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How Obagi Treats Brown Spots and Melasma from Tampa and St Pete’s Holistic Skin Care Doctor

Sun damage causes wrinkles and sun spots while melasma is mostly caused by hormonal changes.  Laser can be helpful with sun damage, but is not effective for melasma.  Skin care is always the treatment of choice for melasma and is often the treatment of choice for sun damage.

We use Obagi for sun damage as it is the longest lasting, most well proven prescription treatment for skin care.  Often, we will apply a deep Obagi Blue Peel prior to starting the daily skin care program to “kick start” the benefits.  Obagi is a system that includes:

Cleanser and toner:  this is the first step in getting the oils and dead skin off the face, so that medicated creams can be absorbed.

Exfoliderm:  exfoliating cream applied in the morning.  When patients use this, they may peel slightly for the first few weeks.  Exfoliation is important to get rid of surface layers of skin, because the medicated creams are more effective on new skin.

Retinoic Acid: This cream is FDA approved for dark spots, wrinkle reduction and acne.

Hydroquinone 4%:  This is a prescription strength bleaching cream.  It is most effective in combination with Retinoic Acid and exfoliation.

Sunscreen/moisturizer:  It is important to keep protect against the sun or much of the benefits of the treatment will be lost.

We recommend that patients use the full Obagi system for three months.  They will notice the spots and wrinkles improve after 6 weeks and continue to improve as they continue to use the system.  After three months, patients should go off the hydroquinone and retinoic acid for at least three months.  Then, they can repeat the process if they would like additional improvement.  Even when we use laser to reduce dark spots, we recommend prescription skin care after laser treatments to extend how long the results of laser treatments last.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your appointment, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

How to Treat Acne with Diet From Tampa and St Pete’s Nutrition Doctor: Acne Part 2

Typically acne is caused by a combination of hormones, diet, bacteria and skin oils.  We discuss hormone treatment and skin care for bacteria and oils on other blogs:

http://www.doctorhermann.com/blog/bid/142718/How-Hormone-Evaluation-Can-Solve-Acne-in-Tampa-and-St-Pete-Acne-Care-Part-1

http://www.doctorhermann.com/blog/bid/142704/The-Best-Skin-Care-for-Acne-in-Tampa-and-St-Pete

Diet makes a big difference in acne treatment.  Anyone who is distressed enough by their acne to see a doctor, owes it to themselves to eliminate foods that may be causing their problem for one month.  If after a month, their skin is better, then they will be motivated to continue to avoid the foods that cause acne.  If after a month, the acne has not improved then, food is not contributing to the acne, and the patient should return to normal diet.  When acne is not affected by diet, we focus on hormone and bacterial treatments.

The key dietary changes that can improve acne are listed below.

Eliminate Milk:  All dairy, which includes cheese, yogurt, milk and ice cream, make acne worse. Believe it or not, skim milk is as bad for acne as whole milk.  When you are not drinking milk, you should take 1000 mg of Calcium per day to keep your bones strong.

Food Sensitivity Testing:  If you are allergic to a food, it can cause acne and other rashes.  You can get blood work to determine whether you have food sensitivities.  If you test allergic to any foods, then avoid the food and your acne should improve.  Since insurance often does not cover this type of testing, you can also do an elimination diet.

Elimination Diet.  If you do not get tested for food sensitivity, the other way is to determine if foods are causing your acne is to do a special diet that is free of foods people tend to be allergic to.  If, after being on the diet for three weeks, the acne is improved, then, you add back one food at a time to see which foods you react to.  This takes more time, but does not cost anything.

We educate patients on elimination diets, test hormone levels and food sensitivities and use prescription skin care to give optimum results for acne treatment.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your appointment, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Micropoint Stimulation: Painless Acupuncture by Tampa St. Pete’s Medical Acupuncturist

Posted by Anne Hermann on Thu, May 10, 2012 @ 11:03 AM

Microcurrent Point Stimulation is a technique in which an acupuncturist, physical therapist or massage therapist applies low frequency, DC current stimulation to acupuncture and trigger points.  It is FDA approved and often covered by insurance as part of a physical therapy treatment.  The treatment takes 5 to 15 minutes.  It feels like a buzzing on the surface of the skin.  Micropoint stimulation is a well proven method for pain management.  It can be used on its own or with physical therapy to give improvement in pain above physical therapy alone.

