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© MikeSaran via Canva.com Hair is often considered a symbol of identity and self-expression, from scalps and eyebrows to beards and bodies. But what happens when this symbol starts to fall out? The 6.7 million people across the country living with alopecia know this feeling all too well. Alopecia, or hair loss, is a medical condition with variable causes, presentations and treatments. Experts at Renown Health dive into the world of alopecia, its causes and how to address it – especially as we embrace National Alopecia Awareness Month this September.   Types of Alopecia  The term “alopecia” is a broad umbrella term that encompasses many different forms of hair loss that can present itself at any age, no matter your gender or ethnicity. The most common types include:  Alopecia Areata: An autoimmune disorder where the immune system targets hair follicles, typically resulting in patches of hair loss on the scalp and/or other body parts. More severe forms of alopecia areata also exist, such as alopecia totalis and alopecia universalis. Androgenetic (or Androgenic) Alopecia: A disorder also known as male or female pattern baldness that causes gradual hair thinning and loss often around the temples and crown. Unlike alopecia areata, this form of alopecia is usually hereditary. Telogen Effluvium: A condition resulting in hair shedding, typically after high-stress or infectious events, such as after giving birth or after a COVID-19 infection. This usually resolves itself within a few months to a year. Traction Alopecia: Hair loss resulting from the effects of tight braiding or styling of the hair, which can cause permanent loss over time. Scarring and Inflammation-Mediated Hair Loss: Patterns of hair loss related to lupus, lichen planus or other autoimmune conditions that can unfortunately be permanent and progressive.  Options to Treat Alopecia  While there isn’t a cure for most types of alopecia, some treatments are available to help minimize the effects of the condition and promote hair growth. Treatment varies depending on the type of alopecia. Potential options can include:  Topical Minoxidil: An FDA-approved over-the-counter medication available in foam or liquid form and applied directly to the scalp, which helps stimulate hair growth by increasing blood flow to hair follicles. Hormone Therapies: A hormone regimen that can help minimize the resulting hair thinning and balding. Corticosteroids: A topical cream or ointment – or an injection for severe cases – that help reduce inflammation and re-grow hair. Low-Level Laser Therapy: A therapeutic, non-invasive intervention involving wearing special caps or combs that release painless, low-level lasers to stimulate hair follicles. Healthy Diets and Nutritional Supplements: A diet rich in vitamins and minerals essential for hair health, such as biotin and collagen, can aid in recovery. Vitamin D and iron are also important hair growth nutrients. Stress Management: Stress can impact the speed and frequency of hair loss. Managing your stress can help mitigate the effects of alopecia.  Treatment for alopecia is not a one-size-fits-all approach. A scalp skin biopsy may help determine a cause for hair loss and help guide the best management strategies with your provider.  Addressing the Emotional Impacts  Even though alopecia isn’t life-threatening, the impacts of the condition can affect your self-esteem and self-image. The most powerful tool to help you manage alopecia is knowledge. Keeping yourself educated about your condition, and encouraging your loved ones to do the same, can help arm yourself with the acceptance and self-compassion you need and help combat misconceptions.  With the rise in awareness in the mainstream media for alopecia and other hair conditions, beauty standards and fashion are shifting to become more inclusive for those experiencing hair loss. Celebrating the many diverse hairstyles and fashion statements can help you regain your confidence. There are many options you can advantage of to help style your hair and protect your scalp:  Hairpieces: Wigs, extensions and other hairpieces can help cover up balding or thinning patches and add volume to your hair. Hairpieces have come a long way in the past few decades, and many use real human hair. Hats: Hats serve a dual purpose – a fun fashion accessory to help boost your confidence and a method of protecting your scalp from the sun. As someone with alopecia, your scalp is more exposed, and hats can provide that extra layer of protection you need. Scalp Sunscreens: While regular body sunscreens can provide good scalp sun protection, they can result in oily scalp and hair appearance. Sunscreens that are specifically designed for the scalp are available at most beauty stores or online. Remember, patience is fundamental, as many treatments require consistent use over time to see noticeable results. Stay resilient, and don’t give up – you are not alone in your alopecia journey.

