Adrenal Fatigue & You

 

 

The adrenal glands are small glands located on top of each kidney. They produce hormones that you can't live without, including sex hormones and cortisol. Cortisol helps you respond to stress and has many other important functions.

 

Adrenal fatigue results when the adrenal glands function below the necessary level. Most commonly associated with intense or prolonged stress, it can also arise during or after acute or chronic infections, especially respiratory infections such as influenza, bronchitis or pneumonia. As the name suggests, its paramount symptom is fatigue that is not relieved by sleep. You may look and act relatively normal with adrenal fatigue and may not have any obvious signs of physical illness, yet you live with a general sense of unwellness, tiredness or "gray" feelings. People experiencing adrenal fatigue often have to use coffee, colas and other stimulants to get going in the morning and to prop themselves up during the day.

 

Adrenal fatigue can wreak havoc with your life. In the more serious cases, the activity of the adrenal glands is so diminished that you may have difficulty getting out of bed for more than a few hours per day. With each increment of reduction in adrenal function, every organ and system in your body is more profoundly affected. Changes occur in your carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system, and even sex drive. Many other alterations take place at the biochemical and cellular levels in response to and to compensate for the decrease in adrenal hormones that occurs with adrenal fatigue. Your body does its best to make up for under-functioning adrenal glands, but it does so at a price.

 

STAGES OF ADRENAL MELTDOWN:

 

 

Stage 1

 

 

In the early stages, cortisol and DHEA remain at normal levels. The adrenal glands are able to handle the stress being placed on the body. Hormone production may be somewhat affected but for the most part, the body is able to produce enough cortisol and DHEA to compensate.

 

Stage 2

 

With the body under constant stress, cortisol levels continue to rise. DHEA levels begin to gradually decrease. As the adrenals begun to struggle, symptoms like nervousness, disruptions in sleep patterns, body aches and digestive problems begin to start.

 

Stage 3

 

In this stage, anxiety and exhaustion begin to appear simultaneously. Panic attacks can result from extremely high levels of cortisol in the system. With the level of DHEA continuing to drop, sleeplessness may result. When these two extremes begin to affect day-to-day activities, people usually seek medical treatment.

 

Stage 4

 

As the body's stored DHEA, begins to be used up, cortisol levels begin to drop. Cortisol levels may taper off and symptoms may seem less. The body remains under stress, and resources of cortisol and DHEA are being depleted. A person's energy patterns begin to change. It becomes more difficult to wake up and even harder to fall asleep. Sleep is often disrupted as blood sugar begins to drop.

 

Stage 5

 

Stage 5 of adrenal fatigue shows DHEA levels rising. Because cortisol production has stalled, very little of the existing DHEA is being used. What little cortisol is available is quickly being used in the effort to handle stress. The body continues to weaken, and little activity is possible.

 

Stage 6

 

During this stage, the body tries to stimulate the production of cortisol as DHEA levels rise above normal. Adrenocorticotropic hormone, or ACTH, is not available to fuel the process, so the body continues to weaken. ACTH levels have continually dropped, along with levels of other hormones throughout the body. This is usually the body's final attempt to correct the imbalance.

 

Stage 7

 

Stage 7 is rarely seen; it's basic adrenal failure. The adrenals have ceased to function for the most part, and little can be done to restore balance.

 

 

In view of this, it is so important to understand the importance of stress management in a more holistic level. So what can one do, when we start to face adrenal malfunction? In my next blog post, I will discuss at length the role of exercise, nutrition, adaptogens, supplements and treatment of adrenal fatigue. Keep reading!

 

 

 

Diabetic Foot Ulcer and Platelet Rich Plasma (PRP)

Dear Readers,

 

First and foremost, my advanced apologies for the long absence since Christmas. The season to be jolly truly turned out to be one with never ending things to do for both family, friends and patients included.

 

So here goes my first topic for the new year - 2015.

