using the cream…and if that doesn't correct the imbalance, we'll consider supplementing with GLA. We'll keep you posted!
The product I'm referring to is called Natralia. I did not see it in my local Sprouts store, and I did not see a store locator on their website. But I did find it on amazon.com. Here is the link to all of the Natralia products. (The products I'm sharing from the Expo are so new many of them can only be found online for now. Be sure to ask for them at your favorite store so they are more convenient to buy locally.)
Henz BM, Jablonska S, van de Kerkhof PC, Stingl G, Blaszczyk M, Vandervalk PG, Veenhuizen R, Muggli R, Raederstorff D. Double-blind, multicentre analysis of the efficacy of borage oil in patients with atopic eczema. Br J Dermatol. 1999 Apr;140(4):685-8.
*****WE INTERRUPT THIS BLOG POST FOR AN IMPORTANT ANNOUNCEMENT***
So excited to announce that starting this week, the Nutrition 101 series will be co-written in conjunction with PCOS Diva Amy Medling, of Nashua, NH. Amy, a professional health coach, is currently completing the inCYST training. She also loves to cook, and has a great series on her own blog with a week's worth of menus. You all are always asking for those, so I like that Amy likes so much to take the time to prepare them. The theme in her menus will be the nutrient I feature over here. It's so fun to see what she did with this first round…and I like that you get suggestions more diverse than what I would eat myself. Increases the likelihood that you'll find something between both blogs that works for you.
Riboflavin is my favorite vitamin. Not for any nutritional reason, but because in my senior year of college I was lucky enough to work in renowned nutrition researcher Daphne Roe's laboratory, as a lab assistant for a riboflavin study. I was one of the people who prepared the food for female subjects in a study evaluating whether riboflavin requirements increase with increased activity (turns out they do).
It was a most unique job, because riboflavin is destroyed by ultraviolet light. In order to keep it stable to increase the accuracy of the experiment, my entire work shift was spent weighing and measuring all of the subjects' food IN THE DARK. Yes, for a semester, I dished out rice and poured milk with the shades pulled and the lights out.
As you can see in the bio I linked to, Dr. Roe was highly intelligent, hugely curious, and very high energy. She completely intimidated many of her students, as she loved the Socratic method and thought nothing of stopping midlecture, looking a student straight in the eye, and asking their opinion on the subject of the day's lecture. It is in her class that I developed a keen ability to avoid eye contact and feign complete focused interest on the notepad on my desk.
I was so very fortunate to be able to work side by side with Dr. Roe, because I had the honor of seeing her other side, that of someone who was intensely curious about problems affecting real people. She had questions she needed to answer, and did her best to do that. She didn't have patience with messing around, because she had important things to do. It is because she was an MD (a practicing dermatologist of all things!) that I become somewhat impatient with physicians who do not appreciate or take the time to understand solid nutrition principles. Sorry guys, Dr. Roe set a very high standard. It would serve you well to follow in her footsteps. (On the flip side, I do my very best to work well with those who DO appreciate nutrition, like our own dermatologist, Dr. Van Dyke, who took time out of her busy schedule to take our training, much of which is not directly related to her personal medical specialty.)
I love riboflavin because by the end of the study I hated the tedious work so bloody much I decided I never wanted to be a researcher. BUT…I also gained such an appreciation for people who have the capacity to think about those questions and piece together the details of such a study to get answers that make the world a better place. I credit Dr. Roe for planting the very first seed of the inCYST Institute in this college senior's heart.
And since you all are working to increase your activity level, it's important that you benefit from Dr. Roe's research on the influence of exercise on how much riboflavin you need.
If you're vegetarian, vegan or dairy-free, be sure and take the time to analyze your diet to see how you measure up with this vitamin. You may be falling short.
Got milk? That's a good start. Look for the following in your next shopping trip. asparagus popcorn bananas persimmons okra Swiss chard Cottage cheese Yogurt Meat Eggs Fish Green beans
Thanks, Dr. Roe, for all of what you did that rubbed off on me. I was pretty humbled by your presence and am grateful for your passion and enthusiasm for instilling excellence in budding nutrition experts like myself. I hope if you're looking down on your students, like me and fellow classmates and researchers Valerie Duffy at the University of Connecticut, and Karen Parfitt at Pomona College, you're smiling. You laid the foundation for many professional passions and successes.
