If you have a FLEX plan or other medical expense reimbursement plan for your out of pocket medical expenses, check with your plan administrator about whether your 2009 skin care product purchases qualify for reimbursement.

Over the years I’ve seen many patients who can get their medical skin care product expenses reimbursed by their pretax health benefit accounts or who can deduct them as medical expenses.  If you think this is you, ask your plan administrator.   In my experience, patients need a note from their treating doctor stating that they have an active medical condition and that their skin care products are used to treat that problem.

Medicated OTB Skin Care products that I use to treat active medical conditions in my patients include:

1. All of our sunscreens (which are SPF 30 or higher)
2. All of our OTB SKIN acne kits and OTB SKIN individual acne products (they are medicines containing either salicylic acid, benzoyl peroxide or pyrithione zinc)
3. Noble Zinc Soap (with pyrithione zinc for treatment of active rosacea or seborrheic dermatitis)

From my experience and research on the subject it’s clear that skin care products in general do not qualify as medical expenses when they are used for routine hygiene or for prevention of a medical condition (sunscreen may be the exception here, ask your plan administrator).  However, people who use medicated skin care products to treat their active skin problems may have purchases that qualify as medical expenses.

The 3 OTB Skin Care product categories above contain FDA regulated over the counter medicines for the treatment of medical conditions.  Ask your plan administrator or tax specialist if your purchases qualify as medical expenses and find out what documentation you need for your records. Remember, just because the treatment makes sense doesn’t mean the IRS thinks the expense qualifies.

Photo attribution: > / <a rel=”license” href=”http://creativecommons.org/licenses/by/2.0/”>CC BY 2.0</a></div>

My number one pick for what to do  in Sebastopol  is to take an art walk on Florence Avenue to see Patrick Amiot’s sculptures then eating at the Peter Lowell’s on the corner of Florence and Highway 116. I always do this with my out of town guests.

Patrick Amiots makes enormous, joyful, comic sculptures from found objects.  He lives on Florence Avenue and most of his neighbors have one of his big sculptures in their front yard.   To visit Florence Avenue, park anywhere on Florence between Highway 116 and Wilton and walk those few blocks.  There’s even some of his pieces on Huntley.   My dear friend Lorraine from Australia took photos of some of the Florence pieces when she visited me this summer:

Patrick Amiot is a real West County treasure and a proliferic artist.  If you keep your eyes open in Sebastopol, you’ll see his work all over our town.

Peter Lowell’s restaurant is right on the corner of Florence Avenue and Highway 116.  For me, Peter Lowell’s really nails the Sebastopol food scene.  His biodynamic, local, organic ingredients come out of the 800 degree hearth oven and make my ‘health nut’ foody heart quiver!  My favorites are the macro bowl (which I never tire of) and his amazing thin crust pizzas.  The wines, coffee and teas are also organic, thoughtful, local and not to be missed either.  Take a look at the building that houses the restaurant.  It’s a cool live/work project made from entirely green construction.  It represents the type of lifestyle that many Sebastopolians envision for our towns future.  The landscaping is particularily interesting to me as a gardener.

If you want a longer walk, you can cross the very busy Highway 116 and walk up Ellis Ct. to the West County/Rodota trail.  This paved bike path actually goes all the way from Forestville to Santa Rosa.  You can bring your dogs and give them a good workout too.  I recommend walking left until the trail meets on Highway 116 then turning back and walking until it hits High School Road.  That gives a nice little walk either before or after your meal at Peter Lowell’s.

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More ideas for spending quality time in and around Sebastopol

Places I Love To Shop In Sebastopol-North Main Street

Places I Love To Shop In Sebastopol-North Main Street’s East Side

Sculpture by Sebastopol Artist Patrick Amiot on Florence Ave.

There’s no place quite like Sebastopol!

I love giving my out of town patients recommendations on what to do here.

Sebastopol’s the hub for the artsy and alternative culture of Western Sonoma County. Our town is small and not touristy, yet our businesses thrive because so many people come through Sebastopol on there way to the Russian River or our beautiful coast. This means that our stores and restaurants rock!

Many of my patients are from out of town and drive hours to my office. They want to run errands, eat, and stretch their legs before driving home again. I love giving patients my recommendations for how to spending time in Sebastopol. By posting my favorite Sebastopol things to do here on my blog, I hope to give my out of town patients good ideas for what they can do here in wonderful ‘West County’.