 

We all know that Diabetes Mellitus is a pandemic that has plagued mankind for centuries now. The disease is centered on dysfunctional glucose regulation and metabolism - leading to a state of persistent hyperglycemia. This results in corrosion of small and large blood vessels alike. Following years of persistent corrosion, Diabetes causes target organ damage especially of the kidneys, retina and micro capillaries. Diabetic Foot Ulcers (DFU) occur when vascular perfusion to the foot and toe digits are compromised causing persistent tissue ischaemia - meaning low oxygenation. We all know that our cells mandatorily require oxygen to survive, grow and replicate. So what happens when oxygen becomes a scarcity to the tissues of the foot, which is also routinely exposed to the environment and our daily weight bearing? The skin and tissues have now become very vulnerable and the slightest of trauma may provoke a detrimental cascade of events that can even result in an amputation. A recent study states that Diabetes causes 1 million amputations a year.

 

This article focuses on the role of Platelet Rich Plasma and its role in treating a DFU.

 

But before I go there, I would like to highlight some salient points and the general treatment of  a DFU.

 

1. Never walk barefoot. The nerve damage decreases sensation so you may not notice small abrasions or trauma.  Always wear shoes or slippers to reduce this risk.

 

2. Wash your feet every day with mild soap and warm water. Do not soak your feet. Pat dry with a towel. Be gentle.

 

3. Use lotion to keep the skin of your feet soft and moist. This prevents dry skin cracks and decreases the risk of infection. Do not put lotion between the toes.

 

4. Trim your toe nails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, visit a podiatrist or pedicurist.

 

5. Do not use antiseptic solutions, drugstore medications, heating pads, or sharp instruments on your feet.

 

6. Always keep your feet warm. Wear loose socks to bed.

 

7. Do NOT smoke. Smoking damages blood vessels and decreases the ability of the body to deliver oxygen. In combination with diabetes, it significantly increases your risk of amputation — not only of the feet, but can include the hands, as well.

 

Definitive treatment includes regular and appropriate wound dressings and debridements by your doctor.

 

So now coming to the interesting bit. where does PRP come in all this. Please forgive my enthusiasm, simply because I have recently treated one such DFU with PRP, and the results were absolutely great. It started off as a trial to which patient had consented, but after four weeks of PRP and follow ups - the outcome was quite astounding. Unfortunately the pictures of the concerned patient cannot be uploaded, but instead I will take you through her progress in a more literary manner.

 

Before that, an overview of PRP - Platelet Rich Plasma:

 

 

PRP is a concentrated blood sample extracted from the patient, that contains high levels of platelets, a critical component of the wound healing process. Platelets contain growth factors that are responsible for stimulating tissue generation and repair. Growth factors derived from platelets are responsible for soft tissue repair, bone regeneration, development of new blood vessels, and stimulation of the wound healing process.Clinical studies have shown that application of PRP can help reduce bleeding, minimize pain, reduce infection rates, and optimize overall healing.

My patient had a typical DFU with areas of dry gangrene and almost 80% loss of soft tissues in one of her toes. The tendons and bones were visible, and the entire wound was infected with pus and foul smelling discharge. The front of her foot was darkened with hyperpigmentation and the skin was dry and cracked. She was also suffering from a lot of pain. She was extremely anxious that there would be no choice except for an amputation of the digit.

 

It was at this junction, that I suggested the PRP treatments for her. It took me some time to explain to her how the treatment would be conducted and how it would benefit her. She agreed and I silently hoped I could help provide her the result she wanted.

 

Treatment included direct injection of autologous PRP into the toe digits and skin of the foot, after complete cleansing and debridement. Approximately 3ml of PRP was injected each time and another 3ml of PRP was applied topically on to the wound. Dressing composed of PRP soaked gauze and topical antibiotics. This was repeated weekly for a month.

 

In her last review, the improvement was short of excellent. The tendons and tarsal bones were no longer visible, as healthy granulation tissue had grown to fill up the previously empty digital skeleton. The skin of the foot was less pigmented and lichenified. The patient also felt the mobility and comfort level of her foot had improved.

 

So what actually had transpired?

 

The platelets in the PRP act as healing agents that help to mend the wound via aggregation and cellular cohesion. The abundant growth factors inside the plasma generate new vessels - a process called angiogenesis, stimulate cellular growth and differentiation. The new vessels increase cellular oxygenation and assist in deterring infections by creating an aerobic environment. The end result is tissue and neurovascular genesis within the affected toe.

 

I would like to conclude that PRP is definitely an alternative and effective treatment modality when conventional medicine fails to provide adequate improvement. It has numerous other indications including scar revision, facial rejuvenation, venous, arterial & pressure ulcers, superficial thermal wounds, vitiligo, skin graft sites, hair loss, stretch mark revision, sports injury and cutaneous & musculoskeletal degeneration.

