Please teach me, Suetake Sensei

“I had double eyelid surgery, but when I close my eyes, I see a bumpy, protruding scar.”
Mr. A : At a nearby clinic, I was told that the burial method does not leave any scars, so I underwent double eyelid surgery, but when I close my eyes, the bumpy, protruding scar stands out, which is a problem.What is this scar?
Dr. Suetake : This is not a scar.Ligation (a technique used to tie and secure body parts or medical equipment used during surgical procedures) In other words, the knot is placed in a shallow area of ​​the skin because it is not buried deeply. It stays in place and when you close your eyes, it swells up and looks like a scar.
Mr. A : Why does this happen?
Dr. Suetake : In double eyelid surgery, the burial method does not involve making an incision using a scalpel on the eyelid skin.As the name suggests, this is a surgery in which special thin threads are buried in the eyelids to artificially create a double eyelid material made of cord-like material that is separated from the levator palpebrae superioris muscle, a muscle that raises the eyelids.If you go to a cosmetic surgeon with skilled techniques, you won't have such troubles.This is a problem that occurred after double eyelid surgery due to inexperience or sloppy treatment.This condition is not so much a scar as it is a condition where the ligated part of the suture that should be buried has not been properly buried.
Mr. A : If this happens, how can I fix it?
Dr. Suetake : The best treatment method is not to treat scars with a laser, but to make a small incision in the raised area, remove the knot, and repeat the burial method again.At our hospital, we always make a XNUMXmm cut into the skin using a special needle that cuts his XNUMXG blood vessel at the site where the thread is ligated, and then place the ligature in this area to ensure that the ligated site is buried. Because of this, problems like this are unlikely to occur.If the surgery is performed in a careless manner, the knots of the threads that are not buried properly may protrude outside, causing infection and the appearance of a sore.
Mr. A : Doctor, how should I select a clinic for double eyelid surgery?
Dr. Suetake : The burial method may seem simple, but it is actually a surgical procedure that requires a high degree of technical skill if done properly, and there are large differences in the results and complications that occur among various medical institutions.At our hospital, patients who have undergone the burial method at other clinics come to us for consultation because they are concerned that when they close their eyes, a raised lump appears.If your eyes are closed and the ligation site is noticeably swollen, please consult us.You can definitely improve your situation by taking measures that avoid risks.
Mr. A : thank you!

“Please tell me about armpit gas and medicine.”
Mr. A : Can armpit pain be cured with cream?
Dr. Suetake : There are advertisements for armpit cream on the internet.In conclusion, he can get rid of the odor even with armpit cream.However, it depends on the ingredients of the armpit cream.Commercially available armpit creams are not very effective and only slightly reduce odor, but recently some deodorants have come out that are quite effective.Medical armpit creams are the most effective in eliminating odor.The ingredient is to sterilize the resident bacteria on the skin, which has the effect of destroying the substances secreted by the apocrine sweat glands that cause armpit irritation.If you use a special antibiotic cream that can kill this bacteria, you can definitely expect it to be effective.We can also prescribe armpit cream at our clinic.Of course, medical expenses are subject to deduction.However, unfortunately, permanent effects cannot be expected.The odor only disappears while you apply the armpit cream.In order to completely cure armpit odor, the best treatment is to destroy the sweat glands that cause the odor using physical energy such as the EL method.
Mr. A : Is there a difference between armpit gas and body odor?
Dr. Suetake : Everyone has body odor.However, armpit gait is considered to be a genetic disease, and people with moist earwax and well-developed apocrine sweat glands are prone to armpit gait.Armpit odor and body odor are different, but in a larger sense, armpit odor is included in body odor.Armpit odor is a unique body odor.Wakiga's odor, in particular, is a decomposition product of bacteria indigenous to the skin, so it is an unpleasant odor for everyone and is subject to treatment.Since ancient times, it has been treated as armpit odor, a disease that can be operated on even though it is covered by insurance.
Mr. A : Do disinfectants work for Wakiga?
