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Thursday, July 21, 2011 – Daily News 5A FEATURES Melasma linked to birth control pill DEAR DR. GOTT: I have had melasma on my upper lip for about five years now. Looking online, I read that birth control pills could be associat- ed with this con- dition. Sun expo- sure makes it worse. I am 44, and up until recently had been on birth control pills since I was 18. I stopped taking the pill to see if it was the culprit behind a consistent, unexplained elevated liver enzyme (I have never used alcohol). Two years ago I had a series of microdermabra- sion treatments on my face, which was per- formed at a plastic sur- geon’s office. This did remove the melasma, but only for a short time. I am aware that using fade creams can result in the melasma returning in a darker form. I live in Bermuda, where it is difficult to avoid the sun. I apply 60 SPF sunscreen every day. I started taking grapefruit seed extract five weeks ago, as I read this could help remove the melas- ma. It appears to have faded somewhat but is still lingering. Should I continue with the grape- fruit seed extract, or can you suggest a better treatment remedy? DEAR READER: Melasma is a common skin condition. It can affect anyone, but is most common in young women with brownish skin tones. It is most often associated with estrogen and proges- terone, and may result from pregnancy, the use of oral contraceptive pills or hormone replacement therapy (HRT). The only symptom is a uniform, brown discol- oration, typically on the cheeks, nose, forehead or upper lip. It is typically symmetrical, affecting both sides of the face equally. The discoloration often fades over several months following discon- tinuation of the HRT, birth control or delivery. Treatment can include creams with a combina- tion of tretinoin, kojic acid, and azelaic acid, chemical peels and topi- cal steroids. Severe cases may benefit from laser treatments. Using sun- screen daily may prevent the condition or keep it from worsening. I suspect that your birth control pills are to blame. Depending on how recently you stopped the pill, you may still have some months before the fading is completed. They may be to blame for your elevated liver enzymes as well. Poten- Dr. Peter Gott tial side effects from oral contra- ceptives include cholestasis, hepatic vein thrombosis, Budd-Chiari syn- drome and veno- occlusive disease. These all affect the liver. Cholestasis is a reduced secre- tion or flow of bile. Hepatic vein thrombosis is characterized by blood clots that form within the large veins within the liver and the inferior vena cava (which drains blood out of the liver). Budd-Chiari syndrome occurs when the hepatic vein thrombosis results in an enlarged liver, abdom- inal pain, ascites (fluid within the abdomen) and liver failure. Veno-occlu- sive disease is thrombo- sis of the liver’s small blood vessels. I am not familiar with the grapefruit seed extract, so I cannot tell you if it will work or not. If you have been off the birth control pills since starting the supplement, this may explain the results you have seen thus far. Readers who are inter- ested in learning more about skin disorders can order my Health Report “Dermatitis, Eczema and Psoriasis” by sending a self-addressed, stamped No. 10 envelope and a $2 U.S. check or money order for each report to Dr. Peter Gott, P.O. Box 433, Lakeville, CT 06039. Be sure to men- tion the title, or print an order form from my web- site’s direct link: www.AskDrGottMD.co m/order_form.pdf. Dr. Peter H. Gott is a retired physician and the author of several books, including “Live Longer, Live Better,” “Dr. Gott’s No Flour, No Sugar Diet” and “Dr. Gott’s No Flour, No Sugar Cookbook,” which are available at most bookstores or online. His website is www.AskDrGottMD.com If readers want to contact Dr. Gott, they may write to him at his website, or send their mail directly to Dr. Gott, c/o Universal Uclick, 1130 Walnut, Kansas City, MO 64106. However, if readers want to request a newsletter, they should write to the Connecticut address listed above. ★ ★ ★ Family fretting father’s fling Dear Annie:I am worried about my 79-year-old father. My mother died two years ago, and my brother and I regularly see Dad and invite him for dinner and to other events. But he’s still lonely for female companionship. Six months ago, Dad began a relationship with ‘‘Corina,’’ a 33-year-old ex- prostitute with a toddler. Dad says they are in love. We want him to be happy, but we’re worried. Last week, Corina got drunk and hit my father. She’s already been in jail for other rea- sons in the past, and Dad didn’t want to turn her in. Dad bought Corina a car and let her move in with him. She doesn’t have a job. She’s home with her child all day. Meanwhile, my parents’ house is a mess, and we’ve found cigarette ashes and wine bottles all over. We have spoken to law enforce- ment and Dad’s doctor. No one can do Annie’s Mailbox by Kathy Mitchell and Marcy Sugar anything because Dad is in sound mental health, and he refuses to press charges, so no laws are being broken. He’s already given her most of his savings, and now we’re wor- ried he’ll lose his home. What can we do? — Panicked Sib- lings Dear Siblings: Draining someone’s bank account can qualify as elder abuse. Try the National Center on Elder Abuse at ncea.aoa.gov or the Eldercare Locator (www.eldercare.gov) at 1-800-677- 1116 for assistance and suggestions. You and your brother may also want to talk to a lawyer to see if there is a way to transfer ownership of the house and any remaining money to a trust in order to prevent Corina from getting her hands on it. Dear Annie: I recently buried my best friend — my dog, ‘‘Lucky.’’ But I was the lucky one who was blessed to have this wonderful animal in my life. More than 10 years ago, I saved Lucky from an abusive household, and he never forgot it. This perfect mutt loved and dedicated his life to me. All that he asked in return were rigorous belly rubs, the occasional treat and the ability to cuddle between my wife and me on the couch. Lucky and I were inseparable, and now that he is gone, I feel as if a part of me has died, too. I miss him terribly, and I can’t imagine this hole in my heart ever being filled. Please tell your readers to give their pets an extra hug when they get home from work this evening and every evening, because one day, it might be too late. — Missing My Best Friend Dear Missing: Our condolences on the loss of Lucky. You have a lot of love to give, and we hope you will consider adopting another dog. It not only can help fill that hole in your heart, but will also provide a stable home for an animal that surely needs one. Selling a home? Hire a pro Dear Mary: We purchased a new home and are ready to sell the old one. We have a couple of people who have expressed interest. How hard is it to sell without a real estate agent? We aren't sure how much to ask. We have lived in our home for 15 years, but the market has changed. -- Connie, Texas Mary Hunt Everyday Cheapskate Dear Connie: I would not recommend that you sell your home without the services of a competent real estate professional. Doing a FSBO (for sale by owner) deal will theoretically save you 6 percent of the sale price that you would have to otherwise pay out in real estate commissions. Theo- retically. Realistically, buyers aren't dumb. They'll feel perfectly justified offering less than your asking price because they know you aren't paying a realtor. Sell- ing a home is a lot of work. Determining the asking price is no easy feat. A pro- fessional has access to area "comps" and knows how buyers are trending. A pro- fessional knows what con- tingencies and benchmarks to include in the escrow instructions that will protect you from getting ripped off or taken advantage of by an unscrupulous buyer or agent looking to "steal" the property. A good realtor will be invaluable in making sure 64 Mulberry Ave., Red Bluff • 527-1755 • Fully Fenced • Onsite Manager • Well Lit Property website: www.americanselfstorage.biz • RV & Vehicle parking now available *Some restrictions apply. Good through 8/31/11 CALL NOW FOR RATES Tehama County’s Personal/Professional Service Directory AT YOUR SERVICE! BANKRUPTCY Bankruptcy Clock Repair Free information $50/mo. + court fee MICHAEL O. HAYS Attorney at Law 1-800-387-9299 530-736-7079 Grandpa’s Clocks Jim Paul 20910 Pebblestone Dr. Red Bluff Shelf & 31 Day Clocks Repaired Call for appt. 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Dear Mary: Do you pay full price for oil changes and tire rotations? These services are necessary to maintain a vehicle, yet it's so hard to pay $30 or more per service. Occasionally there are coupons, but it's still a costly expense. Any tips? -- Betsy, Ohio Dear Betsy: I try not to pay full price for anything. The shop where we buy our tires does not charge a penny extra for routine rotation, which is one rea- son we have purchased our tires there for over 25 years. Remarkably, their price is cheaper than even Costco for name brand, high-quali- ty tires. As for changing the oil, it's not that difficult. Have you considered learn- ing how to do that yourself? You might be able to cut that cost in half, provided you can buy the oil on sale or at a warehouse club. Per- sonally, I find paying $30 to have the oil changed every 3,000 miles is cheap insur- ance to make sure an engine will perform well for at least 300,000 miles. Dear Mary: A friend of mine spilled gas in her car, and she doesn't know how to get rid of the stain and the smell. She was going to try Mur- phy Oil Soap and baking soda. -- Carol, Minnesota Dear Carol: I would only trust this problem to a product called Nok-Out. It's going to cost her around $30 including shipping to order a bottle of this amaz- ing stuff, but that's cheap for the job it will do. Nok- Out doesn't cover up an odor, it eliminates it -- and that goes for every kind of smelly situation you can imagine. I suggest your friend order the Nok-Out Carpet Cleaner to rescue her car's interior. It will take care of the stain and odor, and quite miraculously.