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Seeking protection for yourself and your loved ones from the intense sun rays at northern Nevada's elevated altitudes? With so many choices available, selecting the ideal sunscreen can be daunting. To guide you through this, we consulted Dr. Angela Walker, a dermatologist from Renown Medical Group, for her expert insights. Sunscreen Application Dermatologists recommend a broad-spectrum sunscreen with a minimum SPF of 30, but keep in mind that no sunscreen protects against 100 percent of UV radiation and that reapplication is necessary. “No matter the SPF, sunscreen must be applied adequately and frequently, meaning a quarter-sized amount to cover the face and neck and a full shot glass amount for the body when wearing a bathing suit,” said Walker. “Reapplication should be every 80 minutes.” Why not use a high SPF, such as 70 or 100? According to the Skin Cancer Foundation, they don’t offer significantly more protection than SPF 30 and mislead people into thinking they have a higher level of protection. Here’s the breakdown: SPF 15 blocks 93 percent of UVB rays SPF 30 blocks 97 percent of UVB rays SPF 50 blocks 98 percent of UVB rays SPF 100 blocks 99 percent of UVB rays Do specific populations require a higher SPF? Walker explains that infants, seniors, and those with a history of skin cancer must take precautions against UV radiation, as their skin is vulnerable. Sunscreen should be an absolute priority before spending time outdoors and avoiding prolonged sun exposure, wearing a hat with wide brim (recommended 4-inch brim) and UPF (ultraviolet protection factor) clothing. Due to the sensitive nature of an infant’s skin, babies under six months should not spend time in the direct sun. For infants and toddlers six months and older, whose skin is thinner than adults, a sunscreen that contains zinc oxide or titanium dioxide (physical protectors) should be applied. Zinc and titanium are less likely to irritate because they do not penetrate the skin and instead sit on the surface and deflect UV radiation. Zinc oxide and titanium dioxide are vital ingredients to seek out in sunscreen due to their strong ability to deflect UV radiation. Sunscreen Terms Explained UVA = Long wave ultraviolet light. Penetrates deep into the dermis, the skin’s thickest layer, causing tissue damage that wrinkles and photo-aging and contributes to developing skin cancer. UVB = Short wave ultraviolet light. The biggest contributor to the development of skin cancer and are more prevalent during mid-day. SPF = Sun protection factor. Calculated by comparing the amount of time needed to burn sunscreen-protected skin vs. unprotected skin. So, SPF 15 means you can stay in the sun 15 times longer than you could without protection.

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As the seasons shift, so do the demands of our skin. We sat down with Heidi Nicol, a seasoned aesthetician at Renown Dermatology, Laser & Skin Care, to uncover the secrets of pampering your skin during the winter onset. The aftermath of summer often leaves us with dry, dull skin and unexpected breakouts. However, a few tweaks to your skincare regimen can make this seasonal transition smoother. 1. Re-evaluate Your Cleanser Now might be the opportune moment to transition to a non-drying cleanser. The one that worked wonders in the summer might be aggressive for the colder months. Nicol suggests opting for a "gentle" cleanser that effectively cleanses and exfoliates without including abrasive ingredients. 2. Amp Up the Hydration With the dip in temperature, your skin craves a richer moisturizer. Seek out products enriched with Hyaluronic Acid. This powerhouse ingredient amplifies your skin's ability to retain moisture, ensuring it stays supple throughout the day. 3. Introduce Retinol If retinol isn't a staple in your skincare arsenal yet, consider introducing it now. Its prowess in diminishing sun-induced brown spots and fine lines is unparalleled.

