I'm so excited to be offering Collegen Induction Therapy or, as its commonly known, Micro-Needling.   As many of you know, I've been offering acupuncture rejuvenation facial treatments for a few years now and 6 months ago when Dermapen reached out to notify us of upcoming trainings, I jumped on it. 

I love this therapy because it is a minimally invasive skin rejuvenation treatment with a quick recovery time. It promotes natural collagen reproduction, similar to fractional laser treatments, IPL, and laser resurfacing, but without the side effects and downtime. 

This is a unique way to address and improve:

• Fine lines & wrinkles
• Acne scars
• Smokers lines around the lips
• Skin tightening and rejuvenation
• Large pores
• Hyperpigmentation (dark spots)
• Skin texture
• Stretch marks
• Scars (surgical and burns)
• And encourage hair rgrowth ( more to come in a future blog post)

The goal in any facial rejuvenation treatment is to make the fibroblasts in the skin produce more collagen. Collagen provides the scaffolding and support (volume and lift) for your skin.  Another added benefit is by creating micro-channels with a Microneedling pen, the absorption of serums and creams are increased by 80%. These tiny channels also stimulate the healing response in your skin which in turn starts the production of new , fresh collagen.

All appointments will include a powerful, rich serum customized for you along with Celluma LED light therapy

Have questions?  Book a phone consultation with Elanita by clicking here

​MicroNeedling Studies:

• Fabbrocini G, Fardella N, Monfrecola A, Proietti I, Innocenzi D (2009) Acne scarring treatment using skin needling. Clin Exp Dermatol 34: 874-879.
• Fabbrocini G, Annunziata MC, D’Arco V, De Vita V, Lodi G, Mauriello MC, Pastore F, Monfrecola G (2010) Acne scars: Pathogenesis, classification, and treatment. Dermatol Res Pract 2010: 893080.
• Fife D (2011) Practical evaluation and management of atrophic acne scars. Tips for the general dermatologist. J Clin Aesthet Dermatol 4: 550-57.
• Goodman G (2003) Post acne scarring: a review. J Cosmet Laser Ther 5: 77-95.
• Goodman GJ, Baron JA (2006) Post acne scarring: a qualitative global scarring grading system. Dermatol Surg 32: 1458-1466.
• Jacob CI, Dover JS, Kaminer MS (2001) Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol 45: 109-117.
• Leheta TM, Abdel Hay RM, Hegazy RA, El Garem YF (2012) Do combined alternating sessions of 1540 nm nonablative fractional laser and percutaneous collagen induction with trichloroacetic acid 20% show better results than each individual modality in the treatment of atrophic acne scars? A randomized controlled trial. J Dermatolog Treat epub ahead of print.
• Leheta TM, Abdel Hay RM, El Garem YF (2012) Deep peeling using phenol versus percutaneous collagen induction combined with trichloroacetic acid20 in atrophic post-acne scars: a randomized controlled trial. J Dermatology Treat epub ahead of print.
• Leheta T, El Tawdy A, Abdel Hay R, Farid S (2011) Percutaneous collagen induction versus full-concentration trichloroacetic acid in thetreatmentofatrophicacnescars. DermatolSurg37:207-216.
• Levy LL, Zeichner JA (2012) Management of acne scarring, Part II: A comparative review of non-laser based, minimally invasive approaches. Am J Clin Dermatol 13:331-340.
• Shah SK, Alexis AF (2010) Acne in skin of color: practical approaches to treatment. J Dermatolog Treat 21:206-2

One of the keys to a youthful-looking skin is having plenty of super-protein collagen. Collagen is the scaffolding that prevents complexions from becoming droopy or slack. It’s a wonder-working, naturally-produced ingredient that keeps faces looking plump, taut and radiant.
Where's the catch...
As we age, our production of collagen slows down, and the reserves of this protein diminish. Without this on our side, the signs of ageing – lines, wrinkles, uneven texture and sagginess – start to become visible.
Luckily, it’s possible to replicate the process that leads to collagen being formed. Did you know whenever your body is injured, it triggers the production of collagen to aid in the healing of connective tissues. That’s why treatments like Micro-Needling and Acupuncture, which involve small, almost imperceptible skin punctures can organically provoke the collagen response.
Both involve micro injuries to the skin to stimulate collagen synthesis, but they are distinct treatments. What are the main differences? And how do you know which one is right for you?
Micro-needling in a nutshell
Also known as Collagen Induction Therapy or Micro-needling, is a therapy that involves repeatedly puncturing the skin with tiny, sterilised needles at a specific depth. Over a number of sessions, this causes the body to produce collagen. It is used to treat scarring and acne and to counter the effects of ageing. There is minimal downtime, though you may appear a little pinkish after your treatment – as if you’ve had too much sun. Swelling and minor bleeding can also result but the treated area is anesthetized to eliminate any pain. Six treatments spaced out over a year are recommended for optimum ‘wow’ results.
Facial Acupuncture in a nutshell
Facial Acupuncture also replies on needles. But unlike Micro-needling, this treatment is not about rapidly pin-pricking the skin, but about inserting needles and leaving them in there. Usually for a period of 20 minutes. The needles are carefully positioned in areas of the face where a blockage of energy is perceived or into the muscles that control our facial movements (where wrinkles often occur). Unblocking this energy has an overwhelmingly positive effect on the whole body. Facial Acupuncture is a Chinese therapy, rooted in ancient medicine and is therefore a more holistic approach to take. The process not only works to enhance the complexion, it also improves the mood and boosts general well-being. There is no downtime. And like micro-needling, six treatments are recommended to see results. But Facial Acupuncture is one of those treats you’ll want to get over and over again – whenever you need a pick-me-up.
Still confused about what to go for? At San Francisco Integrative Medicine we are expert in both treatments and can advise you on what’s right for you, your skin-type, your expectations and your lifestyle. Book a consultation today.