Dr. Suetake:Yes, it works.This is a surprisingly unknown fact.The secretions secreted by apocrine sweat glands are almost odorless, but when they are broken down by resident skin bacteria into lower fatty acids, volatile sulfur compounds, volatile steroids, etc., these produce a characteristic odor.Research has revealed which bacteria on the skin are involved in the generation of armpit odor.Reducing these bacterial groups with disinfectants can reduce armpit odor in the same way as applying antibiotics.
Mr. A : I heard that there are oral medications for armpit bloating and hyperhidrosis. Is that true?
Dr. Suetake : Unfortunately, there are no oral medications that can suppress armpit odor.However, there are oral medications that can suppress sweating.Propantheline bromide is used to treat hyperhidrosis.Propanthene bromide is a cholinergic receptor antagonist.Eccrine sweat glands are innervated by sympathetic nerves, and the chemical transmitter secreted from the nerve endings is acetylcholine.Sweating can be suppressed by systemically administering drugs called cholinergic receptor antagonists that block the action of acetylcholine.For adults, the usual dose is XNUMX-XNUMX mg per day in divided doses.However, there are also many side effects.Dry mouth, nausea, vomiting, constipation, headache, urinary problems, eye coordination problems, and drowsiness.The drawback is that you cannot perform dangerous tasks such as driving a car while taking the drug.
Mr. A : Teacher, I understand!

“Please tell me how you view armpits.”
Mr. A : Do people with moist earwax have armpit pain?
Dr. Suetake : The diagnosis of armpit moth is whether a characteristic odor is emitted from the armpits or not.Some people are not diagnosed with armpit bug even if their earwax is moist.However, it is known that almost all people with armpit syndrome have moist earwax.In an epidemiological survey, more than 11% of people with armpit syndrome had moist earwax.On the other hand, it is said that XNUMX% of people with moist earwax have armpit irritation.A nationwide survey was conducted in XNUMX regarding earwax.When we investigated the earwax gene (ABCCXNUMX) of XNUMX high school students from all over Japan, the national average was XNUMX%, but there were regional differences, with more people in the Tohoku region and southern Kyushu to Okinawa having wet earwax, and more in the Kansai region. There were very few.This corresponds to the distribution of the so-called Jomon people and Yayoi people.Dry earwax is thought to have originated from the Yayoi people, who arose as a mutation in northern China tens of thousands of years ago, migrated south while increasing their offspring, and came to Japan via the Korean Peninsula.
Mr. A :Which is more common in men or women?
Dr. Suetake : Genetically speaking, there is no difference between men and women in the expression of moist earwax.There is no difference between men and women in the onset of armpit bugs.However, the overwhelming majority of patients who come for armpit pain consultations are women, with a male:female ratio of XNUMX:XNUMX.Regarding the level of axillary odor, gauze tests show that men have higher levels of odor than women, and normally there should be as many male patients as there are female patients.Are most men unaware of this? It can be said that women are more sensitive to armpit odor than men.It is also thought that Japanese women have a significantly lower olfactory threshold for isovaleric acid, a component of armpit odor, than men.
Mr. A : Is there a genetic test for armpit moths?
Dr. Suetake : There is no genetic test that can diagnose armpit odor itself, but there is a genetic test that can diagnose whether earwax is moist or dry. It is easy and optimal to detect single nucleotide polymorphisms in the ABCC11 gene.
Mr. A : Is there an armpit gas diagnostic test?
Dr. Suetake : A gauze test is a simple test regarding odor. A doctor will make a diagnosis by placing a piece of gauze under the patient's armpit for about XNUMX minutes and smelling the odor from the gauze.The degree of armpit odor is classified into five levels.
Mr. A : Teacher, I learned a lot!

“Please tell us about the characteristics of miraDry, the armpit treatment method.”
Mr. A : Underarm pain treatment method Please tell us the characteristics of MiraDry.
Dr. Suetake : A non-invasive treatment method that cures armpit irritation without surgery.A medical treatment that does not involve bleeding. ) equipment.This is an electromagnetic wave treatment device developed by Miramar Corporation in the United States that irradiates microwaves from the surface of the skin to thermally destroy sweat gland tissue and permanently remove sweat gland tissue.Thermal energy is applied to the skin using a surface and the treatment is performed while cooling the skin strongly to minimize damage to the epidermis.