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Want to know more about osteoporosis and osteopenia? We'll dive into these conditions and give you some handy tips on preventing future problems and taking care of your bones. What is Osteopenia? Osteopenia (low bone density) is the initial stage of bone mineral density loss, which can eventually progress to osteoporosis if steps are not taken to prevent it. What is Osteoporosis? Osteoporosis is a condition that weakens our bones. While it literally means “porous bone," it doesn’t mean that our bones are doomed to succumb to the changes that can happen to us silently over time. Our bones are living tissues that are constantly breaking down and remodeling themselves.  Osteoporosis and osteopenia are typically diagnosed by testing bone mineral density using scans that your primary care provider can easily order. This is important testing because it dictates your risk of breaking a bone in common areas like your hip, wrist or spine. It also helps set the stage for talking with your healthcare team to develop a treatment plan. Most people will reach their peak bone mass in their mid to late twenties. There are several factors that increase our risk of osteoporosis or osteopenia as we age, such as menopause, genetics and other lifestyle factors. However, there are several things you can do to mitigate this breakdown and assist your body in the constant remodeling it does to our bones. 3 Controllable Factors to Build Strong Bones 1. Talk to your primary care provider They can go over a plan and prescribe things such as vitamin D, calcium and medications that can help if you are at risk or have osteoporosis or osteopenia. 2. Maintain a healthy diet Talk to a dietician if you need further help as they can be an invaluable resource to develop a plan.  Eat foods rich in calcium, vitamin D and vitamin C. These assist with the rebuilding of bone. Examples include but aren’t limited to leafy greens, legumes, salmon and healthy dairy products.  Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture.  Limit alcohol to two to three beverages per week. Alcohol interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. 3. Exercise Talk to your primary care provider to get a referral to physical therapy if you need help with exercise.  Our bones adapt to the stresses we put them through. Therefore, exercise should be tailored to putting the right stress on our bones. There is good quality research that most exercise is safe when dealing with less bone mineral density.  The exercises should be progressively challenging and increase the load for resistance and weight training at least two to three days a week. Examples include squats, step-ups, chest presses and rows.  Exercises higher in velocity will lead to more power and bone adaptation. Examples include quicker push-ups, marching and quicker walks.  Exercises that are weight-bearing will lead bones to adapt to the stress placed on them. Movements such as mini stomps, step-ups, jumping, jogging and so forth may be used depending on how your body tolerates these things to really stimulate bone adaptation. There are aspects of aging and bone health we can’t control, but we can take steps to minimize the chances of bone loss and osteoporosis. Talk to your healthcare team to determine your risk and don’t forget to show your bones a little TLC – you’re going to need them.

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Our skin loses its elasticity and ability to retain moisture as we age. As a result, sun exposure leads to age spots, wrinkles and even cancer. Dermatologist-recommended treatments can reverse the signs of aging and help resolve skin conditions. The board-certified experts at Renown Dermatology, Laser and Skin Care provide care for various skin conditions—from psoriasis and acne to skin cancer. We've outlined the top three treatments available, how they work, and the results you can expect. 1. Define with Dermaplane Our popular Dermaplane procedure exfoliates the outermost layer of dead skin cells, and vellus hairs (peach fuzz), leaving the skin smooth and supple. A glycolic peel is then added for a fresh, healthy glow. Dermaplane can be combined with other skin care treatments and will reveal immediate results with zero downtime! Your vellus (fine) facial hair will not become thicker or darker after dermaplaning. Instead, the hair will grow back but won't change color or thickness. 2. Illuminating Omnilux LED Light Therapy LED therapy is a natural treatment, does not contain harmful UV wavelengths, and does not create heat or thermally damage the skin. Omnilux LEDs emit light photons of specific wavelengths into your skin and are absorbed by cell components, particularly the mitochondria. Two Types of Light Therapy Red Light Reduces wrinkles by stimulating elastin and collagen Improves skin tone Warm, relaxing 20-minute treatment with no downtime Blue Light Reduces active acne Helps reduce redness and inflammation Reduces length of breakouts Relaxing 20-minute treatment with no downtime 3. Therapeutic Triple Facial Plus Reduce the appearance of fine lines instantly with our most popular skincare package. This ultra-conditioning treatment freshens the skin's appearance without extended healing or downtime. Enjoy three treatments in a single 60-minute session: Dermaplaning for exfoliation and the removal of vellus hair Glycolic mask for a fresh, healthy glow Laser toning for collagen stimulation   The Dermatology, Laser and Skin Care team offers competitively-priced treatments and procedures. In addition, our seasonal specials provide competitive pricing to help you stay on budget. Sign up and be the first to know about money-saving cosmetic service specials sent to you quarterly!