​

• Right now were unsure when the air quality will stabilize but until then before leaving the house - check the ever shifting air quality at airnow.gov
• Wear a mask when outside for extended periods.  Although a N95 or N100 respirator is ideal, some prevention is better than nothing.
• Use a Neti pot if you have one.  Clearing the build up out of your sinuses daily can help immensely.
• Eating pears (check out our recipe here) can calm a scratchy throat and dry cough, especially when boiled or sautéed with honey.
• Take extra immune support as your body is recognizing the new stressors present.  Things like a lingering cough, sinus congestion, and dry, red or watery eyes are examples of ways our immune system lets us know its under stress and trying to rid our body of the junk we're being exposed to. (If you need input here please email us directly)
• Remain indoors. Yeah, you won’t hear us say that very often but especially if there is a preexisting vulnerability, it can be very important to avoid unnecessary exposure to more smoke. There is likely still some amount of particulate matter in the air, but it certainly seems lessened.
• Don’t increase particulate matter in the air – This includes not lighting candles, woodstoves, fireplaces, cooking food at high temperatures on the stovetop and not vacuuming. All of these activities either increase or create particulate density and circulation in the air.
• HEPA filters or even air conditioners with filters and recirculating air can help cut down on particulate matter in the air indoors. Do NOT use an air conditioner or swamp cooler if it doesn’t have air filters or it will only suck in smoke and make breathing conditions worse.
• Avoid unnecessarily exerting yourself. Heavy breathing means you’re going to suck in more smoke. Avoid it if possible.
• Be especially conscious of breathing conditions for children and pregnant women.
• Stay hydrated. Drink detoxifying and cooling teas like dandelion or mint are especially helpful.
• If your system tends towards asthma, respiratory conditions, or you have a chronic health issue or weakened immune system please be extra careful
• We are all affected when these fires occur.  If you're able to help, there are some great groups collecting donations and  supplies.  Here's one that we just donated to Corazon Healdsburg 

Cupping and acupuncture can be very helpful. If you've been affected by the fires either physically or emotionally, please don't hesitate to reach out so we can find a time that works for you! 

Autumn and Chinese Medicine

While summer emphasizes being physically and socially active with its long days and warm weather and even though its still warm this week, the changes that autumn brings is already becoming evident. Now in October, the nights are noticeably cooler, daytime temperatures can wildly fluctuate, leaves change color and sunlight is intense but lessening. As the veil thins as we approach winter solstice, it is important to make a conscious transition from this outward time of summer to a more yin and contracting time of autumn for maintaining a healthy balance in both physical and emotional well-being. With this shift, comes natural changes in our bodies, mood and health.


This is a time to strengthen and protect your health.  Fortifying during autumn months will in turn create a reservoir of wellness to sustain vitality in winter months.  
  
The Lung Organ

• The Lungs pull in and refine qi, sending it downward to nourish our roots.  
• Ruling the skin, the outer boundary of the body, the Lung protects against external invasion and safeguards internal resources.  
• The organ is delicate and associated with taking in the new.  
• Stagnation occurs with unprocessed grief and sadness and a difficulty of "letting go." 
• When Lung qi is flowing freely and balanced, one experiences more clarity of thought, positive self-image, a sense of inner peace and joy regardless of circumstances. 

 
Ways to Support the Lungs
Nourish Fluids  Since autumn is a dry season, we need to protect ourselves from  cold-air evaporation of moisture from our skin.  Pay attention to hydration with fluids coupled with moistening foods, such as  pears, sea vegetables, cabbage, turnips and parsnips. 