Mr. A : What kind of energy is miraDry's microwave?
Dr. Suetake : Microwave is a type of electromagnetic wave, and electromagnetic waves below 3.000 GHz are classified as radio waves.Radio waves with a frequency of 300MHz to 300GHz are called microwaves, and the radio waves used in mobile phones are also microwaves.Microwaves have the characteristic of being easily absorbed by water, and the frequency that is most efficiently absorbed by water is said to be around 18GHz.MiraDry uses a frequency of 2.45 GHz, which is more easily absorbed by water than the microwave frequency of XNUMX Hz.
Mr. A : Where are the sweat glands that cause wakiga?
Dr. Suetake : There are many sweat glands in the armpit skin, which are located XNUMX-XNUMXmm below the skin, from the deep dermis to the subcutaneous adipose tissue.From this, the sweat gland tissue has a luminal structure and a large amount of water, so the deep dermal layer to the adipose tissue layer is considered to be the heat zone of MiraDry.
Mr. A : Will a nurse perform the miraDry treatment for armpit pain?
Dr. Suetake : Under the Medical Practitioners Act, nurses are not allowed to perform medical treatment even if they are under the supervision of a doctor.Treatments such as injections, blood draws, and gauze effects can be performed by nurses as long as they are under the direction and supervision of a doctor, but therapeutic treatments are considered to be a violation of the Medical Practitioners Act.First of all, it is ethically a big problem for a nurse to treat armpit itch using MiraDry, which should be done by a doctor rather than legally.Common sense suggests that no patient would want to be treated by a nurse.It is medical common sense that a specialist who fully understands the anatomy of the axilla, the mechanism of the armpit, and the functions and characteristics of MiraDry directly performs the treatment.Unfortunately, however, the reality is that in many cosmetic surgery clinics, doctors do not perform any procedures; all procedures are performed by nurses.The reason for this can simply be said to be a business strategy that prioritizes profit over medical care.Nurses, who are paid much cheaper than doctors, perform the treatments, resulting in price competition to lower the unit cost of treatment and attract customers.Naturally, many problems occur.There is probably no cosmetic surgeon who does not question this act performed by a nurse...
Mr. A : That's right.I understand that.

“Please tell us about the characteristics of miraDry, the armpit treatment method.”
Mr. A : Does MiraDry not cool the treated area?
Dr. Suetake : MiraDry has a hydroceramic cooling device at the tip of the handpiece to prevent heat damage from the epidermis to the shallow dermis.This tip uses a powerful suction device to keep the skin in close contact with the skin during the procedure to prevent damage to the axillary nerve.However, increasing the output can cause burns, which can cause severe pain for several days after surgery.
Mr. A : How is anesthesia used for armpit treatment?
Dr. Suetake : Basically, all treatments for underarm pain involve anesthesia with a local anesthetic injection.As a general rule, general anesthesia is not used, but laughing gas anesthesia may be used for patients who are extremely anxious or when pain relief is a priority.Whether it's surgery, MiraDry, ViewHot, or the EL method, local anesthesia is used.However, the amount and concentration of anesthesia will vary depending on the procedure time.MiraDry and surgery can take up to XNUMX minutes on both sides, so a relatively high concentration of anesthesia may be used.Generally, the local anesthetic is administered by injection using a drug called lidocaine hydrochloride (trade name: xylocaine).In the past, a fatal accident occurred at a certain cosmetic surgery clinic due to local anesthesia prior to underarm surgery.Xylocaine poisoning appears to have occurred when an inexperienced doctor injected a large amount of local anesthetic into the skin of the armpit.It is important to use anesthetics as minimally as possible.At our hospital, the treatment for EL is completed in about XNUMX minutes per armpit, so he only uses about XNUMX-XNUMXcc of an extremely low concentration of XNUMX% anesthesia, which is a lower amount of anesthesia than when undergoing treatment at a dentist. There aren't many.This allows you to minimize the risk of anesthesia and receive treatment with peace of mind.Please note that just because local anesthesia is used does not mean it is safe.Treatment should be entrusted to a doctor who can provide a thorough explanation of anesthesia before treatment.