Ideas for spending quality time in and around Sebastopol:

Visit Florence Ave for a Nice Walk, Delightful Art and a Great Meal-Very Sebastopol!

Places I Love To Shop In Sebastopol-North Main Street

Places I Love To Shop In Sebastopol-North Main Street’s East Side

I would like to wish all my patients and readers a Happy Thanksgiving!

I am blessed to share time with you.  My career is one of the deeply rewarding parts of my life….. and you make that possible.

In the coming year, I look forward to sharing more exciting challenges with you, both in the office and on the web.  Your questions and dermatologic puzzles help keep my brain nimble and I am forever grateful!  Everyday I learn something  new about life through my conversations with you, my patients, and  I’m thankful for your openness and your trust.

Please note, our office and OTB Skin Care will be closed  today through Sunday so than my employees can spend time with their families.  We will open again Monday morning at 9am.

I wish you all a wonderful holiday, spent with people you love, and eating food that represents the bounty of our earth.

Warm Regards,

Cynthia Bailey MD

Simple changes in your skin care regimen will help you control your facial seborrheic dermatitis. You also need to know what things make seborrhea flair up so you can avoid them as much as possible. Finally, when this chronic rash starts to act up in spite of your best efforts, you need tools to treat it fast before it really gets going and makes an embarrassing mess out of your face.

1. Washing with medicated soap is the best skin care trick to control seborrheic dermatitis. You need to pick the right product for your skin. Pyrithione zinc is my favorite medicated ingredient for facial seborrhea. I’ve never seen anyone allergic to pyrithione zinc, and it works really well.

1. People with normal to dry or sensitive skin do best with Noble Zinc Soap. It’s a natural soap meaning the glycerin was not removed when the oils were turned into soap, so it’s hydrating and won’t dry out your skin. Noble Zinc contains the important medicine pyrithione zinc plus some natural ingredients to soothe inflammation (redness).
2. People with really oily and tough skin do best with ZNP soap, which can be purchased at your local pharmacy. This soap efficiently degreases oily skin, but may be irritating to sensitive skin types.

To help remove the scale buildup, I recommend you use your medicated soap with a Facial Buf Puf in the morning . Gently lather your skin and then rinse well. This helps exfoliate the loose scale to give your skin a clean look. The soaps leave a layer of medicated pyrithione zinc on your skin to help combat the pityrosporum yeast that lives in your pores and that plays some unknown but important role in flaring up seborrhea.
When your seborrhea is a big problem, use your medicated soap twice a day. When things are pretty quiet, you can get away with using the soap just once a day.

2. Seborrhea may flair up even with diligent use of your medicated soap and my strategy for treating the flair is to apply over the counter medicated creams to the involved areas of your skin:

1. Lotrimin Cream (the generic ingredient name is clotrimazole) should be applied twice a day until the rash abates plus 2 weeks. Stopping too soon will result in rapid reoccurrence. With seborrhea, you need to snuff it out plus some because it’s a tenacious rash.
2. If Lotrimin hasn’t cleared the problem in about 2 weeks, you can try adding 1% hydrocortisone cream on top of the Lotrimin for a few days. This should help jump start the Lotrimin by quieting the inflammation of the rash. (Be aware that hydrocortisone is a CORTOSONE and will thin your skin and damage your eyes if you use it for long periods of time. You can use it for a few days, but if things don’t clear up, you need to see your doctor to supervise your treatment. Also, don’t use it on kids without your doctor’s supervision. Also, never self treat yourself by using prescription cortisones on your face without your doctor’s supervision. Many prescription cortisones are much stronger than the over the counter cortisone, even if the names sound similar, and will cause big problems on your facial skin!)
3. A natural remedy for facial seborrheic dermatitis that I have seen yield remarkable results is oil of oregano. I don’t know why it works, and it smells a little like a Greek salad, but I had one patient with sever disfiguring seborrhea who failed to clear with all the biggest, strongest prescription treatments available and she absolutely cleared up with oil or oregano applied twice a day. Topical oil of oregano is available in health food stores. Another natural skin care remedy for seborrheic dermatitis is tea tree oil. Tea tree oil is anti microbial natural medicine and has the potential to kill the pityrosporum yeast that I mentioned above. However, products containing tea tree oil are irritating so I typically don’t recommend using them on facial skin.

