Axillary Hyperhidrosis: The Old is New Again

The standard treatment for increased sweating of the armpits (axillary hyperhidrosis) has been the use of aluminum hexahydrate in either prescription or nonprescription strengths. If that fails the next step has generally been the injection of Botox, although other methods such as iontophoresis (the patient uses a battery powered device to deliver an electric current to the skin while the skin is immersed in water) have sometimes been used. All of these methods have disadvantages. Botox is expensive and lasts 4 months to a year. Topical antiperspirants can be irritating and can loose their effectiveness. Iontophoresis can be painful, time consuming and of limited effectiveness.
In a recent letter to the editor of the journal Dermatologic Surgery, Dr. James Swinhart, of Denver Colorado, reminds of a technique that he described in 2000.

Melasma: The Mask of Pregnancy

Melasma is probably the most common pigmentary abnormality in women. The average age of onset is in the early 30s. Almost half the sufferers from melasma have family members who also have melasma. This condition most commonly starts during pregnancy, but it may also start before or after pregnancy. Much less commonly, it can be seen in males. Melasma is more common in women with darker skin types, and more time spent outdoors during pregnancy is associated with an increased risk of melasma. Inreased maternal age at first pregnancy and multiple pregnancies both increase the risk of melasma. Birth control pill use is another factor that has been associated with the onset of melasma.