If you are considering acupuncture, but are afraid of needles, microcurrent point stimulation is a safe, effective way to have the benefits of acupuncture without needles.  Many patients request laser acupuncture.  This is a technique in which low level lasers is applied to acupuncture points.  While we have the laser required for laser acupuncture, we do not use it much. Painless acupuncture without needles is better than laser acupuncture. Microcurrent Point Stimulation is better proven by studies and is the method we prefer to use.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your appointment, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Trigger Point Injections for Pain Management: From Tampa and St Petersburg’s Holistic Pain Doctor

Posted by Anne Hermann on Fri, May 04, 2012 @ 07:04 AM

Dr. Anne Hermann

Most adults have small, tender, damaged areas inside muscles called trigger points.  They are the size of a pencil eraser and feel like a knot when you press on them.  They can be in any muscle, including the neck, jaw, back, shoulder, hip, arm and leg muscles.  Trigger points are caused by injury or overusing a muscle.

A doctor performs trigger point injections by injecting into the trigger point.  The fluid injected can be sterile saline, lidocaine, steroid or herbal anti-inflammatory such as Trameel.  Trigger points have scar tissue inside them that prevents healthy blood flow.  The fluid breaks up the knot so that the muscle will relax and normal blood flow can return to the area.  Often, the patient will feel a muscle ‘release’ as when the knot is injected.

Trigger point injections are safe and often covered by insurance.  They can provide significant relief for many pain syndromes.  In our clinic, we also perform trigger point release with pressure or “dry needling” in which we needle the trigger point to release the knot, but do not inject fluid.

Learn how acupuncture point injection therapy and trigger point injection work together to eliminate pain at Dr. Terry Graham’s blog: http://www.doctorhermann.com/blog/bid/129100/Acupuncture-Treatments-Tampa-St-Pete-Acupoint-Injection-Therapy.  Even Dr. Oz has supports trigger point injections as an alternate cure for pain:http://www.doctoroz.com/videos/alternative-cure-biopuncture

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your consult, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Why More Tampa and St Pete Residents are Using Low Dose Naltrexone, LDN

Posted by Anne Hermann on Wed, Apr 25, 2012 @ 02:07 PM

Anne Hermann, MD

Low Dose Naltrexone, or LDN, is a small dose of a medication called Naltrexone that was FDA approved for treatment in opiod addiction in 1984.   Naltrexone is believed to increase our body’s production of endorphins, which boosts the immune system.

Within a year of hitting the market, some physicians noticed that very low doses of naltrexone reduced decline rates in HIV and cancer patients.

Currently, multiple research centers, including Stanford, Penn State University, University of California, San Francisco and University of Utah performed small studies that demonstrate that LDN is beneficial for:

  • Multiple Sclerosis
  • Chronic Fatigue Syndrome
  • Crohn’s Disease
  • Autoimmune skin disorders
  • Ovarian cancer
  • Pancreatic cancer

In general, LDN is safe and tolerated very well.  It may enhance treatment of many autoimmune diseases.  While studies are small, they are all positive and since the medication is safe, it can make a big difference to a lot of people.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your consult, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

ALCAT vs IgG Antibody Testing for Food Sensitivities: From Tampa and St Pete’s Medical Nutrition Expert

Anne Hermann, MD

Food sensitivities are mild allergies that can cause migraine, fatigue, weight gain, gas, bloating, joint pain and rashes.   If you have food sensitivities, you will feel much better when you eliminate the foods you are allergic to. So how do you find out which foods are causing your symptoms?   We offer both IgG antibody and ALCAT testing for food sensitivities.  ALCAT is more effective than the IgG antibody testing.  ALCAT measures the total amount of inflammation in whole blood that you have to a food, while IgG antibody testing measures antibodies, but not inflammation.

ALCAT is the gold standard for food allergy testing because it is the only lab that has been shown to have 83.4 % accuracy with food and 96% accuracy with food additives in double blind trials.  The level of accuracy with IgG diagnosis of food allergies is much lower.

Prices for ALCAT testing vary based on how many foods and additives are being tested.  The range is between $450 and $1100.  IgG testing is much less because the insurance will often pay a portion.  Typically, IgG cost is between $80 to $250 depending on how much insurance covers.