Mr. A : Please tell me the principle of miraDry Wakiga treatment.
Dr. Suetake : Currently, the most popular treatment for armpit blemishes is MiraDry, which is a non-invasive sweat gland destruction device that uses XNUMXGHz microwaves and is FDA approved.Microwave irradiation is performed by injecting an anesthetic into the layer containing sweat gland tissue to increase the water content, making it easier for microwaves to be absorbed.The purpose is also to avoid the risk of axillary nerve damage caused by microwaves.The output of MiraDry is variable, with XNUMX levels of settings from level XNUMX to XNUMX.Output is set by irradiation time.XNUMX seconds at level XNUMX, XNUMX seconds at level XNUMX. Each irradiation takes XNUMX seconds including cooling time, so it takes about XNUMX-XNUMX minutes for both armpits to carefully treat the entire affected area.The theory is that microwaves generate heat in areas where sweat gland tissue exists, thereby thermally destroying the sweat glands.Naturally, even though the epidermis has been cooled, it is difficult to completely avoid heat damage, and strong swelling and pain may occur after surgery.It is not a painless treatment.Burns are much more painful than peeling or cutting the skin with a scalpel, and painkillers are often required after surgery.
Mr. A : Is surgery the most painful treatment for armpit pain?
Dr. Suetake : There is an image that the pain is strong after surgery, but in reality, the pain after armpit surgery is minimal, but if strong pain occurs after surgery, blood clot formation due to bleeding is suspected, and immediate treatment is required to remove the blood clot. .I have performed more than XNUMX cases of underarm surgery in the past, and most of the patients did not complain of pain after the surgery.The most painful treatment is miraDry microwave irradiation treatment.Heat is applied to the skin with a surface to thermally destroy the sweat gland tissue, but a cooling device is attached and the irradiation is carried out while cooling the skin, but the epidermis and shallow dermis are thermally damaged to a large extent, resulting in the same condition as a burn.Burns are the most painful injury to the body.It is definitely a more painful treatment than surgery.In particular, recently, MiraDry treatment is performed by nurses rather than doctors, so doctors often do not know about the condition and progress after surgery.There are actually some cosmetic surgeons who believe that because there are no complaints, there is no pain.Among all treatments, only the EL method is painless after surgery. The EL method destroys sweat gland tissue in a pinpoint manner, so there is no damage to normal tissues such as the epidermis and superficial dermis.ViewHot also randomly inserts needles into the skin and destroys the skin using high-frequency waves, resulting in strong pain similar to burns or pain caused by burns that match the needle holes.
Mr. A : Only the EL method is painless.I did not know.I learned a lot!

“Wakiga treatment can also remove hair”
Mr. A : What are the complications and after-effects of armpit treatment?
Dr. Suetake : Wakiga treatment is a non-invasive treatment method (treatment that causes bleeding by incising the skin is called invasive treatment, although many complications were observed after surgery). After the spread of non-bleeding treatment, complications have decreased.In surgery, the skin is peeled off, and if a gap is created between the peeled skin and the matrix, bleeding will occur in that space and hematogenous formation will occur.When blood clot formation occurs, oxygen and nutrients cannot be supplied to the skin, and the skin becomes necrotic.If skin necrosis occurs over a wide area, it will take a long time to close, resulting in a tragic situation.Even if the wound heals, it may become difficult to lift the upper arm due to cicatricial contracture.After surgery, it is not uncommon for a substance such as sebum to accumulate in a capsule called atheroma to swell.Complications with miraDry seem to have occurred quite frequently when this device was first popularized.Skin necrosis and axillary nerve damage due to burns have actually occurred, and I have consulted more than a few patients who have suffered from complications after receiving miraDry treatment.I also experienced a case in which a nurse performed an operation and suffered extensive burns.View Hot also experienced contracture due to burn scars, and many consultations after surgery for her extremely ugly wart-like burn scars.No surgery does not mean no complications.In particular, recently, there has been an increase in the number of nurses who do not have the knowledge to perform procedures, and I am concerned that serious complications may occur.
