March 21, 2023

51% #1691: Pores and skin Care and Self Care

On this week’s 51%, we take a break to focus ourselves. Dermatologist Dr. Jean Buhac presents up some tricks to higher love the pores and skin you’re in. Dr. Hida Nierenburg discusses the way to keep off complications and migraines this vacation season. And Dr. Sharon Ufberg speaks with creator Elayne Fluker concerning the significance of asking for assist, and the way doing all of it doesn’t must imply doing it on their own.


You’re listening to 51%, a WAMC manufacturing devoted to ladies’s points and experiences. Thanks for tuning in, I’m Jesse King. We’ve obtained one other trio of health-related discussions for you immediately. The vacation season is usually a notably irritating time for us all, and in between purchasing, and work, and planning household events, it’s essential to not let your well being go to the wayside, and to ask for assist should you want it (that’s one thing even I have to remind myself occasionally).

In order that’s what we’re doing immediately. Our first visitor is Dr. Hida Nierenburg, director of headache drugs at Nuvance Well being. Dr. Nierenburg is double board-certified in neurology, and whereas headache drugs would possibly appear to be a reasonably specialised area, she says it is definitely a much-needed one – particularly through the vacation season. She says the vacations carry an ideal storm of migraine triggers.


What are frequent triggers for complications and migraines? 

So frequent stranger triggers for complications and migraines: stress is an enormous one, doing loads of issues suddenly. Sure meals for some sufferers, smelly cheeses, nitrates, sure seasonings. For some sufferers, an excessive amount of sugar. Alcohols as nicely. Lack of meals, lack of sleep, so particularly going consistently. I at all times counsel my sufferers about triggers, and never all people will get predictable triggers, however when you’ve got predictable triggers you possibly can keep away from or reduce [them], so that they don’t trigger migraines.

What precisely is occurring when somebody’s having a headache or migraine? 

Common complications, lots of people get, so it is extra like stress [in the head], and you do not get sick. When you have got a migraine, it is a headache that makes you sick. Lights hassle you, smells, noises, you get fatigue, nauseous, and it can also trigger issues with focus. Normally, the sign for migraine begins at the back of the mind – the realm that controls imaginative and prescient, that is why some folks see colours or shapes. One of the best ways I defined it to my sufferers is that it is a chemical wrestle within the mind. Arteries increase and so they launch pain-causing chemical compounds. Different arteries within the mind get activated that trigger all the opposite signs with migraine, and this settles on a nerve known as the trigeminal nerve, which is the nerve that carries sensation to the face – nevertheless it connects to ache pathways for head and neck ache.

So is it regular on some degree to get complications, or perhaps a migraine occasionally? At what level do you search therapy?

So migraines are much less frequent. Common complications, rigidity kind complications, are the commonest kind of headache. 89 p.c of individuals get it. Normally, migraines are just a little bit harder. We suggest somebody to see anyone, as a result of the ache will be very disabling. Truly, migraines are the second reason for incapacity on the earth. So should you’re having one migraine a month, nevertheless it’s lower than three days or 4 days, and it is making you miss work or faculty, then that’s one thing it’s best to see anyone [for], as a result of loads of instances the over-the-counter medicines don’t work. Similar factor with common complications. I see many sufferers with common tension-type complications, however they’ve been very frequent, over-the-counter medicines don’t minimize it, and should you’re taking an excessive amount of over-the-counter medicines, generally it will possibly make the complications worse.

Once you’re taking a look at remedies for migraines and complications, what are a few of the remedies that you simply get? 

So there’s totally different courses of remedies that we’ve, and it is form of like an artwork. Each affected person is totally different. Within the Headache Society, we at all times say no migraine sufferers are alike. So, we’ve oral medicines. We’ve gadgets that assist for breaking a migraine. We’ve injection medicines. We might use Botox when folks have greater than 15 headache days per thirty days. So it is at all times a unique class of medicines, and it’s a dialogue with the affected person about different situations. They could have medicine unintended effects – I’ve loads of sufferers that inform me, ‘I do not need any medicines,’ and nicely, when you’ve got excessive frequency migraines, it’s just a little bit harder to deal with with out medicines, however there are alternatives I inform my sufferers [so they] do not undergo. I’ve the dialog – if there’s some dietary supplements that may assist, but when the dietary supplements aren’t serving to them I’m going to oral medicine.