Even though the ALCAT is the better test, I also carry the IgG testing because it costs less than ALCAT and still gives us some information about foods that people might be allergic to.  Also, if cost is an issue, I offer elimination diets, which cost nothing and can help you determine whether you have a food sensitivity.  To learn more about IgG testing and elimination diets click this blog: http://www.doctorhermann.com/blog/bid/129091/How-to-Treat-Food-Allergies-in-the-Tampa-St-Pete-Area.

To schedule your appointment with Dr. Anne Hermann, call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Why You Should Take Vitamin K from Tampa and St Pete’s Medical Nutritionist, Anne Hermann, MD

Posted by Anne Hermann on Mon, Apr 16, 2012 @ 05:28 PM

Anne Hermann, MD

The buzz in the nutrition world is that Vitamin K2 (menaquinone) is more important that we ever realized.  Vitamin K2 has always been recognized
for its crucial role in blood clotting.  Here are a few new recent findings about Vitamin K2:

 

Adding K2 to Vitamin D and Calcium reduces risk of fracture by 25%.  Vitamin K Supplementation for the primary prevention of osteoporotic fractures: is it
cost-effective and is future research warranted?  Gajic-Veljanoski O, Byoumi AM, Tomlinson G, Khan K, Cheung AM.  Osteoporosis Int. 2012 Mar 8

Vitamin K reduces heart disease.  High dietary menaquinone intake is associated with reduced coronary calcification.  Beulens JW. Bots ML, Atsma F, Bartelink ML. Atherosclerosis. 2009 Apr; 203(2):489-93

People with higher dietary Vitamin K2 intake have lower rates of death from cancer. Dietary vitamin K intake in relation to cancer incidence and mortality:  results from the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition.  Am J Clin Nutr. 2010 May, 91(5):1348-58.

With all these benefits, I recommend that patients take 125 mcg of vitamin K2 per day.  For bone health, I recommend a preparation of Vitamin D and Vitamin K2.  Sources of vitamin K include kale, and other leafy green vegetables.  If you would like to have your vitamin K level checked, we do this through Spectracell Labs.

If you are on a blood thinner, you will need to talk to a physician about the safe amount of K2 for you.

Anne Hermann, MD, is a board certified physician nutrition specialist.  To schedule your appointment with Dr. Hermann, call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Is Natural Progesterone Cream Safe and Effective? Learn from Tampa and St Pete’s Expert

Posted by Anne Hermann on Fri, Apr 13, 2012 @ 04:39 PM

Anne Hermann, MD

Bioidentical hormones are exactly the same molecule as those produced in our own bodies.  Most standard hormones are chemically different than the hormones made by our bodies.  Progesterone is a hormone that is also converted to other hormones in our bodies.  So, when we take the bioidentical form, we are not only replacing progesterone, but also the other hormones that are made with progesterone.  Standard, synthetic progesterone cannot be converted into other hormones in our bodies.

As early as the late 1990’s, I saw patients who used natural progesterone cream for menopausal symptoms.  At that time, most doctors had no knowledge about the difference between standard hormone therapy and bioidentical hormones.   When I spoke with one expert in the field, he told me that “in order to absorb enough progesterone through the skin, you would have to wear a progesterone patch the size of a vest”.  I knew this could not be correct as my patients were having real benefit from the progesterone creams they were using.  I set out to perform a study to determine how much natural progesterone is absorbed from the creams.  At Bassett Hospital, a Columbia University Hospital, where I did my residency, I worked with two clinical pharmacologists, Joe Bertino, PhD and Ann Nafsiger, MD.  They helped me develop a protocol to compare the FDA approved oral natural progesterone, Prometrium to over the counter progesterone cream.  The results were surprising to many (but not to me):  40 mg of progesterone cream twice a day gives same blood value of progesterone as 200 mg per day of Prometrium!

Because we already know that prometrium is effective against endometrial cancer, we can say that progesterone cream is equally effective at this.  The cream provides additional benefit because it does not yield as many by-products as the oral form.  Now, research is leaning towards bioidentical progesterone as being less likely to cause breast cancer than synthetic progesterone.

All progesterone use should be used under medical supervision.

For more blogs on bioidentical hormones, check out http://www.doctorhermann.com/blog/?Tag=Bioidentical+Hormone+Therapy.

To schedule your consult with Dr. Anne Hermann, call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Bioidentical Hormone Therapy from Tampa and St Petersburg’s Own Expert!