Mr. A : Can hair removal be done at the same time as armpit treatment?
Dr. Suetake : Whether it's surgery or non-invasive treatment, treatment at a level that can effectively remove hair is necessary for a complete cure from armpit irritation.There are apocrine sweat glands in the hair follicle and eccrine sweat glands around it, and when the hair follicle is destroyed by heat, the stem cells of the hair follicle and the hair root are also destroyed by heat.If heat energy at a level that causes hair loss is irradiated near the sweat glands, the sweat glands will almost certainly be destroyed.For this reason, in armpit ga treatment that is highly effective, hair removal is seen in the same area as the treated area.
Mr. A : Killing two birds with one stone!

“We will ask you a lot about moles and warts.”
Mr. A : What kind of anesthesia do you use when removing moles and warts?
Dr. Suetake : At the time of consultation for moles and warts to be removed, patients are concerned not only about the scars but also about the pain during the treatment and the pain of the anesthesia.For mole removal, a local anesthetic called xylocaine is used.It is a local injection.Since men are more sensitive to pain than women, our hospital manufactures local anesthetics in-house to minimize pain during anesthesia.At most medical institutions, local anesthesia is performed by injecting a drug called lidocaine hydrochloride (trade name: xylocaine) into the area where the mole is removed using a special syringe.This xylocaine is mainly used in cosmetic surgery clinics in concentrations of XNUMX%, XNUMX%, and XNUMX%, but it has an acidic PH, and the higher the concentration, the greater the difference from the PH of the body, so when injected. I feel a strong pain spreading from the local anesthetic.At our hospital, we adjust the concentration of xylocaine to XNUMX%.We mix an alkaline drug called Mayron to adjust the anesthetic to be neutral so that it approaches the pH of the living body.This greatly reduces pain during injection.Also, the thicker the injection needle, the more pain it will cause when it penetrates the skin, so he uses an ultra-thin needle of XNUMXG to XNUMXG to administer the anesthesia, so he administers local anesthesia with a normal-sized needle. It will be much less painful than when you receive it.Consideration must also be given to the anesthesia method and drugs, and when moles and warts are removed by a cosmetic surgeon at their own expense, they are performed with advanced knowledge, skill, and delicate consideration.When moles are removed for cosmetic purposes, we provide the best medical services to our patients, going beyond the framework of conventional insurance treatment such as removing moles or treating them with liquid nitrogen. .
Mr. A : Is carbon dioxide laser the latest treatment for mole removal?
Dr. Suetake : wrong.Moles removal using carbon dioxide laser has been practiced for about XNUMX years.Laser has an image of being the latest and most cutting-edge, so it is often used as a PR keyword to attract customers at beauty clinics, but the reality is different.Many laser devices have been developed depending on the wavelength of light.Ruby laser, alexandrite laser, YAG laser, diode laser, thulium laser, etc.The carbon dioxide laser was developed from the earliest stage among these lasers, and was developed primarily for use in skin incisions, mole removal, and tumor removal, and has been widely used in actual clinical settings.About XNUMX years ago, I used a carbon dioxide laser to remove moles compared to mole removal because the scars were less noticeable.At that time, we were using products made by Nippon Infrared Industries.Since then, carbon dioxide lasers have been developed and sold by various manufacturers, but the basic principle and performance have not changed significantly.At our hospital, we perform mole tissue ablation using high-frequency waves using a Surgitron, and thulium laser ablation for shallow pigmented nevi.Although the thulium laser is in the same infrared region as the carbon dioxide laser, it causes less damage to the surrounding tissues and can be removed cleanly.Carbon dioxide lasers are not used because delicate adjustments may not be possible.There are beauty clinics and cosmetic surgery clinics that remove moles as much as you want, but it seems that the treatment is carried out because it can be completed in a short time by laser irradiation, and it saves time and effort. Many patients come to our clinic for consultation regarding mole removal scars that remain after mole removal as burn scars.Carbon dioxide lasers may be a good introductory treatment device for dermatologists, laser beginners, and doctors new to beauty treatment.It may be best to refrain from simply vaporizing mole tissue with a carbon dioxide laser for all mole removal treatments.It is currently questionable in medical practice whether he can remove it cleanly with the latest carbon dioxide laser treatment.We recommend that you receive mole removal treatment based on a comprehensive evaluation of the treating doctor's skills and post-surgery care.