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Renown Health is proud to embrace the Reno-Sparks culture that makes our community stand out, which is why we sponsor the Reno Rodeo, an early summer staple with roots in the community as deep as our own. One of our many ties with the Reno Rodeo includes Renown Regional’s own emergency room nurse and Miss Rodeo Nevada 2022, Gabby Szachara. A Reno native, Gabby developed a love for the Reno Rodeo at a very young age. “I loved watching the girls on the Reno Rodeo Flag Team when I was little and knew I wanted to be part of the Reno Rodeo someday,” said Gabby. “As I got older, I started to make connections and build relationships with some people in the rodeo scene, and they generously lent me their horses so I could participate in the Reno Rodeo Flag Team.” Gabby was on the flag team for three years before being crowned Miss Rodeo Nevada 2022 last year.  Before joining the Reno Rodeo Flag Team, Gabby was a student at the University of Nevada, Reno, and a member of the women’s volleyball team. In December 2017, she graduated with a bachelor’s degree in public health. At first, Gabby was interested in a career in sports medicine – it made sense with her background in athletics. But, after working in the medical field as a certified nurse assistant and an emergency medical technician, she grew passionate about patient care and decided she wanted to become a nurse. “I’ve always loved teamwork and helping others,” said Gabby. “It’s important to me to be there for others, especially when it might be their worst day.”  In December 2021, Gabby graduated from Truckee Meadows Community College with a nursing degree and joined Renown Health this February. “I love Renown for various reasons. Everyone here is so nice and welcoming, and there is a great team dynamic,” said Gabby. “And I love that Renown’s main color is purple because that is my favorite!” When Gabby isn’t in her scrubs and caring for patients, she is in western wear and carrying out her duties as Miss Rodeo Nevada. “I do a lot of traveling across the country to attend other rodeos,” said Gabby. “I enjoy meeting so many wonderful people and experiencing the culture of different states.” Gabby’s main goals as Miss Rodeo Nevada are to promote the western way of life, agriculture, rodeo and community benefit. In addition, she visits local schools to talk with kids about how they can get involved in these areas and inspires them to turn their dreams into reality.  Gabby has a special place in her heart for the Reno Rodeo. “Reno is my home, and the Reno Rodeo is the heart and soul of summer in northern Nevada. Everyone comes together and dusts off their boots to have fun and also contribute money to important causes in our community,” said Gabby. “I love the comradery, the friendly and healthy competition and the great people.”  If you’re going to the Reno Rodeo this weekend, watch for Gabby and her horse, “Torque.”  And if you see Gabby in the halls at Renown Regional, give her a high-five for all her hard work as a nurse and Miss Rodeo Nevada!

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Visiting a Renown Urgent Care location is an excellent option when you have a non-severe condition, such as a skin rash or sore throat, can't get in to see your primary care provider in a timely manner or if you need an appointment after regular business hours. To learn more about the ins and outs of Urgent Care, we spoke to David Lemak, MD, Division Chief Urgent Care, who let us know some reasons to visit Urgent Care, how to make your visit as efficient as possible, and more. Remember, for a life-threatening emergency, call 911 immediately! Urgent Care is similar to a Primary Care provider Urgent Care providers can do most of the things your Primary Care provider can do, with visits billed the same as an office visit. If you could put the word “severe” in front of your reason for visiting Urgent Care, please go to the emergency department right away For a list of what is an appropriate visit for Urgent Care click here. Also, we recommend that babies 2 months old and younger should go to the Renown Children’s Emergency Department, not Urgent Care.  Renown Health has 10 Urgent Care locations across northern Nevada There are five locations in Reno, two in Sparks, one in Carson City, one in Fernley and one in Fallon. For a complete list of Renown Urgent Care locations, click here.  Many of your Urgent Care needs can be accomplished via a virtual visit, from the comfort of your home or office Conditions Appropriate for a Virtual Visit Included:   - Common cold and cough symptoms - Muscular, tendon or joint pain not cause by injury  - Allergy or sinus symptoms   - Pink eye  - Urinary discomfort  - Backache  - Sexually transmitted illness screening   - Rashes or skin sores - Medication refills (no controlled substances) Some conditions are not appropriate for a virtual visit. They include:  - Chest or abdominal pain   - Shortness of breath  - Traumatic injuries  - Dizziness or confusion   - Bleeding    - High fever   - Persistent vomiting  - Loss of vision   - Substance abuse or psychiatric problems Book ahead for shorter wait times, but remember walk-ins are always available. Click here to make your appointment. This booking page conveniently shows the next available appointment at each location. Typically, mornings and late afternoon (right before dinner time) have the shortest wait times if you plan on walking in.   You will be asked to wait in your car when you arrive at a Renown Urgent Care facility. While you wait (or even before you arrive), patients are encouraged to complete all registration paperwork and co-pay information online.  Urgent Care is great for visits such as back-to-school physicals, camp physicals, commercial motor vehicle exams and more. Sometimes you cannot get in to see your primary care provider to meet the last-minute deadlines for certain school or work-related physicals. Many of these appointments can be completed at Urgent Care; we just recommend you call ahead and confirm that our facility offers what you need.  An Urgent Care provider can virtually order a PCR COVID-19 test.  Whether you have a possible exposure, are not feeling quite like yourself or need a negative test for upcoming travel, a COVID-19 test can be ordered for you. The cost for a visit to Urgent Care is dependent on your benefits, but the visit is billed the same as a standard office visit. If you don’t have insurance, a basic visit to a Renown Urgent Care will cost $125.