Can migraines be tied to every other points or issues that individuals ought to be anxious about?

Typically with autoimmune situations, however generally it is by the way. After we see migraines and different [things] like seizures, it’s normally coincidence. Migraines are normally a silent illness, as a result of sufferers look regular or [if you] search for imaging, it is regular, however we perceive quite a bit concerning the ache and the severity of migraines.

Is there a distinction between the best way migraines would possibly pop up in ladies versus males?

Normally they’re about the identical. Truly, migraines earlier than puberty, they’re extra frequent in boys, and after puberty [they’re more common in] ladies. [But] males nonetheless get migraines. Normally there’s a specific migraine that ladies get that’s PMS migraines, migraines across the menstrual cycle. These are usually just a little bit extra disabling or extra extreme, [with] physique pains, cramps. However different sorts of migraines may very well be simply the identical as males, too.

As persons are planning for the vacation season, what are your suggestions for planning to be able to assist keep away from migraines? 

So positively shopping for presents will be irritating, so plan forward, on-line purchasing. Different issues like concentrate on the meals that they may be serving in a spot, sure alcohols if folks need to drink, attempt to be well-rested. A part of what the headache docs say [is] we wish folks to take pleasure in life on the fullest with out migraines interfering together with your life. So [if] you have got loads of triggers that not at all times you possibly can keep away from, then we suggest beginning every day medicines or preventive medicine or one thing, to have one thing helpful as wanted.


Our subsequent visitor is Dr. Jean Buhac, a board-certified dermatologist who has been working out of her observe, in Saratoga Springs, New York, for greater than 20 years. She’s fairly an completed particular person, who first obtained her Bachelor’s diploma in economics at Cornell College earlier than diving into her ardour for drugs and pursuing her medical diploma from Tufts College Faculty of Medication. She credit her many professors and her college friends on the College of Iowa hospitals and Mass Basic Hospital with sculpting her into the dermatologist she is immediately. At Saratoga Dermatology and Medical Spa, she treats sufferers of all ages, races and genders for a spread of advanced pores and skin situations and anti-aging procedures.

What points do your sufferers normally come to you with? 

I see all ages, and I see a ton of pores and skin most cancers each single day. Numerous pre-cancers, that are known as actinic keratosis, and fairly a little bit of melanoma. Folks suppose that something that is raised is an issue – nonetheless, an essential take-home message is that moles which are flat are normally the issue. They usually might not even itch, so melanoma’s very visible. You’d sometimes observe a mole and it’ll not have a pleasant, uniform colour, or good, even edge to it. What sometimes occurs is, should you’re watching one thing over time, that individual lesion would tackle further traits the place it is rising outward in its diameter. After which it will get an irregular edge, possibly a shadow, and it will get totally different colours. It’s not symmetric, it’s very agated. These [signs] are actually essential. I imply, folks want to have a look at their whole pores and skin floor, look with a mirror, test their backs, their toes, their palms, the scalp. So we do a full pores and skin test to make it possible for they don’t have anything that is evolving. However [with] early detection, it is probably the most curable most cancers that we’ve immediately. And the opposite two sorts of primary classes of pores and skin most cancers are basal cell cancers, which usually come up like a pimple that does not heal. So we inform sufferers, if something lasts for 2 months or extra, to go and have that investigated. It will probably additionally appear to be a patch of eczema. So something that is a flat, pink, scaly patch, [you] should not assume that it is just a bit patch of dry pores and skin if it is nonetheless persisting, regardless of over-the-counter use of cortisone, or any applicable therapy of eczema. If it is nonetheless there [you need] to have that checked. After which the third can be squamous cell most cancers. These can look warty: they’re crimson, they are often very tender. All of those that I’ve simply talked about are sometimes seen on the sun-exposed areas of the physique.