Belko AZ, Meredith MP, Kalkwarf HJ, Obarzanek E, Weinberg S, Roach R, McKeon G, Roe DA. Effects of exercise on riboflavin requirements: biological validation in weight reducing women. Am J Clin Nutr. 1985 Feb;41(2):270-7.
Our own Dr. Susan Van Dyke, in this video, demonstrates Fraxel, a type of laser treatment that is helpful for acne scars and skin discoloration, issues many of you readers face with your PCOS.
Dr. Van Dyke's office is located in Paradise Valley, Arizona.
If you've been enjoying the PCOS Challenge Radio Show, you'll love Sasha's latest venture! Dr. Van Dyke, Ellen Goldfarb, Gretchen Kubacky, and myself will be presenting more in-depth seminars on our areas of specialty.
Topics to be covered include:
Nutrition Essentials for PCOS--Monika M. Woolsey, MS, RD Tuesday, October 20
Eating Disorders and PCOS--Ellen Reiss Goldfarb, RD Tuesday, October 27
Living Happier and Healthier with PCOS--Gretchen Kubacky, PsyD Tuesday, November 3
Hair Removal Solutions for Women With PCOS--Susan Van Dyke, MD Tuesday, November 10
The Natural Solution to Overcoming PCOS--Julie Walsh, ND Tuesday, November 17
All webinars will be held from 8:00 — 9:00 Eastern Time.
Space is limited for the live sessions, but if you can't make any of the live sessions, they will all be recorded and made available on CD.
Please join us! We've all been working hard on this project and it's all been especially for YOU!
We're in the middle of a fun series here in Phoenix, called"Training Your Mental Athlete". It's designed as a wellness program for highly energetic, intelligent, creative people, for whom it is extra important to nourish brains and nervous systems.
We started off last week with an event featured on skin. Sarah Jones, inCYST's very first registered yoga teacher, created a whole class of yoga poses designed to improve skin circulation and tone. Here's the class warming up for yoga.
Susan Van Dyke, MD, came for the second half, and shared her wisdom regarding keeping skin healthy. She had a lot of great information about choosing healthy skin care products and sunscreens. She also gave us a peek at some of the technology she has to help reduce the effects of sun damage and other skin problems. Participants were invited to come to her office and have a special imaging done that visualizes the degree of sun damage existing under the skin that is not yet visible to the eye. It was eye opening!
Deborah, wo has been participating in inCYST events for five years, enjoyed her very first yoga class. Sarah is telling her about more classes she can enjoy at Metta Yoga, who is hosting this series.
We have more classes through December! Here is our poster with details. For registration information visit the Metta Yoga website.
If you missed this event, and you're interested in Dr. Van Dyke's services, she's got a great open house coming up. Here's information about the schedule. Note, there are a ton of giveaways! I learn so much when I go to these event, there's always a new technology she's using. It's totally worth putting into your schedule!
I just received a review copy of Living With PCOS by Angela Boss and Evelina Sterling. I actually sold the original edition of this book in my bookstore for a time, so I was interested to see the new version.
Before I review, I want to qualify, I went into reviewing this book a little differently than many readers would. I am a dietitian who believes in the power of nutrition to help women with PCOS. In the process of building the inCYST network, I've also had the honor and pleasure of meeting and working with colleagues who use many different (and evidence-based) approaches to PCOS management that expand past what a medical doctor might offer. So I am most likely to connect with experts on the topic with a similar perspective.
What this book is very good at: --putting the readers in the frustrated and invalidated shoes of a woman with this diagnosis, and advocating for better identification and syndrome management. --providing a laundry list of qualities to look for in a primary care physician. --summarizing lab values typically used to develop a woman's treatment plan. --explaining medications typically prescribed for PCOS management. --including an entire chapter on depression, an aspect of PCOS that medical professionals seem to not want to acknowledge, but which is very, very prevalent.