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According to the Skin Cancer Foundation, higher altitude increases the risk of sun-induced skin damage. UV radiation exposure rises 4 to 5 percent every 1,000 feet above sea level. In addition, snow reflects up to 80 percent of the UV light from the sun, meaning that you are often hit by the same rays twice. This only increases the risk of damage. If you're among the 58 percent of adult Americans who choose not to wear sunscreen, you may be even less likely to apply sunscreen during the fall and winter. Experts at the William N. Pennington Cancer Institute, explain that exposure to the sun happens when we least expect it, like during our daily commute. The ultraviolet A (UVA) rays can penetrate the windows of your car, office or home and get deep into the dermis, the thickest layer of our skin. So what’s the solution to preventing skin damage — or even worse, skin cancer — in the colder months? Apply, then Re-apply Sunscreen "There are a million sunscreens, so find one that feels good on your skin. Hydrating formulas are great for the drier months, so use a broad spectrum UVA and UVB lotion with a mix of ingredients to ensure you are fully protected." Still not sure which sunscreen to use? Look for the Skin Cancer Foundation Seal of Recommendation next time you’re out shopping for your sun protection products. A good rule of thumb is to use about one ounce (a shot glass full) and re-apply every two hours, or more often if sweating. Also, make sure to: Follow directions and shake the bottle before using. Make sure all skin is covered (including neck, ears and lips). For people with thin or thinning hair, apply to the scalp as well. Carry your favorite bottle of sunscreen with you at all times. Skiers, snowboarders, snowshoers, sledders, snow shovelers and winter enthusiasts take note: When spending time out the snow, we recommend a sport sunscreen with an SPF of at least 30.

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Want to protect yourself from skin damage from the sun’s harmful rays? Dr. Angela Walker, dermatologist with Renown Medical Group, shares what you can do to prevent skin cancer. What can people do to prevent skin cancer while enjoying the outdoors? There are several steps you can take to protect your skin from the sun. “I caution all of my patients to avoid the sun during the hours of 10 a.m. until 2 p.m. when UV rays are strongest. I also encourage people to wear sleeves on cooler days. And don’t forget that we still need to wear sunscreen on cloudy days! UV rays can still cause sun damage on cloudy days. Preventing skin cancer also entails wearing sunscreen of at least SPF 30 everyday.  Are hats also a good idea for skin protection? Yes, of course! Choose a wide-brim hat that shades the face as well as the back of the neck for extra protection against UV rays. When it comes to identifying skin cancer, what should people watch for? We use easy-to-remember letters when checking for spots on the skin; it’s called the ABCDEs: How often should people go to a dermatologist for a full-body skin check? People with a family history of melanoma or who have already had skin cancer need to be screened at least once a year. Those who are younger and use sunscreen daily don’t need to be seen as regularly. Their primary care provider can do a yearly screening. And remember to do self-screening at home to keep an eye out for unusual looking spots. Is it best to visit a care provider with an expertise in skin with questions or concerns? Absolutely. As a dermatologist, I see a lot of people coming in with a changing mole or brown spot that looks irregular. I can assure them it’s benign or get them the treatment they need. We can even use photography to monitor skin spots and have the patient take photos at home. We also perform biopsies as needed.

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As we begin to enjoy the springtime weather in northern Nevada, are you finding your skin less than tip-top shape? Here’s how to add moisture back in easy, natural ways. You don’t need to be a medical aesthetician: Dry, cold climates can often wreak havoc on your body’s largest organ — your skin. These tips from Renown Dermatology, Laser & Skin Care will quickly put moisture back and relieve dry, chapped skin. 11 Miraculous Moisturizing Tips Always wear broad-spectrum sunscreen, even during winter months. Don’t forget to use an SPF lip balm, too. Heaters dry out your skin. Use a humidifier to keep moisture in the air. (And try these simple tips to make sure you’re keeping that humidifier clean.) If your skin is dehydrated, try using a nighttime moisturizer during the day. Use a hydrating mask or moisturizing mask twice a week. Don’t forget your hands and feet. Apply a rich cream to the hands and feet at night and cover them with gloves and socks to restore moisture while you sleep. Drink plenty of water to stay hydrated. Try adding a hydrating serum to your morning and nighttime skincare routine to heal the skin. Use a gentle exfoliant to remove dry skin at least once a week, which helps your skin absorb your moisturizer. Apply body oil or lotion in the shower while your skin is still damp to trap moisture. Hot water dries out your skin, so turn down the temperature in the shower and bath.   A little pampering goes a long way, and Renown’s medical aestheticians are here to help. Trained in skincare and advanced therapies, our experts can transition your skin to look healthy, youthful and rejuvenated.