How early ought to folks begin taking a look at this stuff?

As a matter of reality, I did a biopsy on an 11-year-old boy immediately. So melanoma can happen as younger as that. And I’ve seen younger ladies who’ve completed tanning cubicles of their early 20s. With melanoma, anybody is a candidate for good pores and skin test. However the folks that ought to be extra conscious or urgent to get in for a test can be these with giant numbers of moles. I do know for people, generally they suppose freckles are moles, but when they don’t seem to be certain, they should not attempt to keep at dwelling and determine for themselves. They need to speak to their major care physician, or attain out to a dermatologist for a go to. Or if there is a household historical past, after all, if there is a household historical past of melanoma, and even basal cell / squamous cell [cancer], as a result of loads of these will cluster and folks have multiple kind of most cancers as nicely.

You talked about tanning cubicles. Are there every other sorts of actions that may contribute to pores and skin cancers? 

Smoking, extreme smoking. There’s environmental elements that play a task. Solar publicity is the commonest and the most important purpose why folks develop pores and skin most cancers. Beginning at an early age, placing the SPF 50 on, reapplying each couple of hours, utilizing protecting clothes, avoiding the excessive peak [of the day] from like 10 a.m. to 2 p.m. or 10 a.m. to three p.m., and defending the pores and skin is most essential. And that’s the most main anti-aging cream or remedy that we’ve – sunscreen. You recognize, should you begin early and also you do it, that is like one of the best anti-aging cream, in addition to defending in opposition to pores and skin most cancers.

That goes into one in every of my subsequent questions. What would you say, general, is an effective instance of wholesome skincare, or a skincare routine? As a result of if I’m going on Instagram, I see a billion various things speaking about like face serums or combos of lotions to make use of and stuff like that, and it at all times makes me surprise what’s a great way to go about it.

Now, that is a superb query. I believe we’re over-burdened with method too many merchandise on the market. There’s fundamental tips on sure classes of issues which were confirmed, and researchers on the market that present they’re efficient. In order that’s the primary factor [to focus on], as a result of anybody can placed on their label “improves the looks of,” however what we’re actually considering is that it might assist enhance collagen, it stimulates collagen manufacturing, and helps with effective strains. These classes will mainly be vitamin C, which is an antioxidant, retinols, particularly tretinoin, which stimulates collagen protein. Glycolic acid. However I believe folks ought to adhere to, like I stated earlier, the SPF 50. And good moisturizers which are oil-free are appropriate for everybody. There are different folks with several types of pores and skin situations that profit from sure merchandise if they’ve rosacea, which are geared for delicate pores and skin. And there is lists of these: Cetaphil, Cerave, you already know, the quite common ones which are on the market.

Would you take into account rosacea extra of a medical situation or extra a beauty concern? 

Properly, that is very fascinating how a few of the diagnoses in dermatology will be interpreted in several methods. You recognize, there’s that spectrum. So rosacea is a medical situation – they’ll get bumps and pimples, nodules, pustules, that may be disfiguring. It is on a spectrum, everybody’s totally different. Some folks simply have delicate redness. So there’s alternative ways of approaching it. There’s topical prescriptions, and oral prescriptions, in addition to laser functions that may assist reduce the looks of the blood vessels on the face.

I am additionally simply serious about different causes folks would possibly are available, possibly like zits or for anti-aging remedies? 

Sure, we see loads of sufferers with zits. There’s genetic elements and stress elements that play a task, in addition to issues that they eat, you already know, there’s inflammatory meals and junk meals and whey protein. I see some athletes, they will take whey, after which they will get this actual giant nodule or cystic zits breakout. So we’ve to strategy each individually. And there is grownup zits. There’s such a spectrum, however there’s a number of totally different remedies which are accessible on the market that may actually assist. And so anybody with zits struggling at dwelling, I really feel dangerous for some folks that they do not get the eye [they need], as a result of they may very well be left with scarring, long-term scarring.

