The latest on botox, hair dye, and cellulite We can’t turn back the clock on aging. But a lot of people try. In fact, millions of people around the world get treatments for wrinkles on the face, whitening of the hair, and cellulites in the thighs. Here are the latest facts you should know about the different procedures to treat them. Smile (if you can), You’re on botox Botox is the brand name for a purified form of botulinum toxin, a potent paralyzing agent produced by Clostridium botulinum bacteria. The toxin can produce a life-threatening illness called botulism, which you can get from eating contaminated food. But injected in tiny amounts, botulinum toxin has been widely used over the last few decades to treat muscle spasms and other medical ailments. It was found that the toxin could also reduce wrinkling by relaxing the small muscles involved in facial expressions, and the drug was approved for smoothing eyebrow furrows in 2002, though it’s commonly used for forehead creases and crow’s-feet as well. The effects last about four months. The drug does not work against fine wrinkles caused by sun damage. More recently, the US FDA has also approved a rival brand, Dysport (available also in the Philippines), for cosmetic use, which may have longer-lasting effects than botox. Botox is generally considered safe and is less risky than plastic surgery. But you can get temporary muscle weakness or paralysis adjacent to the injection site, which can result in a droopy eyelid or brow, double vision, or asymmetry in features. Temporary loss in facial expression is common. Side effects are more likely with larger doses and with less experienced practitioners. As with any injection, there can be redness, bruising, mild swelling, and pain. Allergic reactions, characterized by itching, rashes, wheezing, and asthma-like symptoms, are possible. Botox is approved for excessive sweating under the arms and on hands, crossed eyes, eyelid spasms, and cervical dystonia, a condition characterized by severe neck muscle contractions. It’s also used off-label for migraine and sinus headaches, fibromyalgia, vocal cord problems, overactive bladder, post-stroke limb spasticity, arthritis pain, enlarged prostate, and other ailments. Several clinical trials are underway looking at Botox’s effects in some of these conditions. You should not get Botox if you are pregnant or breastfeeding. If you have any neurological disorder, such as multiple sclerosis or myasthenia gravis, talk to your doctor first you may be at an increased risk of side effects. And some medications, such as calcium channel blockers, may increase Botox’s effects. Botox for cosmetic use is expensive and it must be repeated every four months or so if you want to maintain the appearance. A less expensive and risk-free alternative is, of course, to learn to accept the wrinkles. The best way to prevent wrinkles, in the first place, is to limit sun exposure and not smoke. Scared of dyeing? Many women, as well as some men, have dyed their hair at one time or another. People all over the world change their hair color. Men often use “progressive dyes,” such as Grecian formula, and women may use semi-permanent dyes such as henna. But most dyeing (70 percent of market share and the kind I am talking about here) is done with permanent colors. You bleach out the pigment and simultaneously add whatever color you want, which is absorbed by the hair shaft. Permanent hair dyes have been the subject of scientific studies for decades. Do they promote cancer of any kind? That’s been the main worry. You’ll find sites on the Internet telling you they do. It’s impossible to prove that anything is completely safe. Still, most good studies have failed to find any significant link between today’s hair dyes and cancer. There are many chemicals in hair dyes, but the ones that have attracted the most scientific attention are aromatic amines, which in lab animals have been shown to increase the risk of cancer or genetic mutations. Results have been inconsistent in humans, however. Some studies have suggested that hairdressers, because of their higher long-term exposure, are at slightly increased risk for cancer, but other studies have not. The American Cancer Society has concluded that recent studies have not found that hair dyes pose a significant cancer risk, even when used for years. However, more research is needed on the long-term use of the darker shades, as well as occupational exposure. If you do dye your hair, follow the package instructions. Do the patch test to make sure you are not allergic or have not become allergic to any ingredients. Wear plastic gloves; most packages provide them. Don’t leave the dye longer than directed. Rinse thoroughly. You might try henna or other non-permanent dyes, but these don’t cover gray as well. Cellulite: Now you see it, Now you still see it Nearly all women, even the skinny ones, have some cellulite. Cellulite is the non-medical term for pockets of fat separated by bands of connective tissue, which