 

 

 

 

For more information on PRP, do make an appointment with myself at Premier Clinics, Bangsar or TTDI branch.

 

 

Thank You.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stem Cells

Dear Readers,

Today let's take the opportunity to discuss the very elusive and less understood topic amongst many - stem cells. An overview of their origin, behaviour and most importantly functions. 

Just imagine the stem cell as the mother of all cells - the one who nurtures and teaches the other cells, transforming them into adult cells with specific roles and responsibilities within the human body. Like in all hierarchy, there is one that also exists in this stem cell world. Some stem cells have greater capacity to differentiate and direct tissue systems, where as other stem cells may only have limited power and life span. It makes sense that stem cells would be more effective when obtained from an actively growing life source, whereby their degree of differentiation and maturity would be unrivalled. 

They serve as an internal repair system, dividing essentially without limit to replenish other cells as long as the person or animal is still alive. When a stem cell divides, each new cell has the potential either to remain a stem cell or become another type of cell with a more specialized function, such as a muscle cell, a red blood cell, or a brain cell. Stem cells are capable of replication, proliferation, differentiation and long term cell renewal.

Broadly stem cells are categorised as Embryonic and Non Embryonic (adult). Embryonic stem cells are derived from the embryo, as the name implies. These cells are very versatile and can differentiate into any cell type. Adult stem cells on the other hand, are not from the embryo, but instead from specific tissue systems like blood, muscle, skin etc. They can only differentiate into their own lineage and kind. The word "potency" describes the degree of differentiation capable of a stem cell.

The extensive research on stem cells and its capacity to replenish itself has brought about a profound eye opening in the medical world. Most research is on adult stem cells, as studying human embryonic cells is deemed unethical - and rightfully so too.

Just to add on, a popular subtype of adult stem cells are Mesenchymal Stem Cells. Mesenchymal stem cells (MSCs) are adult stem cells traditionally found in the bone marrow. They can also be isolated from other tissues including cord blood, peripheral blood, fallopian tube, and fetal liver and lung. Multipotent stem cells, MSCs differentiate to form adipocytes, cartilage, bone, tendons, muscle, and skin. Mesenchymal stem cells are a distinct entity to the mesenchyme, embryonic connective tissue which is derived from the mesoderm and differentiates to form hematopoietic stem cells.

So in conclusion, we have this great repair system whose consumables consist of our very own blood, fat and skin. Really makes life a whole lot easier when one needs a new kidney.

In actual fact however, stem cell research has pioneered numerous success stories. Stem cells are being used to treat a variety of disorders like Parkinsons, myocardial ischaemia, congenital disorders and many more. In years to come, we should be able to regenerate faulty organs within the body and restore balance and homeostasis.

The Miracle Hormone - Melatonin

Dear Friends & Readers,

Today, let's talk about the king of the hormones - melatonin. I am assuming that many of you may not have heard about this silent giant, who works stealthily at night.

Melatonin is a natural hormone primarily made by the pea sized pineal gland located in the mid-brain. It is also produced in the gut and retina. During the day the pineal is inactive. When the sun goes down and darkness occurs, the pineal is "turned on"  and begins to actively produce melatonin, which is released into the blood. Usually, this occurs around 9 pm. As a result, melatonin levels in the blood rise sharply and you begin to feel less alert. Sleep becomes more inviting. Melatonin levels in the blood stay elevated for about 12 hours - all through the night - before the light of a new day when they fall back to low daytime levels by about 9 am. Daytime levels of melatonin are barely detectable. 

Just a nutshell about sleep itself. Definitely an interesting physiology in my opinion. Still baffles me as to how God figures out things to such intricate of details. 

Sleep starts of with non-REM (rapid eye movement) phase - during this phase the body repairs and regrows tissues, builds bone and muscle, and strengthens the immune system. REM sleep happens 90 minutes after you fall asleep. The first period of REM typically lasts 10 minutes. Each of your later REM stages gets longer, and the final one may last up

to an hour. Your heart rate and breathing quickens. You can have intense dreams during REM sleep, since your brain is more active.

So where does melatonin  fit in in all this? Basically this wonder hormone keep the sleep wake & light cycle in check. If not for melatonin, humans may be running about like bunnies on Redbull, not being able to cease the body's activities. This in turn would result in defective healing and restoration of cells and organs. Simply put, we would be ageing at the speed of lightning.