What are a few of these totally different remedies?

Properly, as I discussed, tretinoin is nice for wrinkles. However it additionally, initially, has been for zits: it helps with blackheads and whiteheads. And there is one other drugs known as Differin which is over-the-counter. It was once a prescription. There’s these topicals, topical antibiotic lotions, benzoyl peroxide and salicylic acids are used. After which we do oral antibiotics, extra from an anti-inflammatory standpoint, versus actually treating the micro organism. However I educate my sufferers, so that they perceive the significance of utilizing their medicine, as a result of some anticipate, “Oh, I can do that for a number of weeks, and I ought to get higher.” It is essential, so they do not waste their time, that they perceive that they’ve to take a position that point. And after in all probability about six to eight weeks, that is when issues actually begin working.

To get to the subject of anti-aging, at what level do you normally begin seeing sufferers for issues like that? 

You recognize, it may very well be mid-20s, as a result of they see loads of pictures on social media, and so they need the nicer, fuller lips, or they really feel they need to look in a different way than they’re. As much as people who find themselves 80/85, who I would counsel with them and say, “You recognize, this won’t make that a lot of a distinction.” They usually’ll say, “Properly, I simply need to look, like, 75.” So everybody has their little method of approaching issues and what actually bothers them. So I actually hear fastidiously. Though we can provide recommendation as to the worldwide look in skincare from our skilled standpoint, I actually listened to what bothers them probably the most so I can put it in perspective – as a result of generally there are sufferers who maximize one thing that is very minimal. However I do not need to reduce their complaints, do you hear what I am saying? And training drugs is a mixture of artwork and science. We’ve the data, the scientific data, on the way to strategy an getting old face. However I believe the artwork is, how far will we take it? And the way a lot is an excessive amount of. Which I believe brings on one other philosophical query: I imply, will we do it in any respect? Our complete society is geared towards producing new anti-aging issues, however I believe there comes a time when it must be a mixture of acceptance, and possibly therapy assuaging a few of the indicators of getting old which are affordable. And having a dialogue is admittedly essential with sufferers, to see the place they’re at. I speak to sufferers and I say, “Hear, should you really need that Botox, let’s go forward and do it. And you are able to do it for so long as you need, should you’re going by a tough time proper now accepting what issues appear to be. Sooner or later down the street, it may be that you do not even need it anymore.” However so many instances I’ve individuals who have spent a boatload of cash, and then they arrive to the appointment. And I’ve to inform them, “Properly, you already know, there’s nothing confirmed behind what you simply bought. However I can inform you that these sure issues are actually useful to your pores and skin, should you needed to begin with this.” And so folks can find yourself investing an excessive amount of in one thing that will not be therapeutic for them.

One thing that I’ve learn quite a bit about on-line is “pre-juvenation,” about youthful folks attempting specific remedies to, I suppose, assist keep off the indicators of getting old just a little bit additional if they’ll. Am I getting that proper? 

Properly, I believe they could provoke some anti-aging remedies earlier, as a result of then there will be some advantages the place they don’t seem to be attempting to play catch as much as it. But when they merely…if you concentrate on it, there’s intrinsic getting old, which is internally preprogrammed, how our genes set off our getting old as we become older. However extrinsic is from the solar. And so SPF, sunscreen is the simplest “pre-juvenation,” anti-aging therapy throughout the board. If they begin merely with simply doing that, and possibly like vitamin Cs, that are antioxidant. No extreme alcohol, consuming a extra plant-based food regimen, avoiding hormone-infused meat merchandise and milk, dairy of that nature. That will go a really good distance.