Mr. A : Is it difficult to treat raised moles?
Dr. Suetake : Flat moles are more difficult to treat when removing moles.Raised moles are easier to treat and generally cause less scarring.Raised moles are basically removed by evaporating only the raised part using a carbon dioxide laser or high-frequency heat energy.There is often no need to gouge and remove the pigment, and tissue damage other than the mole is kept to a minimum.For moles that are flat and not raised, the pigment is located deep in the dermis, and it is necessary to apply heat to that area to evaporate the tissue.The so-called wounds become deeper.If the mole looks like it has been gouged out, it will become depressed, or conversely, it will swell up as a scar, making the scar after the mole removal look ugly.This should be avoided at all costs.Therefore, when removing a mole that is raised and skin-colored, there may be no scar left at all.
Mr. A : Are there any parts of the body that cannot be removed when removing moles?
Dr. Suetake : Basically, it can be removed from any part of the body, but we do not recommend removing it from areas where scarring will definitely remain after removal and will be noticeable unless malignancy is suspected.Even if the scar on the sternum and shoulder is not noticeable immediately after removal, the scar will always swell up because it is a place under stress.When tension is applied to the skin, the scarred area is pulled from the surrounding area and forms granulation to resist.Other areas to be careful of when removing moles are the areas above the lips, above the cheekbones, and on the lower jaw as these areas tend to bulge.
Mr. A : It's different depending on the part!

“Please tell me the difference between a mole and a stain”
Mr. A : Please tell me the difference between a flat mole and a blemish.
Dr. Suetake : In both cases, the pigment is present inside the skin, and it stands out because it differs from the surrounding skin color.Pigmented spots, where pigment exists within the epidermis, are generally called moles.Nevus, where pigment exists in lumps that extend into the dermis, are called moles.Is it a stain at first glance?Sometimes it is difficult to tell whether it is a mole or not, but if you examine the skin with a diagnostic device called a dermascope, which is constantly used in dermatology, you can almost certainly tell the difference between a stain and a mole.Treatments for spots and moles are different, so it is necessary to make a thorough diagnosis and then perform the appropriate treatment.
Mr. A : A mole-like stain on an old man's face?What is ...?
Dr. Suetake : Raised spots that often appear on the temples and foreheads of elderly people.I think the medical name is senile warts or seborrheic keratosis. It is a benign skin tumor that appears in your 30s and increases with age.Basically, it does not become malignant, but if it causes inflammation or causes inconvenience in daily life, it is better to treat it.Unlike moles, most moles are located within the epidermis, so they are easy to remove, and the easiest way to remove them is to evaporate them using radiofrequency waves rather than excision, leaving no scars at all.The scar heals quickly and the redness after removal will almost completely disappear within XNUMX-XNUMX weeks.
Mr. A : Are raised moles difficult to treat?
Dr. Suetake : Flat moles are more difficult to treat when removing moles.Raised moles are easier to treat and generally cause less scarring.Raised moles are basically removed by evaporating only the raised part using a carbon dioxide laser or high-frequency heat energy.There is often no need to gouge and remove the pigment, and tissue damage other than the mole is kept to a minimum.For moles that are flat and not raised, the pigment is located deep in the dermis, and it is necessary to apply heat to that area to evaporate the tissue.The so-called wounds become deeper.If the mole looks like it has been gouged out, it will become depressed, or conversely, it will swell up as a scar, making the scar after the mole removal look ugly.This should be avoided at all costs.Therefore, when removing a mole that is raised and skin-colored, there may be no scar left at all.
Mr. A : How many moles can be removed at once?