People with sleep disorders generally have irregular melatonin levels. Melatonin release is inhibited by light - whether it is sunlight or even the blue light from your iPhone. So imagine the chaos in a shift workers hormone cascade. Take for a example, a nurse on night duty at the hospital - she is busy taking care of her patients and serving drugs - her pineal gland is going to be confused as to whether it should release melatonin or not. The last thing we want is a nurse doing CPR going into non-REM sleep!! Similarly, the same chaos occurs on long distance flights - the result jet lag. Besides being affected by occupational reasons, immuno-suppressed individuals may also be combating irregular melatonin levels due to compromised nutrition and depleted hormones. On the contrary, your friend whose always yawning at work is probably producing too much melatonin in the daytime - causing him to feel sleepy and less alert.
                                     

 Melatonin also functions as a potent antioxidant in our bodies. Amongst its numerous functions are:

a) free radical scavenger

b) stimulates anti-oxidative enzymes

c) lowers free radical generation

d) augments efficiency of other antioxidants

e) Protects against molecular damage

Melatonin and its metabolites are potent antioxidants with anti-inflammatory, hypotensive, cell communication enhancing, cancer fighting, brown fat-activating, and blood-lipid-lowering effects, thereby protecting tissues from a variety of insults. Melatonin has been shown to support circadian rhythm, hormone balance, reproductive health, cognition, mood, blood sugar regulation, and bone metabolism, while improving overall antioxidant status and lowering blood pressure. Melatonin may assist in preventing diabetic complications, and improving treatment outcomes in patients with cardiovascular disease and certain types of cancer.

For those of you against taking supplements, here's a list of melatonin boosting foods - pineapples, papaya, oranges, sweet corn, oats, rice, barley, bananas & tomatoes.

Now for those who are supplement addicts, please add this miracle hormone into your routine. Melatonin can be taken as a pill or sublingually. It has a short half and only stays active in the system for about 20 minutes. Ideally it is taken about 30 - 60 minutes before sleep. Do not be exposed to bright lights and activity before taking melatonin, as this would negate the effects of the supplement. Please also be warned that melatonin interacts with other drugs like oral contraceptive pills and anti-epileptics - so do consult your doctor before starting your melatonin journey!!

     

 If you think you might benefit from melatonin, click here

Pineapples

Bananas

Oranges

Oats

Sweet corn

Rice

Tomatoes

Barley

- See more at: http://naturalsociety.com/8-foods-naturally-increase-melatonin-sleep/#sthash.doWmO8T0.dpuf

Overview of Some Melatonin-Boosting Foods:

• Pineapples
• Bananas
• Oranges
• Oats
• Sweet corn
• Rice
• Tomatoes
• Barley

- See more at: http://naturalsociety.com/8-foods-naturally-increase-melatonin-sleep/#sthash.doWmO8T0.dpuf

Overview of Some Melatonin-Boosting Foods:

• Pineapples
• Bananas
• Oranges
• Oats
• Sweet corn
• Rice
• Tomatoes
• Barley

- See more at: http://naturalsociety.com/8-foods-naturally-increase-melatonin-sleep/#sthash.doWmO8T0.dpuf

Mediterranean Diet & Longevity

Dear Readers,

A warm welcome, following a restful weekend I hope. Today's topic will definitely delight the Malaysian individual.










The Mediterranean diet was originally inspired by the traditional dietary patterns of Greece, Southern Italy and Spain.  This diet includes proportionally high consumption of olive oil, legumes, unrefined cereals, fruits, and vegetables, moderate to high consumption of fish, moderate consumption of dairy products like cheese and yogurt, moderate wine consumption, and low consumption of meat and meat products.

A new study hints that eating the much acclaimed Mediterranean diet may help boost longevity. Researchers found that the mediterranean regimen appears to be associated with longer telomere length, which are indicators of slower aging.

Continue reading below...