Breathe  Take time to focus on full, deep abdominal breaths as you become aware of that which needs to be released.    

Purge  Free up more space by letting go of clutter and excess possessions- donating and giving away unused clothes will be deeply appreciated by those who need them this winter.  This can also mean letting go of relationships and friendships which no longer serve you in a positive way.  

Grieve  There is no one right way to grieve, there is no standard timeframe and each person's grief process is unique. Chinese medicine is concerned with grief that is repressed and unexpressed. 

Sleep  In general: aim to go to bed an hour earlier and wake an hour later.  It definitely may be appropriate for you to sleep longer than that as we head towards winter. 

Dress Appropriately  Wear a scarf - even a light one will protect your lungs and throat from harsh wind and cold.

Compost!  Another crucial way of letting go of what is no longer needed and supporting the lungs of our planet.   

Whether you're trying to conceive, prevent pregnancy, or understand your body better, OPKs (Ovulation Predictor Kits) can be pretty darn helpful.  ​Ovulation predictor kits react to the luteinizing hormone that is present in urine, which is at its peak 12–36 hours before the egg is released (or ovulation). While they are not my favorite way of determining ovulation, they are fairly easy to use and have a high accuracy rating. That being said, OPKs come with a few perimeters and a bit of a learning curve.

Below are the basics, pros and cons, tips, brands, and the problems we run across the most in the clinic. 

Which to Choose

Fertility Monitors 
I've found that patients new to tracking their cycle will choose fertility monitors, such as ClearBlue, to track ovulation. These are a bit more high tech because they involve plugging the tests into a small machine that signals low, medium, or high fertility because they track both luteinizing hormone and estrogen levels.
Pros

• The Clearblue ovulation test detects your four most fertile days (most kits usually predict two) by tracking both LH surge and estrogen. Test once per day until estrogen levels rise, indicating high fertility (displayed with a flashing smiley face). Peak fertility happens after the LH surge, and it’s displayed with a static smiley face.
• Considered to be 99% effective

Cons: The reason this is not my favorite:

• women's hormones aren't synced up the way the monitor is programmed to look for, so they never get the high fertility signal and are left confused about when ovulation is actually happening.
• Possibility of the monitor acting glitchy or not working at all.
• Since a majority of women are tracking their cycle over several months, this option can become expensive.
• Not a good option if you are over 40 or PCOS.
• Now this is an Elanita style complaints, the whole smiley face thing feels less scientific to me and kinda patronizing.

Ovulation Strips
These are as basic as it comes, They have one line for negative and two lines for positive, because they only track the rise in luteinizing hormone. When used every day you can see the line get darker and darker until it peaks.
Pros:

• Less expensive, especially the dip strip format, so you can buy a ton in bulk.
  • Some examples are Babi or Clinical Guard

Cons

• You need to pee into a clean cup first before dipping the test strip in depending on where you are when you test, this might require some coordination, or you might opt for the slightly more expensive midstream version (like these).
• Only track LH 

User's Manual
OPKs are designed to test your urine for luteinizing hormone, which peaks mid-day, so I usually recommend testing sometime between noon-5pm.  Begin testing 4-5 days prior to when it's estimated you ovulate, and test every day until after you get a positive.  Some tests also often recommend you stop testing once you get a peak, but some women get at least 2 or 3 days of luteinizing hormone peaking before ovulation actually occurs. You can't know which day was your peak day unless you see another negative test again.

Review!

• You should start taking tests several days before the expected ovulation (with a regular 28-day cycle, you should start on day 11–12).
• Continue taking the tests until the result is positive.
• It is better to do tests twice a day (but do not use the first morning urine).
• Before taking a test, do not drink a lot of water and do not urinate for about 4 hours.
• Follow the instructions closely (collect urine in a clean container, put the test strip in it for no more than 10 seconds, check the result no later than 10 minutes).
• Track this info in your fertility app or on a graph!  This is a great way to get a better understanding of your cycle. 
• To determine fertile days most accurately, you can additionally measure your basal temperature and/or monitor your cervical mucus during the cycle.

5 Common Problems We See In The Clinic

1. OPKs do NOT confirm that ovulation has occurred
Although both urine and saliva kits test for increased hormone levels prior to ovulation, they do not confirm whether ovulation actually occurred. An LH surge can sometimes occur without the release of an egg.  Likewise increased estrogen levels are not always followed by ovulation.

2. It is possible to miss the LH surge
Because the LH surge can be extremely brief, it can be easy to miss. For this reason, some women may need to test their urine twice a day. If you find that your OPK is never positive, you may just be missing the LH surge. However, it could also mean that you’re not ovulating.