What this book could have been better at: --advocating for as much discretion when choosing a nutrition professional as choosing a physician. Many dietitians say they treat PCOS when they haven't even pursued specialized training for the diagnosis. --advocating for as much discretion when choosing an alternative care provider as choosing a physician. Again, there are many people who view women with this diagnosis as a revenue stream, not women who deserve evidence-based, ethical treatment. --explaining why breastfeeding can be problematic in PCOS. --describing and evaluating alternative therapies, supplements, and herbs. A very high percentage of women with PCOS are so desperate for help they are doing a lot of self-treating and self-medicating, which can be helpful…or very dangerous. --broaching the topic of emotional eating, binge eating, and eating disorders. It's rampant in this population, it needs to be validated, explained, and destigmatized, as much as the rest of the symptoms do.
I was not entirely comfortable with the section on low carbohydrate diets. Even though it acknowledged that these diets are restrictive and difficult to maintain, it went on to make some general recommendations about how to pursue one. One of the most common problems we encounter at inCYST in our individual counseling, is a blanket carbohydrate restriction that eventually ends up with a binge. It's a noble goal, to reduce carbohydrates, but there are ways to do it that do not promote disordered eating. Perhaps including a dietitian in a future version of this book could help promote healthier eating patterns that are evidence-based.
Because I've been working with Dr. Van Dyke to better understand laser treatment for hirsutism, I was interested on the section regarding laser hair removal. There were some important facts about this treatment that were not included.
In general, for someone who is new to the diagnosis, it's a helpful rundown of what to expect when working with a medical doctor, but the slant is toward that relationship. If you have chosen, in your own personal situation, to prioritize medical treatment without using nutrition, naturopathy, acupuncture, or other complementary treatments, it is a good resource. However, if your treatment team includes other approachess, you will not find information in this book to enlighten you or guide you with regard to those issues.
Not a whole lot, unfortunately. There is no board certification for the disease, no school, nothing. It's the whole reason I started inCYST. I was appalled at the things I was hearing women say they had been taught by specialists. When I looked on the Internet, I saw a lot of supplement companies filling in the gap. And, of course, using the gap as a way to line their own pockets. Many of the health professionals people turn to in order to get help don't accept insurance. I realized that women with PCOS are very easily taken advantage of without getting much in return for their investment. And now that PCOS is gaining attention, and the economy is struggling, I'm seeing a lot more colleagues advertise that this is a specialty service they provide.
If you've found someone on the Internet who is advertising that they are a specialist, don't assume that means much at all. Take the time to ask them what they did to become specialized.
You can be assured that anyone whose name appears on this blog has worked hard to be informed. The dietitians you see, have taken courses on sleep disorders, dermatology, and biochemistry, not just nutrition. The psychologists and even our dermatologist, Dr. Van Dyke, have taken the time to understand nutrition for PCOS.
We have all committed to that, because we collectively wanted to raise the bar, and we wanted you to know, for sure, if you asked someone in California, Virginia, New York, or Chicago, for help, you'd get a well-informed person who is passionate about understanding what can best help you.
Of course, there are people who do not belong to inCYST who are very good at what they do, with lots of great credentials and training. I can't speak for them. What I can say is, that they should be able to, without hesitation, when asked, provide you with a description of the qualifications they have that allow them to make the claims that they do. And women with PCOS should not be afraid to ask that question before making their first appointment.
Many of our network members have their own blogs. Please check the list on the right hand side of this blog to see what they are up to! It's inspiring to see what a great, talented collection of professionals come together on this blog and who work on behalf of others in so many different ways.
A nutritionist's perspective on psychiatric medications--Monika Woolsey Alimentos y Sentimientos--Ivonne Berkowitz' Spanish translations of selected blog posts Ask Dr Gretchen--Gretchen Kubacky, Psy D Ellen Goldfarb--Ellen Goldfarb, RD Marquette Nutrition & Fitness--Christine Marquette, RD Skin Envy MD--Susan Van Dyke, MD The Doctor's Dietitian--Susan Dopart, MS, RD Twin City Nutrition Blog--Michele Gorman, RD
If you want to learn the latest about hair removal, don't miss this interview with Dr. Susan Van Dyke, a board certified dermatologist!
Here is a video demonstrating Light Sheer Duet, a newer, faster, less painful laser hair removal treatment that was discusssed in the interview.
Hirsutism is such a devastating condition, worthy of understanding and treatment. Here are some explanations about how to get started and how to find the best practitioner to help you.