Telomeres are located on the ends of chromosomes -- much like the plastic tips on the end of shoelaces. According to geneticists, telomeres prevent chromosomes from fraying and scrambling the genetic codes they contain. These bits of genetic material naturally shorten with age, but they tend to shorten more slowly in healthy people.Shorter telomeres have long been associated with a greater risk of age-related diseases and a shorter life span, experts say. Shorter telomeres are also associated with obesity, cigarette smoking and high sugar consumption.

red portions - telomere

Why does the Mediterranean diet work? One theory is that this diet significantly reduces saturated fat consumption and eliminates trans fat intake, thereby reducing atherosclerosis and significantly improving cardiovascular health. Another is that it reduces inflammation. Still another is that it supplies significant quantities of free radical-fighting antioxidants. Perhaps all these factors play a role. Key components of the Mediterranean diet have been shown to be anti-inflammatory. Among these are omega-3 fatty acids from fish.

Greek researchers documented improvements in insulin sensitivity, as well as decreases in cholesterol levels and systolic blood pressure, even among overweight and obese men and women who at least came “close” to sticking to the Mediterranean diet. This implies that this diet is also protective against type 2 diabetes and combats obesity.


So step up and look out for some olive oil today!

Testosterone Replacement Therapy

Testosterone is the primary male sex hormone that is vital to keep in check man's primal and carnal desire. It is also critically involved in building lean muscle, burning fat, and supporting blood function, energy level & mood, immune function, and bone density. By the 7th decade, a man’s testosterone level may only be 20% of what it was in his youth. This slow and steady decline in testosterone can start as early as the mid-30s, and can result in an increased risk of life-threatening illnesses such as obesity, diabetes, and heart disease. This event is termed andropause, the male equivalent of female menopause.

 

Like men, one issue with testosterone that complicates matters is the fact that it exists in several different forms in the blood, and each form has a different hormonal activity. “Free” or unbound testosterone is a fully active hormone, but protein-bound testosterone are only partly active, or sometimes completely inactive. What is usually measured in a blood draw is the total testosterone, which is a combination of the free and protein-bound forms.
 

The good news is that many symptoms of testosterone deficiency can be reversed by restoring youthful testosterone levels in a variety of ways. Millions of men are now using testosterone-building supplements and even testosterone itself for this reason.

 

In a nutshell:

1. Testosterone, the chief male hormone, is essential for libido and erectile function, and plays a crucial role in mood, energy, bone health, and body composition.
2. Testosterone levels decline with age, usually beginning in a man’s mid-30s. Diminishing testosterone levels have been linked with disorders such as depression, fatigue, obesity, and cognitive decline.
3. Low testosterone levels increase the risk of coronary heart disease as well as cardiac mortality.
4. Restoring testosterone to youthful levels offers men a wealth of health benefits, including benefits for heart health, body composition, mood, and memory.
5. Bioidentical testosterone has not been found to have adverse effects on the healthy prostate gland—in fact, it may help improve prostate symptoms in men with low-normal testosterone levels.

Regular blood testing can help you and your physician decide if testosterone therapy is right for you.

 

Optimizing testosterone levels requires a multi-pronged approach that includes optimal diet, proper nutrition, nutritional supplements, exercise, and bioidentical testosterone, if necessary. Optimizing testosterone levels in men requires a multi-faceted approach that includes proper lifestyle, nutrition, nutritional supplements (such as lignan and plant extracts), dietary modifications, and exercise, as well as testosterone supplementation and other prescriptive approaches when indicated.

 

Initially, a medical history and physical examination should be performed, along with a blood-testing panel that includes not only testosterone levels, but also other important parameters such as fasting glucose, PSA, estradiol, and complete blood counts. 

 

Careful, thoughtful optimization of testosterone levels with a comprehensive evaluation and treatment plan can result in dramatic improvements in one’s overall health and well-being.

 

For men who no longer produce enough testosterone,  a topical  cream can be applied to restore testosterone to youthful ranges. These testosterone creams usually come in delivery systems that enable the precise amount of this hormone to be applied to the skin each day for absorption into the bloodstream.

 

The reason testosterone cream is used as opposed to tablets is that the oral ingestion of testosterone can result in rapid degradation in the liver and wildly inconsistent blood levels. A testosterone cream, on the other hand, gradually releases into the bloodstream, which is more analogous to the way testosterone is naturally secreted each day by the testicles of younger men.

 

Follow-up blood testing 30-60 days later is important to ensure that PSA, estradiol, and other blood markers stay in normal ranges. Some men will aromatize (or convert) testosterone into estrogen, which necessitates the use of aromatase inhibitor drugs or nutrient-lifestyle changes to inhibit excess aromatase activity.