3. You may experience a ‘False’ LH surge
It’s possible to have a ‘false’ LH surge before the ‘real’ one occurs. This can result in timing intercourse too early and missing your true fertile time. Women with PCOS (Polycystic Ovary Syndrome) can continually produce false LH surges.

4. Knowing when to test can be difficult (and can end up being expensive!)
If you have irregular cycles, it can be a challenge to know when to begin testing with an OPK. Because the day of ovulation can vary widely between cycles and a urine based kit typically contains a limited number of tests, one kit is sometimes not enough. This can soon become expensive

5. Ovulation predictor kits will NOT alert you to a fertility problem
An OPK can only identify when you might ovulate and will not provide other valuable information about your fertility. This is why we always recommend to collect at least 3 months worth of data before "trying" to conceive and use in tandem with another tracking method until you have a good grasp on your cycle. 
​

ARE YOU EXPERIENCING ISSUES WITH ANY OF THE FOLLOWING: IRREGULAR OR DIFFICULT CYCLES, LOW ENERGY AND/OR MOTIVATION, FEELING TIRED, INSOMNIA, LOW SEX DRIVE, DIFFICULTY CONCEIVING?My hormone mini package may be just for you! In this package, I combine my #1 hormone test (the DUTCH test) with a one-hour consult with me reviewing the results and then creating personalized recommendations for your body, mind, and spirit based on the results.
Why I love the DUTCH test:

• It’s incredibly comprehensive! This test not only takes a look at your reproductive hormones (estrogen, progesterone, testosterone) but it also looks at the metabolites of these hormones (how the body breaks them down to use and get rid of). It also includes a look at your adrenals - including the main hormones (cortisol, DHEA) and a look at how your body is responding to stress.
• It’s easy! The test kit is shipped to your home and utilizes urine (on strips) and saliva samples. These samples of urine and saliva are taken over a one day period and easy to do while at home, work, or out and about.
• Gives us SO much specific information! Since this test not only looks at your sex hormones and your adrenal hormones, we are able to map out where your body needs support with nutrition or targeted supplements, vitamins, or herbs.
• This test can be used for pre-menopausal, peri-menopausal, and menopausal women.

What’s included in this Mini Hormone Package:

• The DUTCH Plus test ($499)
• A one-hour phone consult with me ($300) reviewing the results and my personalized recommendations for you based on the test results. This may include nutrition, vitamins, supplements, lifestyle changes.
• 15% off of any vitamin, herb, or supplement recommendations.

This package normally is $550 for the DUTCH Complete & $650 for the DUTCH Plus, but for a limited time until 6/15/19, I am offering an intro discount of $150 off either test package

For me, Spring is the most mysterious and confusing of seasons.  Winter is a time of comfort and being cozy.  Fall is is about organization, getting ready for the holidays, and new routines that lay ahead.  Summer is for fun, rest, and indulging.  Spring can conjure images of bunnies hopping around, birds singing, and flowers blooming but for me, Sping is really about rebirth, growing, unpredictable weather, and coming out of my lazy winter routine. 

What does that really mean - Spring can be one tough season.  

In TCM, spring is represented by the element wood.  Wood represents birth and newness, the time for fresh ideas and new starts.  Unsurprisingly, its color is green like the fresh growth of spring.

• Wood governs your spine, joints, muscles, ligaments and tendons.  
• A wood imbalance can lead to spinal problems, poor flexibility or arthritis.  
• Wood also governs your eyes.
• Most important for your mood, wood governs your liver. Your liver is responsible for the smooth flow of Qi (energy) and smooth flowing Qi means health and vitality.  The emotion associated with your liver is anger.  If your liver is imbalanced your Qi will be disrupted and you’ll be angry.

In acupuncture terms, in order to have a healthy and happy spring you need to balance your wood element and care for your liver.

Try these spring acupuncture recommendations, to keep your wood balanced and your liver healthy.

• Cleanse.  Cleaning your digestive tract releases accumulated toxins, undigested food, parasites and fungi.  With a clean colon your digestion is more efficient and your body is healthier.
• Detox your liver.  Reduce or eliminate alcohol or drugs that are toxic to your liver.  Consider a detox that specifically targets your liver.  Let us know if you need suggestions or help with this!
• Stretch.  Start or recommit to a healthy stretching routine.  Try yoga, Tai Chi, Qi Gong, or other exercises that move, loosen and flex your joints.
• Exercise your eyes.  Massage your face, especially around your eyes.  Roll your eyes and move them in figure 8s.  Practice focusing on distant objects and then focusing on close objects in quick succession.  Put time limits on your computer sessions.  These exercises strengthen your eyes and can improve your eyesight.
• Control your anger.  If you're notice your anger getting the best of you more days than not, create a healthy anger management plan.  Journal, meditate or get counseling. Put limits on stressful situations.  Find activities that refocus your energy in healthy ways.