Posted by Anne Hermann on Wed, Apr 11, 2012 @ 04:10 PM

Anne Hermann, MD

What You Need to Know about Bioidentical Hormone Therapy from Tampa and St Petersburg’s Own Expert!

This article focuses on female hormone therapy.  On my blog, I also post articles focused on male hormone therapy.  As an author of nationally recognized research on bioidentical hormone therapy, I have been treating men and women for 9 years in Tampa Bay.  I recommend hormone replacement therapy when non-hormonal and natural therapies do not work in treatment of menopausal symptoms including:

  • hot flashes
  • weight gain
  • sleep disturbance
  • “brain fog”
  • poor libido
  • vaginal dryness
  • skin changes

The medical community is learning that some forms of hormone replacement, called bioidentical hormones, have less side effects and less danger than standard hormones.  Less risk does not mean no risk, and I always discuss these pros and cons with my patients.

Hormone therapy is not recommended for women with the following:

  • · Current or past history of breast cancer (standard hormone therapy increase risk of breast cancer)
  • · Coronary heart disease especially if older than 60 or went through menopause more than 10 years ago
  • · A previous blood clot, heart attack, or stroke (standard therapy increase risk of blood clots and stroke)
  • · Women at high risk for these complications

Benefits:

  • Reduces the risk of bone fracture caused by osteoporosis.
  • Lowers risk of colon cancer
  • Make women with menopausal symptoms feel better

The North American Menopause Society, the Endocrine Society, the International Menopause Society, and guidelines from the European Menopause and Andropause Society for the management of menopausal women all favor the use of bioidentical forms of hormone replacement in women with high risk of blood clots.  Unlike standard estrogen treatment, bioidentical estradiol does not increase risk of blood clots or stroke (doses ≤ 50 μg).  Bioidentical progesterone also has less risk of blood clots and breast cancer than standard therapy. Based on these data, which are now included in the guidelines, the use of transdermal estradiol and micronized progesterone could reduce the excess risk of blood clots, stroke, and possibly even breast cancer associated with hormone use.  Simon JA. What’s new in hormone replacement therapy: focus on transdermal estradiol and micronized progesterone. Climacteric. 2012 Apr;15 Suppl 1:3-10.

I was the first author in the study that demonstrated that the bioidentical form of progesterone cream is absorbed as well as progesterone pillsOver-the-counter progesterone cream produces significant drug exposure compared to a food and drug administration-approved oral progesterone product.  Hermann AC, Nafziger AN, Victory J, Kulawy R, Rocci ML Jr, Bertino JS Jr.J Clin Pharmacol. 2005 Jun;45(6):614-9.  Look out for my blog on this topic in the future.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your consult, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

MIC B vs B12 Shots for Weight Loss in Tampa and St. Petersburg

Posted by Anne Hermann on Wed, Apr 04, 2012 @ 12:46 PM

Anne Hermann, MD

Why MIC B Shots are Better than B12 Shots for the Best Weight Loss

We are often asked if we do B 12 shots for weight loss.  To be accurate, there are better shots for weight loss than B12.  We recommend and use a MIC combo shot that provides a combination of amino acids and vitamins to aid in weight loss.

B12 shots (which we do offer for B12 deficiency) contain very high concentrations of B12, but do not have any other vitamins in them.  Before we give either shot, we usually check your blood level of B vitamins.   If you are low in B12, then you will feel better with the concentrated B12 shot.  If your B12 level is normal to high, adding more B12 will not make you feel any better or aid in weight loss.

So, for people with normal B12 concentrations, we recommend the MIC combo which has:

  • Methianine, Inositol and Choline: Amino acids that aid in the maintenance of muscle tissue
  • Vitamin C to boost immune system and skin health
  • Methylcobalamin, pyridoxine, niacin, riboflavin and thiamine, which are B vitamins that help prevent fatigue while you are on a calorie restricted diet.

Our formula also contains lidocaine to ensure that the injection is comfortable.  If you are receiving B shots for weight loss, please ask your provider if you are getting B12 or a B complex.  If it is just B12, be sure that the doctor monitors your blood levels so that you do not get too much.

For more information, we offer consults at 813-902-9559 or 727-278-3992.  Anne Hermann, MD is double board certified in Nutrition as well as Internal Medicine.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.