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Much like general physical and mental health, sexual health is an essential aspect of your overall well-being. Therefore, educating yourself on your sexual health is an important piece regarding your overall wellness. Secure & Private Virtual Visits Did you know that many sexually transmitted disease appointments can happen virtually, in the privacy of your own home? Our providers can perform a screening examination for sexually transmitted illness (without symptoms) when it’s convenient for you. This is a great option if the topic makes you uncomfortable during an in-person visit, or if you can’t find time to visit your primary care provider or local urgent care. After the telehealth appointment, your provider will determine the  next steps for you. Remember, in-person visits are always an option as well.   Here’s how you can take charge of your sexual health:  Get Comfortable with Getting Tested  Surprisingly, some people with STDs don't show symptoms, meaning they may not even know they have an STD unless they get tested. Even if an STD shows no symptoms, the result of non-treatment can be serious. Bret Michael Bellard, MD, with Renown Medical Group, shares that it’s important for people to get tested for STDs because if left untreated, they can cause the following health problems: Loss of fertility Pregnancy complications Other health issues  When to Visit Your Primary Care Provider  Who should get tested and how often? “The recommendations are that everyone from ages 13 to 64 should get tested at least once for HIV. All sexually active adults should also be tested for other STDs once a year, and all pregnant women should be tested at the start of their pregnancy,” says Dr. Bellard. Some STDs, like syphilis, can be passed from mother to baby, so it's important for women to get tested as soon as they know they’re pregnant.  Dr. Bellard recommends going to your primary care provider for testing. “They can also give advice on prevention and other health topics.” If you don’t have a primary care provider, this is a great reason to get established with one. Women with an established OB/GYN can have STD testing done simultaneously with their annual pelvic exam. The providers in Renown's network care for patients of all ages and specialize in family medicine, internal medicine, pediatrics and OB/GYN.   Practice Safe Sex  STDs are preventable. Practicing safe sex and getting tested routinely are your best defenses against all types of STDs.  For many, the conversation about sexually transmitted diseases is awkward and many avoid it. To lower your risk of contracting an STD, don’t wait until you’re “in the moment” to have the conversation with your partner about the last time you were both last tested. If you haven’t gotten tested in-between new partners, use latex condoms every time you have sex until you are both confirmed negative of STDs. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly.   To establish Primary Care, visit renown.org/virtualvisits or call 775-982-5000

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If you’re a parent, you’ve probably been there — the sometimes-nightly struggle to get your little ones off to bed. Elaina Lantrip, an APRN with Renown Pediatrics, offers some tips and explains how your child’s electronics may be getting in the way of a good night’s sleep. These days, kids are consuming media from a very early age on all types of devices — from tablets and phones to TVs. While they can benefit from some media use, it can have a negative impact on bedtime. We asked Elaina Lantrip, an advanced nurse practitioner with Renown Pediatrics, for some advice on downloading a better bedtime routine. What are the most important practices for parents to establish for their children’s bedtime routines? I often have parents tell me that their child won’t go to bed — or to sleep. Parents frequently ask for tips on bedtime routines that work. My first question is whether their regular bedtime routine involves television, iPad, tablet, phone or anything with a screen. It’s very important that bedtime includes a bath, reading a story, talking, singing and bonding with young ones, rather than using any devices. Why shouldn’t children have a device at bedtime? A growing body of research supports that screen time at bedtime contributes to delays in a child’s falling to sleep; overall inability to reach the important REM, or deep sleep; waking up during the night; nightmares and night terrors. For older youth, engaging with social media before bedtime can bring up stresses, emotions and relationship issues with peers that don’t exactly create peaceful bedtime thoughts. Bedtime should be a screen-free, stress-free, peaceful time of day. It’s a great time for parents to promote self-esteem, talk through things going on in the child’s life, to encourage and build them up. Children grow up fast — bedtime is a great the opportunity with younger children to cuddle up and read a story or sing a lullaby. What are other major considerations in making bedtime smooth and relaxing for kids and their parents? Another factor that contributes to positive sleep habits includes children getting enough activity during the the day so they’re genuinely tired at night. Also helpful are ambient noise makers, peaceful music, avoiding sugar two hours prior to bedtime, consistency in bedtime routine, comfortable pajamas and comfortable temperature in the home. Is it important to keep the child’s bedroom dark? Dimming the lights is important, regardless of the time of year. This is another reason to ban screens, as they emit light that stimulates wakefulness.