Our final visitor immediately is the host of the Assist is Attractive podcast and the creator of the brand new e-book, Get Over ‘I Received It:’ Find out how to Cease Enjoying Superwoman, Get Assist, and Bear in mind That Having It All Doesn’t Imply Doing It All Alone. Elayne Fluker says bold ladies in all areas of life, whether or not they’re at dwelling, within the workplace, or within the classroom, too typically really feel like they’re not allowed to ask for assist – and that mindset can truly maintain us again, and stress us out. Fluker shared her suggestions with Dr. Sharon Ufberg, co-founder of the California-based private growth firm, Borrowed Knowledge, for her 51% phase, “Power of Nature.”

Elayne Fluker

Fb: Elayne Fluker


Elayne Fluker is the creator of Get Over, “I Received It.”

Ufberg: How did this e-book come about? 

Fluker: I attended a workshop in 2015, I need to say. And through that point, I noticed a mirrored image of myself and different folks in that workshop who had been battling asking for – truly, two issues, Sharon: love and assist. So not even simply assist – love and assist. After I say struggling, I imply, like, boohoo crying, “Do not make me do it. I do not need to ask,” or, “I do not know the way to ask.” And it was actually my first time saying, “Oh, I believe I’ve that downside, too.” However this was one thing I actually needed to hold with me, this concept of embracing assist as one thing constructive, because it not being one thing that is a weak point, or one thing to shrink back from. And I began saying this phrase, “Assist is attractive,” pondering of assist otherwise: “Assist is attractive. Assist is attractive.” And once I would say it to different ladies, particularly ladies entrepreneurs, or ladies who had been doing simply various things in our lives – this was in New York on the time, so we’ve that complete hustle mentality, and generally do not even pause to consider how assist might present up for us – I might see these ladies gentle up. And that is once I thought, “Perhaps there’s one thing to this complete ‘assist is attractive’ factor.” After which that advanced into finally me doing the podcast known as Assist is Attractive, after which finally penning this e-book, Get Over ‘I Received It,’ as a result of I discovered that almost all of us bold ladies have what I name “I obtained it” syndrome.

Ufberg: What precisely is the “I obtained it” syndrome? Clarify {that a} bit extra to me. 

Fluker: It’s one thing that is virtually like a set off response for a few of us. We do not even suppose consciously about how a lot we’re turning assist away. Whether or not that’s, I ought to say, actually somebody coming to us and saying, “Can I assist you to with that? Is that this a way I can assist you? Do you want some model of that?” or one thing easy, like a serendipitous second on the street the place somebody might probably assist you with one thing – and we’re so fast to show it away. So it is not even simply saying, “I obtained it” to different folks. Typically we’re stopping the universe from coming into our lives and serving to issues work issues out, as a result of we’re so targeted on how we will handle it or do it. We’ll “deal with it,” proper? “I will make it occur. I will deal with it.” Properly, you already know, what you may be affected by is “I obtained it” syndrome, and pushing the chance, however extra so even chance away, by saying this.

Ufberg: How do you see shifting the thought of getting the assist they want, for bold, high-energy ladies entrepreneurs?