Dr. Suetake : As a general rule, moles are not removed if malignancy is suspected or if a diagnosis is not required for cosmetic purposes.For this reason, moles are generally removed by vaporization using a carbon dioxide laser or electrolysis method, but this is less stressful on the skin, and some people may remove dozens of moles at a time.There is no limit on the number of removals.However, at our hospital, local anesthesia is required for each individual item, so we adjust the local anesthesia and use a special needle that is as thin as possible for injections to reduce pain. .
Mr. A : Do you have any moles that need to be removed?
Dr. Suetake : If malignancy is suspected, the general rule is to remove all moles and perform histopathological examination, but there are some moles that cannot be removed using carbon dioxide laser or high-frequency thermal energy transpiration.This mole is a so-called blue nevus, where pigment exists deep within the dermis and appears dark blue.Removal of blue birthmarks is difficult with carbon dioxide laser or high-frequency heat evaporation, so they may be removed by excision from the beginning or by hollowing out with an instrument called a trepan.
Mr. A :Mole has a very deep meaning.

“Please tell me a lot about Chichiga.”
Mr. A : Is surgery the treatment for chichiga?
Dr. Suetake : Chichiga is a condition in which the substances secreted from the apocrine sweat glands in the skin around the areola are broken down by the bacteria that live on the skin, producing a distinctive odor of armpit odor.People who have a strong genetic tendency to have moist earwax are most likely to have chichiga.Many people come to our clinic for consultation after their partner points out that they have a unique taste.It is almost the same as armpit odor, but because the area where the odor is generated is much smaller than the armpit, the odor is often not as bothersome as armpit moth.In principle, surgery cannot be performed on the areola.Surgery requires exfoliation of the skin, requires significant downtime, and is prone to scarring, so treatment using a scalpel cannot be performed.Recently, chichiga treatment has been performed using a treatment device called miraDry, but in reality, it is not recommended because there is a risk of burns and the area is sensitive and the pain after the treatment is strong. We recommend the EL method, a treatment method in which a special needle is inserted into the pores and high-frequency heat energy is used to destroy the apocrine sweat glands that cause odor one by one, as it is painless and leaves no scars after surgery. .The therapeutic effects can be felt immediately after the treatment, and there are no restrictions on daily life after the treatment.Treatment time is about XNUMX minutes per side and can be performed without any burden.You can take a bath and play sports on the same day.
Mr. A : Is chichiga hereditary?
Dr. Suetake : Chichiga is similar to armpits.There is a strong genetic tendency, and although there are differences in degree, it is also related to earwax, so it can be said that it is hereditary.However, it is not XNUMX% inherited; it is considered to be a dominant gene, and there is a XNUMX% chance that the disease will appear in children.However, it seems that XNUMX% of people who have a strong odor will not necessarily be diagnosed with chichiga, as there are large individual differences.First of all, it's hard to imagine that the earwax is dry, so I wonder if the earwax is moist?Is it dry?It is also important to check to see if either of your parents has armpit bugs.
Mr. A : How do you diagnose if it's chichiga?
Dr. Suetake : It is often impossible to diagnose chichiga on your own.Chichiga is a condition in which a unique odor called armpit odor occurs.Many people don't worry about it because it's not as bad as armpit gas.There is no equipment that can diagnose odor, but a specialist will apply gauze to the areola area, leave it on for about XNUMX minutes, and then he will actually check the odor and make a diagnosis.The odor is dispersed into the air along with water molecules from sweat, and since sweat does not occur in the areola area like the armpits, other people (other than your partner) hardly notice it.If you are concerned about whether or not you have Chichiga, we recommend that you consult a specialist and have the smell diagnosed.
Mr. A : Can Chichiga be cured with ointment?
Dr. Suetake : It is also effective as a liniment.However, the effect is temporary and the odor will not disappear permanently.Disinfectants may be effective in applying ointments, but one of the causes of odor is resident bacteria on the skin, so if antibiotics are used to kill the resident bacteria that cause this odor, the odor will disappear.At our hospital, we also treat Chichiga with antibiotics, so please feel free to contact us.
Mr. A : I understand a lot about Chichiga!

“Is it okay to breastfeed even after receiving Chichiga treatment?”
Mr. A : Is there a way to cure chichiga with injections?