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Dr. Max J. Coppes, Physician-in-Chief Renown Children’s Hospital, and Nell J. Redfield Chair of Pediatrics, UNR Med, talks about how much is too much when it comes to teens and social media. Social apps (Facebook, Instagram, Twitter, WhatsApp, Snapchat, TikTok, etc.) have become an integral part of most people’s lives. In contrast to traditional media — where one source goes to many receivers — social media operates in a dialogic transmission system. Many sources interact, sometimes simultaneously, with many receivers and provide for superior interactivity between its users. Not surprisingly, it also plays a significant role in our children’s lives once they are old enough to understand how to access and use these apps. On average, children start exploring social media at around ages 10 to 12. They rapidly discover that electronic communication allows for unique and personalized ways to make and keep friendships. They also use it to develop and expand family ties, get help with homework, share music, art, and experiences, and learn and discover the world. Social Media and Teens Surveys suggest that more than 90 percent of teenagers use social media. Additionally, approximately 75 percent have at least one active profile by age 17. Access to social media is greatly facilitated because more than two-thirds of teens have their own mobile devices with internet capabilities, a substantial change relative to previous generations. The use of social apps can have many positive aspects. But we now also recognize that it can also have negative impacts. The use of hazardous sites or the inherent risks of using social media (identity theft, being hacked, cyber-bullying, etc.) are indeed damaging to children. Any use of hazardous social apps is too much and carries serious hazards. But what about the use of “normal” and/or “safe” social media? Well, data suggest that too much use of “non-hazardous” apps can indeed affect health. How Much Do Teens Use Social Media? First, some basic data. For example, how much do normal teenagers use social media? A study from Pew Research found that more than 50 percent of 13- to 17 year-olds go online several times a day. This quickly increases during the teenage years to more than 70 minutes per day. Teenage girls have the highest usage at just over 140 minutes per day. It is important to recognize that non-school related use of the internet and social media is often beheld by teenagers as important for developing their self-esteem, their acceptance among peers, and their mental health in general. As parents, we recognize that the use of social media can indeed contribute, in many positive ways, to our children’s growth. At the same time, we also worry about them spending too much time online. We worry about their ability to communicate effectively in face-to-face settings or in writing. Many of us also feel and/or worry that our children are addicted. Social Media and Addiction Recent studies suggests that the overuse of social media indeed mirrors addiction. Reports now show that teenagers and college kids experience anxiety when deprived from their connected devices and consequently feel a compulsion to access their social applications. The emotional symptoms they experience are very similar to those seen in substance abuse. In fact, the American Psychiatric Association is considering making internet addition a bonafide diagnosis. Pediatricians therefore encourage limits on the use of social media, a recommendation more easily suggested than accomplished. So when should a parent consider seeking help? Aside from unhealthy use of these apps (cyber-bullying, sexting, online users asking for sexual relations, etc.), which should always trigger concern, the use of social media for more than 120 minutes per day should trigger parental concern. If you feel unable to address the overuse of social media, contact your pediatrician for help and guidance. Renown Children’s Hospital Whether it’s seeing a pediatrician, getting a sports physical or looking for advice, our care is centered around supporting and nurturing patients and families at our many locations. We have pediatricians dedicated to children who have experience recognizing children’s illnesses. They also have knowledge about tests and treatments for young ones to ensure your child gets the best care possible. Explore Children’s Services

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Virtual visits are basically secure, video conferencing visits with your health provider. Of course if you are sick, you want to avoid going outside of your house. With Renown Health’s virtual visit program, you can now see a provider from the comfort of your own home. As we work to keep all of our patients home and healthy, we’re here for any ongoing healthcare needs you have. There are two easy ways to access a virtual visit with Renown Health. If you need an urgent care visit, you can get in line using your MyChart account You can make a virtual visit with some Renown Health providers you see currently Virtual Urgent Care from a Renown Provider By using MyChart, you can now login and request to “Talk to a Doctor.” After filling in some information and confirming your healthcare concern, you will be put into a virtual line. The healthcare team will notify you by text or email when a provider is ready to talk to you virtually. Virtual urgent care visits are available for all ages. Get To Know MyChart Virtual urgent care visits are available for all ages, and can address: Common cold and cough symptoms Muscular, tendon or joint pains not caused by injury Allergy or sinus symptoms Pink eye Urinary discomfort Diarrhea without vomiting Rashes or skin sores Backache Nail problems Screening examination for sexually transmitted illness (without symptoms) Medication refills (not controlled substances) Symptoms for In-Person Urgent Care Visits Shortness of breath Chest pain Abdominal pain Numbness or weakness of any location that is new Traumatic injuries (including eye injuries or something in the eye) Severe pain of any other body location Dizziness or confusion Bleeding from any location High fever (greater than 102 degrees for all ages) Persistent vomiting Loss of vision Ear pain Substance abuse or psychiatric problems Virtual visits are open 9 a.m. through 6 p.m. Monday-Friday and 10 a.m. to 4 p.m. Saturday and Sunday for Nevada residents. Renown Provider Virtual Visits Many primary and specialty care appointments for adults and children are now available virtually. If you have a provider with Renown Medical Group, call 775-982-5000 to see if you can have a virtual appointment from the comfort of your home. MyChart Assistance If you need assistance with your MyChart account, please call 775-982-6686. For all other questions about scheduling and appointments, please call 775-982-5000.