Fluker: Properly, one of many issues that I love to do to remind us all to recollect to even ask for assist, as a result of generally I’ll say we’re all transferring on autopilot. We’ve a lot to do, we’ve a lot to perform, or folks to serve, or issues to do at work. There may be causes that we do not pause for a second and take into consideration this. However I encourage any lady listening, pause and take into consideration the phrase “HELP.” And I take advantage of that as an acronym to do not forget that H: having all of it does not imply doing it on their own. So simply as you simply stated, a few of us really feel like we’ve to do all of it. Properly, is that true? Or is {that a} perception? Typically it is the idea that we’ve to do it on their own, or it is the idea that nobody reveals up for us. Or it is perception that nobody else will do it like “we will.” Having all of it does not imply doing it on their own. You do not have to show that you are able to do it by your self. And loads of instances getting assist will assist you to do it even higher. The E in “HELP” is ask empowering questions. So if you’re searching for assist, it’s not, “Why am I so silly? Why can’t I do that? Why have not I figured this out?” A extra empowered query may be okay, “That is one thing I need to accomplish, and even test off my to-do record. What are the ways in which I would have the ability to get assist for this? Who was somebody who might need completed this earlier than? Who might give me some recommendation?” Whether or not that is somebody you already know personally, or somebody you search for on the pc – we’ve entry to virtually all people and the whole lot now. However what are the questions you are asking your self? The L is to “dwell that query.” So that is one thing I realized from this lady, Patricia Moreno. And it is this concept of – particularly once more, as bold ladies, as go getters, we’re ladies who’ve the solutions. Numerous us are paid to have the solutions, or folks come to us as a result of we’ve the solutions. So it’s powerful for us to think about residing a query, being in that area of openness, of asking, “How can I get assist for this? What are some issues that I may be lacking that may very well be useful to me?” After which not essentially realizing, not less than immediately, the way to reply that query. I wrote down in my journal a bunch of questions that I am residing proper now. And I didn’t reply them, which is the toughest factor ever. So dwell the query, and in addition let go of the reply. Once more, we do not need to get into an area of, “That is one thing I need to do. That is how I will tightly handle this. That is precisely how it will occur.” That is to not say haven’t got a plan. In fact, you need to have a plan. However what if there’s some alternative for assist that comes from some other place? After which the P is “consider within the potentialities.” So you possibly can’t do all these different issues after which not consider it is potential for assist to point out up for you in methods you won’t even have the ability to think about.

Ufberg: I believe it is so essential for girls to learn a e-book like yours so ladies can see that profitable, bold ladies do not must do it on their own. Are you able to converse for a second on the actual challenges ladies of colour face concerning asking or getting the assist they could need or want?

Fluker: Sure. I believe as a Black lady, I can converse to my very own points, expertise, and a few of the ladies that I do know, after which ladies of different cultures. Numerous us had been taught to be seen and never heard – [some are] even from descendants of enslaved Africans. My dad and mom, for instance, grew up within the South within the Thirties. By the South, I imply Alabama. So that they definitely had been taught to be seen and never heard, generally not even be seen. My mom, a narrative I share within the e-book talks about how when she and her siblings, as youngsters going to the shoe retailer, they weren’t allowed to attempt on sneakers. Or I’ve heard different folks’s dad and mom [say] that you simply weren’t allowed to attempt on that hat, since you had been Black, and so they did not need you to attempt on something after which put it again on the shelf. It is a racist coverage, and it seems like a easy factor. However these sorts of issues affect you, as an adolescent [and] as an individual of colour. And there is all types of experiences that many have had in these sorts of conditions, the place you may be afraid to ask – actually, afraid, of their case – to ask for one thing that you really want. After which that form of transfers over in technology over technology. One thing that I prefer to quote now, or point out, is a few analysis that I have been taking a look at from Maria Yellow Horse Braveheart, who was a social employee, clinician and researcher who talks about historic trauma, and the way the multi-generational trauma skilled by sure cultural teams will be handed on to every technology. That is one thing that I believe applies in the identical solution to asking for assist. She first explored it for Native People, you then suppose, as I stated, about descendants of slaves, Holocaust survivors, and descendants of Holocaust survivors, and Japanese People who had been interned throughout World Conflict II. So there’s loads of totally different teams of us, culturally, which may have a purpose that asking for assist wasn’t one thing that we witnessed, and [it’s] one thing that we actually must discover ways to put into observe. However it’s my hope that ladies – my e-book is for all ladies who really feel like they’re attempting to do all of it, determine all of it out, and do it on their own – for us to have the ability to acknowledge that this may be a purpose, or this may be the place this comes from. However I encourage you to make a change, as a result of it’s as you stated, not nearly success, however that is about assist to your peace of thoughts.


51% is a nationwide manufacturing of WAMC Northeast Public Radio. It is hosted by Jesse King, our government producer is Dr. Alan Chartock, and our theme is “Lolita” by the Albany-based artist Lady Blue.