Women’s Health: Asked & Answered
Whether it’s taking care of the family or trying to find the perfect work/life balance, women have a lot on their plates, and that’s before health care even enters the picture. With that in mind, we asked local experts for advice on some of the health questions women face every day.
Q | I’m 30, so you would think acne would be a problem of the past. But I still get bumps every now and then, especially during my menstrual cycle, and I also have clogged pores (they look like little white bumps on my chin). Is there anything I can do to clear my skin?
A | Having acne as an adult is not uncommon, and women often have cyclical breakouts tied to menstruation. If your acne is primarily related to your cycle, it can be treated with oral contraceptives that contain estrogen and progesterone or hormone blockers such as spironolactone. Traditional acne medications like adapalene, which is now available over the counter as Differin, can help unclog pores, but they won’t address surges during your period.
If you want alternatives to medication, there are some simple steps you can take to help clear your skin. Avoid using skin care products that damage or abrade. Toners and other alcohol-based products use chemicals that strip the skin to make them seem more effective. But they also can cause breaks in the surface layers that allow bacteria in, so people tend to get more acne after using them. A gentle face wash is the best option.
There are often triggers for adult acne, and figuring out what affects your skin can be very useful in managing its condition. One of the most prevalent triggers is sunlight, so using a natural sunscreen can help reduce breakouts. Other common ones include red wine, spicy foods and environmental exposure. It’s important to talk to a health care provider about skin problems. Acne impacts how you see yourself and has repercussions on other aspects of your life as well. It’s not just a question of beauty or vanity, so don’t be afraid to seek treatment.
Dr. William McCoy
Washington University dermatologist
Q | I’m thinking of getting a breast lift and implants, but I’m scared because of what happened to my friend. She had to have multiple surgeries because her implants never dropped down properly. Is that common, and can you do anything to prevent it during surgery?
A | Implant malposition is an uncommon problem, affecting only 5% to 10% of patients. The reason placement issues occur varies from case to case. If the problem is apparent immediately after the procedure, the implant likely was improperly placed, and it can be corrected with revision surgery. Sometimes the issue manifests one or two years later. This is usually because of capsular contracture, an immune response that creates unusually hard and dense scar tissue, which can distort the shape of the breast or make the implant rise higher on the chest. Unfortunately, we don’t know much about its causes. It’s a difficult problem to predict and control, but it can be treated by changing the location of the implant or using a different kind of implant.
While implant malposition may seem daunting, it shouldn’t discourage you from seeking care. Just because it happened to your friend doesn’t mean something similar will happen to you. The best thing is to talk to a plastic surgeon about your concerns and learn about the best options for your specific case.
Dr. Sumesh Kaswan
SLUCare plastic surgeon
Q | I’m nearing 40, and as I’ve gotten older, I’ve noticed more ‘fuzz’ on my face. I’m tired of tweezing, and it’s not really working anyway. Also, I have veins on my cheeks that are becoming more prominent. Why did they show up? What solutions are available?
A | Dermaplaning can treat vellus hairs on the face and help with skin rejuvenation. It exfoliates, and as a result, newer skin is pushed to the surface more quickly. Prominent veins on the face could be the result of a number of things. Harsh treatments may damage the skin, old sun damage may weaken blood vessels, rosacea can cause a flushing response, or various other skin disorders could be to blame. I would recommend consulting a dermatologist about the problem.
It is important to be aware that even if you treat the unsightly blood vessels, they may return, or new ones may appear. Discuss therapy options with your dermatologist and make sure you have a good understanding of the process and costs before proceeding.
Jackie Carr, RN
Q | I am pregnant with my first child and naturally am a little nervous about the delivery. Are there any major risks with an epidural, and any benefits to natural childbirth? Also, my friend was telling me hospitals can provide remedies that help ease the pain of contractions. What are they? And are there any exercises I can do now to help the process go as smoothly as quickly as possible and help me avoid post-delivery issues?
A | It is quite natural to be nervous about childbirth. The first thing I tell my patients is to create a dynamic birth plan. It is very difficult to predict what you will need physically and emotionally during labor, and straying from your initial plan shouldn’t be viewed as a failure. The majority of women require anesthesia. Given the intensity of labor, many seek an epidural, which results in a denser pain blockade. It is safe for both mom and baby. Some women require anesthesia earlier in the process, while others wait. The American College of Obstetricians and Gynecologists says that maternal request is sufficient medical indication for pain relief during labor. There are some alternatives to anesthesia that can be used alone or as a complement to traditional methods. These include massage, hypnosis and water immersion therapy.
Benefits of natural childbirth include quick return of ambulatory and bladder function. Bonding, skin-to-skin contact and breastfeeding can be achieved with either method of childbirth and should not affect a woman’s decision to obtain anesthesia. For those who desire natural childbirth, I strongly recommend preparation and planned methods of pain control. It often is helpful to take classes or work with a labor doula.
Staying active and fit throughout pregnancy can aid in a smooth labor and delivery experience. Many women continue to participate in their normal activities, modifying them as their bodies need. Perinatal yoga and walking are two of the most common exercises for pregnant women. Attention to core strength and stability will help during labor.
Dr. Juliana Verticchio
Consultants in Women’s Healthcare