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Many factors are contributing to the rise of early onset puberty in girls. Learn what they are below and how you can support your daughter. The number of girls experiencing early puberty has increased dramatically over the last few years and continues to grow. More and more girls in the U.S. are starting to show signs of development before the age of 8. Recent studies show that up to 10 percent of Caucasian girls and 23 percent of African American girls are showing signs of puberty by age 7. What’s Contributing to Early Puberty in Girls? Determining the exact cause is difficult. But experts agree that several factors may be contributing to these growing numbers. Increasing rates of childhood overweight and obesity. Excess body fat alters the levels of hormones responsible for the acceleration of pubertal timing. Physical inactivity may decrease melatonin levels, which can also trigger pubertal development. Increased animal protein intake. Higher total protein, animal protein and meat intake in children ages 3 to 7 have been associated with earlier onset of menstruation. High protein intake elevates IGF-1 levels and promotes growth, which could accelerate the onset of puberty. Poor diet. Children with lower-nutrient diets tend to enter puberty earlier. A diet rich in processed foods and meats, dairy, and fast food is disruptive to normal physical development. Exposure to EDCs (endocrine-disrupting chemicals). EDCs are synthetic chemicals found in plastics, pesticides, fuels and other industrial chemicals that inhibit or alter the action of natural hormones. Because EDCs accumulate in the fatty tissues of animals, animal foods contain higher levels of these chemicals than plant foods. Exposure to BPA (bisphenol A). BPA is an industrial petrochemical found in a variety of products including plastics, tin-can linings and even cash register receipts. Because it acts as a synthetic estrogen it may speed up pubertal development. Soy products. Soy contain isoflavones which are converted to phytoestregens in the body, and are similar to the hormone estrogen, Dr. Chelsea Wicks says. “Soy consumed from natural food sources is likely safe and will not cause abnormal hormones levels. However, when consumed in large amounts, such as with soy supplements or in more processed foods, there have been links to chronic medical problems due to elevated estrogen levels. I feel a good answer to this is to continue working on eating fresh foods and trying to avoid the processed, packaged foods as this will be best for overall general nutrition as well,” she adds. What You Can Do While some genetic factors play a role in the early onset of puberty, parents can help lessen environmental causes of the condition. Encourage and help your child to maintain a healthy weight with proper nutrition and exercise. Avoid exposure to hormones such as estrogen and testosterone that may be found in hair products, medications and nutritional supplements. Avoid exposure to EDCs and BPA. Offer your child a diet centered around whole plant foods rather than animal foods, which will help keep protein intake within a safe range and reduce consumption of EDCs. Create a supportive environment for your daughter. Avoid commenting on her appearance and instead focus on her achievements, academic successes or artistic talents. Speak to her openly and honestly about the physical changes she’s experiencing — that although these changes are normal, she’s simply developing early — and that ultimately her peers will undergo the same changes. Encourage your daughter to continue participating in social activities and pursuing her interests, and reassure her you are always open to discuss any questions or worries. If you are concerned that your child may be going through these changes before expected, speak with your pediatrician. Sources: Early Puberty: Causes and Consequences When Is Puberty Too Early? Precocious Puberty (Early Puberty) Precocious Puberty

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