 

It’s important to know that if you’ve had prostate cancer or breast cancer you are absolutely not a candidate for testosterone therapy.  Testosterone can make either of these cancers grow faster. 

 

It would only be fair to also mention the side effects of testosterone replacement therapy in this article:

 

• fluid retention - during first few months of initiating therapy
• liver toxicity - with oral testosterone
• problems with fertility - which is why therapy is more important for men who have completed their families.
•  worsening of sleep apnoea
• enlargement of breasts
• increased red blood cell production
• prostate abnormalities
• altered cholesterol balance

dr aarthi


For more info on testosterone replacement therapy, click here

 

 

Chemical Peel

 

Hello and welcome readers,

 

Today I am going to highlight a fairly common skin treatment - chemical peeling. A novel procedure practiced since the days of Cleopatra and the pharaohs of Egypt.

 

A chemical peel, also called chemo-exfoliation or derma peeling, is one of the least invasive ways to improve the appearance of your skin.

 

Cleopatra was famous for her beautiful skin. Her secret was that she soaked in baths of fresh milk.

Modern laboratories now know why milk worked such wonders for her skin: the lactic acid in milk is an alpha-hydroxyl acid, a natural material that dissolves the glue that holds dead skin cells together. Milk can cleanse the skin down to its deepest layers.

 

A chemical peel can help improve:     

• Acne or acne scars - by regenerating new skin from chemical micro trauma
• Age and liver spots - destroying melanocytes and pigment clusters
• Fine lines and wrinkles - improving skin's collagen and elastin
• Freckles - removes epidermal pigments
• Irregular skin pigmentation - evens out melanocytes
• Rough skin and scaly patches - by chemical exfoliation
• Scars - promotes cell regeneration
• Sun-damaged skin - enhances skin immunity and macrophage clearance of toxins

Chemical peels are broadly defined by the depth of damage in the skin that they produce. They are categorized as superficial, medium, and deep. Superficial peels do not damage skin below the epidermis, the most superficial skin layer. Medium peels may reach to the superficial layer of the dermis, the deeper layer of the skin. Deep peels generally reach the deeper layers of the dermis. The depth of damage depends on the nature and concentration of the chemicals in the peeling solution and the length of time they are permitted to interact with the skin.

 

Generally, fair-skinned and light-haired patients are better candidates for chemical peels. If you have darker skin, you may also have good results, depending upon the type of problem being treated. But you also may be more likely to have an uneven skin tone after the procedure.

 

The skin is thoroughly cleansed to remove all oil, contaminants and sebum. Following this, one or more chemical solutions such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid, mandelic acid, jessners acid with or without added ingredients like vitamin C or kojic acid is applied uniformly on to the skin using a cotton tip or brush. The applied acid penetrates into the skin, the depth depending on the strength of the acid. This results in a controlled micro-traumatised milieu, which in turn provokes cell turnover and rejuvenation. The stronger the acid, the deeper the peel.

 

Depending upon the type of chemical peel, a reaction similar to sunburn occurs following the procedure. Peeling usually involves redness followed by scaling that ends within three to seven days. Mild peels may be repeated at one to four-week intervals until you get the look you're after. Medium-depth and deep peeling may result in swelling as well as blisters that may break, crust, turn brown, and peel off over a period of seven to 14 days. Medium-depth peels may be repeated in six to 12 months, if necessary. During a chemical peel, most people feel a burning sensation that lasts about five to ten minutes, followed by a stinging sensation. Putting cool compresses on the skin may ease that stinging. You may need pain medication during or after a deeper peel.

 

 

 

 

The skin is especially sensitive after a chemical peel. It is essential to practice strict sun avoidance during and after the healing process. The skin may remain sun sensitive for some time after a moderately strong peel.

 

The risks, side effects, and complications of chemical peels include scarring, infection, reactivation of herpes simplex infections, and a substantial contrast in coloration of the treated skin. All patients will have a recuperation period, the length of which depends upon the depth of the peel. Deep peels can result in substantial periods of healing on the order of weeks.

 

I would like to conclude by adding that I had my own salicylic & lactic acid peel done three days ago, and just loving the brighter and smoother complexion.

 

Will keep you posted on my next choice of treatment!

 

To get your affordable chemical peel, click here