3. Avoid coming into contact with irritating ‘things’ on your seborrhea prone skin! Seborrhea is a rash that makes your skin more porous. Things get into your skin faster when you have an active rash because the barrier power of the skin is weaker. That means that ‘things’ which your healthy facial skin can tolerate may now be too irritating for your seborrhea rash zones. Adding irritation to seborrhea makes for more red scaly skin. Irritating ‘things’ include:

1. Harsh soaps
2. Anti aging products with glycolic acid, Retin A or Renova and Retinol, vitamin C, salicylic acid etc.
3. Harsh sunscreens (not the zinc oxide sunscreens though)
4. Harsh weather
5. Being in an environment with harsh chemicals in the air like paint fumes, new carpet, spray cleaning products etc.
6. Look for other harsh things that make your seborrhea flair. For me, excessive facial sweat sometimes irritates my seborrhea and causes a flair up.

4. Pick general skin care products that don’t irritate your seborrhea prone skin. Irritation of your seborrhea zones may be your first indication that your seborrhea is about to flair-up. OTB Skin Care has products that are gentle and safe for most sensitive skin types including the seborrhea prone areas of your face. All of our sunscreens (Citrix, Glycolix Elite and Solbar Zinc) are gentle for most skin. Our moisturizers (Glycolix Elite Facial Cream and Glycolix Fortified Facial Creams) are nonirritating. Also our non-medicated cleanser Tolerian is nonirritating. Remember, if a product stings you seborrhea prone skin it’s too irratating and don’t use it.

When your seborrheic dermatitis is in remission you may be able to tolerate some of the more difficult to use skin care products, like antiaging products. But… it’s important to discontinue their use the minute you see a little irritation develop. I, for example, can only occasionally treat the skin around my nose with Retin A, whereas the rest of my face gets treated almost every night with this powerful but irritating anti aging cream.

5.  Use skin care products that help control your seborrhea. The most successful product I’ve found for controlling facial seborrheic dermatitis is Replenix CF Cream. This is my absolute favorite skin care product, bar none! The amount of green tea antioxidants  is so high (the equivalent of 500 cups of brewed tea’s antioxidant polyphenols per ounce of cream) that you just can’t compare Replenix to any other green tea containing product with a ‘fairy dusting’ of green tea ingredients.  The chemist who created Replenix CF Cream also added caffeine and hyaluronic acid which, with the polyphenols, is a magic combo to control the inflammation of seborrhea.  My facial seborrhea is so soothed by the combination of Replenix CF Cream and Noble Zinc soap that I always pack them in my travel kit and I never  risk running out of them.

6. Lastly, I’ve seen Intense Pulsed Light treatments take the edge off of really stubborn facial seborrheic dermatitis. Intense Pulsed Light (IPL), like the Sciton BBL that I use in my office, helps with rosacea, and rosacea often coexists with seborrheic dermatitis. Patients with both conditions (like myself) struggle with a double wammy of facial inflammation and have extreemly sensitive skin. IPL isn’t a cure for either of these conditions, but in my practice I’ve found it really helpful. It seems to quiet down the inflammation, allowing longer peroids of remission between flairs. It also helps patients tolerate some of the antiaging products that can aggrivate both rosacea and seborrhea.

Facial seborrheic dermatitis is annoying and a chronic issue for those of us who are prone to it. There’s no cure for seborrhea BUT with carefully selected skin care products and quick treatment of flair-ups, you can have healthy and attractive skin almost year round.

My Seborrheic Dermatitis Series:

Dermatologist’s Tips for Dry Flaky Skin on Your Face and Scalp; Tis the Season for Seborrheic Dermatitis

Remedies for the Dry Itchy Scalp of Seborrheic Dermatitis

Remedies for the Dry Itchy Scalp of Seborrheic Dermatitis-Part 2

Remedies for Really Stubborn Scalp Seborrheic Dermatitis

Itchy, Crusty, Scaly Ears-More on Seborrheic Dermatitis

Dermatologist’s Tips for Treating Facial Seborrheic Dermatitis; It Looks Like ‘Dry Skin’ But It’s A ‘Rash’

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