protrude into the skin layer. There’s nothing unique about the fat except that it gives the overlying skin a waffled, dimpled appearance. Women are more prone to it than men because they have thinner skin (cellulite shows less with thicker skin) and a less-even fat distribution under the skin; they also tend to accumulate more fat on their thighs and buttocks, where cellulite typically occurs. Anti-cellulite treatments creams, supplements, injections, seaweed wraps, and laser procedures are big business. Many promise “sleeker” thighs in just a few weeks. What’s lacking is credibility the small studies cited are usually poorly designed, unpublished, and or done by researchers with financial ties to the manufacturers. • Anti-cellulite creams and gels contain caffeine, retinol, amino acids, green tea, herbs, and other substances that supposedly increase fat burning, stimulate circulation, and decrease water retention, among other effects. Some compounds may improve the appearance of cellulite slightly for example, by making the area swell. But there are few published studies on them and no evidence of significant or lasting benefits. As a 2005 review in Dermatologic Surgery pointed out, the ingredients must be able to penetrate the skin and reach the targeted tissue in high enough concentrations to have any effect, and it’s not known if these products do that. There are also reports of allergic reactions from some ingredients. My take: Probably safe but likely a waste of money. • Dietary supplements contain vitamins, minerals, herbs, fish oil, lecithin, vinegar, and other ingredients, and claim to boost fat burning and circulation, reduce fluid accumulation, and have other skin-smoothing effects. But there’s no evidence that any pill can reduce cellulite and supplements may contain ingredients of questionable safety. At best, some have a mild diuretic effect that may temporarily reduce cellulite appearance. My take: Don’t take it. • Endermologie is a massage therapy, administered by a doctor or trained professional that uses a high-powered hand-held roller and suction device. It is approved by the US FDA for the temporary reduction in the appearance of cellulite. They key words are “temporary” and “appearance.” The rollers can help redistribute the fat if used regularly but do not get rid of cellulite. In a small Turkish study in the International Journal of Dermatology in 2009, Endermologie was reported to reduce the circumference of the treated areas but was only mildly effective in improving cellulite appearance. My take: Don’t take it. • Endermologie is a massage therapy, administered by a doctor or trained professional that uses a high-powered hand-held roller and suction device. It is approved by the US FDA for the temporary reduction in the appearance of cellulite. They key words are “temporary” and “appearance.” The rollers can help redistribute the fat if used regularly but do not get rid of cellulite. In a small Turkish study in the International Journal of Dermatology in 2009, Endermologie was reported to reduce the circumference of the treated areas but was only mildly effective in improving cellulite appearance. My take: May temporarily help, but is costly; may be painful. • Laser/light treatments include TriActive and VelaSmooth, which are cleared by the US FDA for the temporary reduction in cellulite appearance (other laser systems do not have FDA clearance for use on cellulite. These treatments heat up and “release” the fat and tighten skin, and then use roller suction massage to smooth the areas. A 2006 paper in Lasers in Surgery and Medicine notes that these laser procedures “yield better and more prolonged clinical results than other therapies” for cellulite, though the benefits are limited. And you have to be treated regularly twice weekly at first and then monthly to maintain any benefit. My take: Promising and safe for most people, but expensive. • Mesotherapy involves injecting a mixture of drugs, plant extracts, vitamins, and other substances into the skin supposedly to increase blood and lymph flow in the tissues to break up fat cells. Studies in people are scarce, and mesotherapy has not been proven safe or effective. None of the drugs are FDA-approved for use against cellulite. My take: Steer clear. • Liposuction removes excess fat from under the skin, but it won’t get rid of cellulite because it doesn’t affect the underlying connective tissue structure. My take: Not recommended. • Seaweed wraps, massage therapy, aromatherapy, and other anti-cellulite spa treatments. None are proven to have more than temporary benefits, at most. My take: Can be relaxing, but pricey. Bottom line: Cellulite is normal and there is no permanent solution. No special diets target cellulite, either. The best advice is to lose weight if you are overweight (weight gain doesn’t cause cellulite but makes it obvious), get more exercise (aerobic activities to burn fat and strength-training to tone muscles), and try to learn to accept your body as it is!