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If you think sore nipples are just a normal part of breastfeeding, think again. Robin Hollen, APRN, and Breastfeeding Medicine Specialist, says that nursing can be an enjoyable experience for mom and baby without pain and discomfort. A top concern of nursing moms within the first week after delivery is how to prevent sore nipples. Even moms who’ve nursed before struggle with this common issue. While many women think it is a regular part of the nursing experience, it is actually a sign that something isn’t quite right. “Nursing your baby should be enjoyable,” says Robin Hollen, Breastfeeding Medicine Specialist with Renown Health. For over 30 years Robin has been supporting moms to breastfeed. Below she shares some valuable information and tips, helping you create a happy and healthy breastfeeding experience for you and your baby. What causes sore nipples? The most common cause of sore nipples involves incorrect latching. For a proper latch, a baby’s mouth takes in the entire nipple and some of the breast, so that the nipple rests at the back of the mouth where the palate is soft. With an improper latch, the mouth may slip down to the tip of the nipple while the baby nurses. This constant pressure on your sensitive skin may cause discomfort and pain. A board-certified lactation consultant can help assess if your baby is latched correctly and troubleshoot your breastfeeding concerns. Less common causes of sore nipples include: • Improper tongue placement of baby • Clenching • Incorrect breast pump use How can a mother prevent sore nipples from an improper latch? Breastfeeding is a learning experience for both mom and baby. Ask for help with the latch so your baby learns it correctly and maintains its depth. In the past, new mothers were surrounded by a community of women — their own mothers, grandmothers, or other family and friends — to provide assistance and guidance with every latch at the beginning of an infant’s life. In today’s culture, new moms can find themselves on their own with no extended family to lend their knowledge. Nurses, pediatricians and lactation consultants now fill that role; they are the eyes and hands along with the much-needed experience to guide new mothers. Our Breastfeeding Medicine experts assist nursing moms with latch every day. Even a single visit with a lactation consultant observing your breastfeeding baby can provide valuable insight on achieving, and maintaining, the proper latch - preventing future nipple soreness and discomfort. How to heal sore nipples from breastfeeding To heal sore nipples, you must first fix the cause, and correcting the latch prevents further damage. A lactation consultant can also help you address the pain. Below are some breast healing tips: • Your own expressed breast milk is excellent to rub into the nipple for anti-bacterial protection. • For those moms who need more lubricant or fat than breast milk offers, use a lanolin or a cream that is labeled safe for the baby. • Soothies are a gel pads providing comfort in between feedings, but should not be used with lanolin products. • Breast shells, not to be confused with shields, can guard the nipples from irritation or pressure in between feedings. If you have more questions about preventing and healing sore nipples or general breastfeeding concerns, talk to your pediatrician or a Renown Health Breastfeeding Medicine specialist at 775-982-6365.

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While breastfeeding is natural, it's not always easy. We asked Certified Lactation Counselor Sarah Mitchell for some tips to help make the process easier for mom and baby. From increased infant immunity to improved maternal health and well-being, the benefits of breastfeeding are many. Still, only 60 percent of U.S. moms in the United States continue to breastfeed past their baby's first six months. There are for many reasons for why moms stop, including the mother's their need to return to work. We reached out spoke to Sarah Mitchell, a certified lactation counselor at The Lactation Connection at Renown, for some expert advice. Tip 1 At first, it's normal to expect obstacles. Even in cultures where close to 100 percent of moms breastfeed, they can experience issues, including getting the baby to "latch on," sore nipples, and milk production. In addition, it sometimes can take several weeks for mom and baby to get comfortable. Tip 2 Line up a coach, even before the baby is born. This can be a professional lactation coach, family member, or friend who is experienced and encouraging. While online videos can be helpful, most new moms need the one-on-one guidance that a coach can provide. Renown offers outstanding resources in its Lactation Connection center, including expert consultants, products, and support. Tip 3 Well ahead of the due date, set up a support network of friends, family members, or community groups such as La Leche League. Women historically have relied on extended support systems to help them with raising children, and breastfeeding is one of those areas that, while natural, still needs encouragement from the women who’ve been there. Tip 4 Don’t get discouraged if you need to supplement at times with formula. This, too, as it turns out, is not uncommon in other cultures. In other parts of the world, babies are given beverages and foods such as tea, broth, soup, juice, mashed bananas, and papaya. The American Academy of Pediatrics recommends supplementation only with approved formula -- but the point is, it’s ok to supplement if you need to. Finally, don’t forget the importance of breastfeeding for connecting with your baby. It’s essential to maintain breastfeeding over the weekends, preferably “on-demand,.” and will keep that special bond strong after you have returned to your job.

