Embarrassing body bummers
For as long as there have been embarrassing health problems -- unwanted facial hair, bad breath, excessive sweating, cold sores, urinary incontinence -- there have been remedies that promise to alleviate them. Unfortunately, the purported cures haven't always worked well and in some cases have made the problems worse.
Now there are new and truly effective ways to battle these classic body bummers. What works, and what doesn't:
If you've experienced noticeable facial hair, you've probably already tried tweezing, waxing, bleaching, shaving or electrolysis.
But there are newer (and sometimes better) options available. A prescription cream called Vaniqa slows the hair-regrowth cycle, so you don't have to remove hair as often. It's relatively free of side effects, outside of slight stinging. If you want benefits to last, you need to use the cream indefinitely. (It costs about $25 for a one-month supply.)
Lasers are a good option for dark hair, and a recent technological breakthrough -- in which the laser's pulse duration is increased to cause the equivalent of a slower "cook" of the follicle -- now makes it possible to treat darker skin without damage. Results aren't necessarily permanent, however. But if you have it done once a month for three to five months, you'll be hair-free for up to eight months, says Deborah Sarnoff, M.D., a cosmetic dermatologist in New York City and author of Beauty and the Beam: Your Complete Guide to Cosmetic Laser Surgery (St. Martin's, 1998). And the hair that comes back tends to be finer and lighter in color.
Excessive facial hair in women almost always involves the male hormone testosterone. "Sometimes the testosterone level is normal but the hair follicles are more sensitive to it," explains Geoffrey Redmond, M.D., director of The Hormone Center of New York. This heightened sensitivity can run in families. But in some cases, the testosterone level is too high: One of the most common causes of excess hair is polycystic ovary syndrome, a hormonal and metabolic disorder that can cause excess facial and body hair, weight gain, irregular periods, fertility problems and acne. (Excess facial hair can also occur during perimenopause and menopause as estrogen levels gradually diminish.)
If you're sensitive to testosterone's effects, you can take a medication such as the prescription drug spironolactone to partially block the effects, along with an oral contraceptive to suppress ovarian function, Redmond says. But, he cautions, "you can't take an anti-testosterone medication if you're thinking about getting pregnant because it could interfere with the genital development in a male fetus."
While there's still no cure for the herpes virus (herpes simplex 1 causes cold sores), cold sores are treatable. A new nonprescription medicine called Abreva can cut your healing time by two to three days and soothe the sore in the meantime. Another cream, Denavir, also can speed healing but is available only by prescription.
If you're prone to frequent or severe cold sores, or you begin to experience the telltale tingling that can precede an outbreak, oral medications like Zovirax or Valtrex, which are used to treat genital herpes, can often prevent a cold sore from appearing before an important event. "It's a much better diagnosis now than it used to be," says dermatologist Deborah Sarnoff. "If you have more than six to eight bouts a year and you take an anti-viral oral medication every day for a year or two, you will seldom get cold sores after that, because the medication will inhibit an enzyme that's involved in replication of the virus."
You know that brushing your teeth twice a day and flossing at least once daily are musts. But giving it a dry run can help too: Gently brush your teeth with a dry brush, then use toothpaste and water. This will help you brush more thoroughly, since you'll brush longer.
And while you probably know that brushing your tongue or using a tongue scraper to get at the far reaches of your tongue can reduce odor-causing bacteria, it's smart to brush the roof of your mouth gently as well. (This may feel awkward, so go back only as far as you comfortably can.) "These are areas that can harbor bacteria that cause bad breath," says Michael McGuire, DDS, a periodontist in Houston and president of the American Academy of Periodontology. Also, massage your gums, especially along the tooth line, but do so gently.
While you may never go anywhere without your breath mints, keep this in mind: Mints and mouth rinses may mask symptoms temporarily, but they won't cure the problem. Plus, "many mouth rinses contain alcohol, which can dry out the mouth and contribute further to bad breath," McGuire notes. If your gums bleed easily when you brush or floss, see your dentist. You may need a deep cleaning to remove bacteria from the roots; otherwise, if the problem gets worse and spreads to the bone, you may require surgery.
If you commonly endure sweatiness not associated with a workout, you've probably already tried various antiperspirants and absorbent cornstarch powders. But if these measures haven't done enough to help, ask your doctor about a stronger prescription antiperspirant, such as Drysol or Certain Dri, which contain a higher concentration of aluminum chloride than over-the-counter products. Applying it to the hands, feet and armpits can help block sweating.
Also, excessive sweating can be symptomatic of a disorder called hyperhidrosis. "Nobody knows what causes it, but it can be associated with hyperthyroidism, obesity, anxiety or menopause," notes Daniel Miller, M.D., an associate professor of surgery at the Mayo Clinic in Rochester, Minn. In other cases, the origins remain a mystery. Sweating can be especially noticeable in the palms, armpits and feet, day and night.
For sweating of the palms, a treatment called iontophoresis (aka iontherapy), in which hands are placed into a small tub of water with an electric current running through it, can sometimes destroy the sweat glands, Miller says, but the procedure can be painful and often isn't covered by insurance. Botox injections can also help with sweaty palms, but they're painful and expensive (roughly $1,000 per treatment) and must be repeated every three to six months. Oral anticholinergic (nerve-blocking) drugs are another option, but these can cause side effects such as blurred vision, dry mouth and urinary retention; plus, the drugs end up being a temporary fix, since many people build a tolerance to them.
For the most severe cases, there's a surgical procedure called thorascopic sympathectomy: A small incision is made in the armpit, and the nerve that controls sweating is cut. "The long-term success rate is about 95 percent," Miller says. "But some people experience compensatory sweating in the lower extremities that lasts six to 12 months." At least this is more easily covered up -- and it's usually temporary.
If you've ever had urine leak while jumping, jogging, weight lifting, or even laughing or sneezing, you're no stranger to stress incontinence. About 30 percent of women in their 20s and 30s have it. Urge incontinence, by contrast, makes it hard to hold your urine once you feel the urge to go, which means you may not always make it to the bathroom in time. Some women experience incontinence for the first time after childbirth because labor pushes the baby through the pelvic-floor muscles, stretching them and damaging nerves in the process.
Doctors recommend urinating regularly, drinking plenty of water and cutting back on acidic beverages, in addition to doing Kegel exercises to strengthen the pelvic-floor muscles. (Ask your gynecologist to check your technique during your next pelvic exam.)
But if you can't do Kegels properly, you may be a candidate for pelvic-floor therapy, which often uses biofeedback, or for a special chair that uses electromagnetic energy to help the muscles contract, says Michael Albo, M.D., co-director of the Women's Continence Center at the University of California, San Diego. For urge incontinence, the drugs Detrol and Ditropan can help, but have side effects such as dry mouth and constipation.
There's also a procedure in which collagen or carbon beads are injected into the urethra to bulk it up and prevent urine from leaking out; short-term success rates are good with these techniques, plus they can be done on an outpatient basis. Collagen, however, gets absorbed by the body, so you may need multiple procedures; carbon beads don't get absorbed, but the long-term effects of this technique aren't known because it's only been used for about two years.
What's your most embarrassing body bummer? Get advice and see what others have to say.