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Did you know that your makeup brushes are likely full of built-up dirt and bacteria? Using dirty makeup tools can lead to irritation, breakouts and even infections. The good news? It's completely preventable. An expert explains For anyone who regularly wears makeup, brushes are great tools for powdering, contouring and finishing touches. Unfortunately, these same brushes also harbor harmful bacteria that can clog pores and cause unwanted breakouts. “Brush hairs and sponges are porous, and hold on to oils, debris and bacteria,” says Heidi Nicole, medical esthetician with Renown Dermatology, Laser & Skin Care. “Also, if they are dirty, the application of makeup can be spotty and make blending more difficult." Most dermatologists suggest that you clean your makeup brushes at least once a week. Because they are used on your face, it makes sense to keep them as a clean as possible. In addition, your brushes will last longer if you stay on top of cleaning them. Six simple steps to integrate makeup brush care into your beauty routine: Wet your brush with lukewarm water. (Don’t soak your brushes, as water in the brush barrel can cause the hairs to fall out.) Place a drop of gentle cleanser or specialized brush cleaner in the palm of your hand. Gently massage the tips of the bristles on your palm. Rinse the bristles well. Blot with a clean towel and reshape the head. Let the bristles dry over the edge of a counter. Do not allow the bristles to dry on the towel, which could cause the brush to mildew. Store your brushes in a clean, dry place in between uses.

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Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

Read More About Bone Fractures in Children Honest Expert Advice

Winter skin alert – cold temperatures can put your skin into chaos. We asked for skin tips from Heidi Nicol, an esthetician with Renown Dermatology, Laser & Skin Care. She shares how to keep your skin glowing through the frosty months ahead. With the change from warm to cold weather, your skin can get stressed out. In fact, issues like flaky skin, irritation and chapped lips can be an everyday struggle. 5 Easy Winter Skincare Tips 1. Re-think your shower Few things feel better on a cold day than a long, hot shower. But hot showers can lead to dry skin because they strip your skin of its natural protective oils. Avoiding them altogether is best – choose a lukewarm, or warm, shower instead. If you have an occasional hot shower, the American Academy of Dermatology (AAD) suggests keeping it at five to ten minutes. Nicol recommends using a gentle cleanser and avoid using too much. Moisturizing after a shower or bath while your skin is still damp is also a must. Slathering on your favorite lotion helps your skin hold on to precious moisture. 2. Stay away from smoke and fire Although sitting close to a roaring fireplace can feel good, it is drying to your skin. Smoking and exposure to smoke also harms your skin. Smoking reduces healthy blood flow to the skin. This also causes your skin to wrinkle faster, making you looker older. Additionally your skin heals much slower if you smoke. 3. Consider a humidifier Cranking up the thermostat dries out indoor air. Skin is our largest organ, and in general, heat is very drying to your skin. To clarify, over time dry air degrades your skin’s natural moisture (lipid) barrier leading to flaking, peeling and cracking. Your skin can overcompensate for the dryness by producing even more oil. In other words it is possible for your skin to be both oily and dehydrated at the same time. Even oily skin needs a daily lightweight, non-pore clogging moisturizer. 4. Use SPF daily The sun’s rays damage your skin even on cloudy days. Sunlight contains UVB (burning) and UVA (aging) rays. Although UVB rays are less strong in the winter, the UVA rays are same strength all year. And snow can reflect almost 90% of UV radiation. With this in mind make sure you have suitable skin and eye protection when going outdoors. 5. Take care of your hands and feet Don’t forget your fingers and toes when moisturizing. These areas tend to be drier than other parts of the body. Gloves help to protect hands from winter weather and lock in moisture. Similarly, putting lotion on your feet before your socks will keep them your skin from flaking and cracking. Follow the tips above to make sure your skin is at its best, despite the winter weather. Renown Dermatology, Laser & Skin Care | 775-982-8255 Renown Dermatology, Laser & Skin Care offers a comprehensive range of treatments and products to address any skin care need. Visit our beautiful office in south Reno and browse our product lines. Experts are available to answer any questions concerning your skin care and health and wellness needs.

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