Dr. Suetake : Treatment is performed by injecting a drug called Botox into the areola area.The effects appear after XNUMX days and remain effective for about half a year.It suppresses odor and sweat production by blocking acetylcholine, a neurotransmitter that activates sweat glands.Although it is not a permanent treatment, it can be expected to have a therapeutic effect on areas other than the areola, such as armpit swelling and sore spots.The treatment only takes about XNUMX minute on each side, and there is no downtime, allowing you to take a bath or play sports on the same day.Of course, it is a treatment that does not leave any scars.There is some pain during the injection, but if you are sensitive to pain, you can reduce the pain during the procedure by applying an anesthetic.
Mr. A : At what age can chichiga be treated?
Dr. Suetake : There is no age limit for treatment.Although most people become concerned about it after they become adults, treatment is possible even for high school students.Armpit cream can be used by people of any age.If a permanent treatment effect is desired, high-frequency thermal energy treatment using the EL method is also possible for children.However, in cases where the child is still in the developmental stage, we recommend that conservative treatment be prioritized and the EL method performed after high school students.Unlike armpit moth, the odor is rarely noticed by those around you.
Mr. A : Is it okay to breastfeed after being treated for chichiga?
Dr. Suetake : If you are breastfeeding, please refrain from breastfeeding for XNUMX hours after the Botox treatment for Chichiga.There is no problem after that. With the EL method, you will be asked to refrain from breastfeeding for one week after the treatment.Please refrain from breastfeeding for XNUMX hours after applying topical medications.Even if all treatments for Chichiga are carried out, there will be no problems with breastfeeding in the future.
Mr. A : Is chichiga treatment possible during pregnancy?
Dr. Suetake : As a general rule, Chichiga treatment cannot be performed during pregnancy.The only method of treating Chichiga during pregnancy is topical medicine.This is the only treatment that does not affect the fetus.
Mr. A : That's right.I understand that!

“Is Chichiga treatment with miraDry effective?”
Mr. A : Is chichiga treatment with miraDry effective?
Dr. Suetake : valid.However, a considerable amount of epidermal burn occurs, resulting in severe swelling and pain post-operatively.Also, whether or not it can be completely cured in one session often depends on the output during the treatment and the practitioner.There are many clinics where nurses administer the procedure, and when nurses perform the procedure, it is thought that the results are less effective and the risks are higher.Although it is highly effective, it is painless and swelling-free, and it is not a treatment that doctors always use.
Mr. A : Is Chichiga treatment with ViewHot effective?
Dr. Suetake : It is effective, but it seems to be less effective than MiraDry or EL method.In particular, because the needles are randomly inserted into the areola area and heat energy is applied, post-operative pain and scab formation are severe, and wart-like burn scars are often left behind.Unlike armpit ga treatment, this is a treatment that should be carefully considered.
Mr. A : That's right.

“What is the difference between piercings purchased at a piercing specialty store and medical piercings purchased at a medical institution?”
Mr. A : Do I need to disinfect my ears after getting them pierced?
Dr. Suetake : Not necessarily required.The reason is that the piercing hole is created instantly with a piercing gun, but at the same time the medical piercing is attached.At this point, the area in contact with the medical piercing is not the epidermis.With the piercing gun, the epidermis is gone and the piercing hole is in direct contact with the dermal tissue.Leave the piercing in this state for about XNUMX weeks and wait for epithelialization.Disinfecting a wound in a state where the epidermis is missing is a no-no from the perspective of wound healing.Disinfectants not only kill bacteria but also damage dermal cells and delay healing.However, the area where the piercing hole is installed tends to accumulate dirt and grime due to sweat, making it a breeding ground for bacteria.For this reason, it is better to use a disinfectant to remove the bacteria and sterilize it than to leave it alone.From this perspective, our hospital prepares disinfectants that do not impede wound healing and promote epithelialization of the piercing hole.After piercing, the best method is to wash the area with tap water, or in the shower, to remove any dirt from the piercing area.We recommend that you wash your piercing in the shower every day after washing your hair.
Mr. A : Please tell me the difference between earrings purchased at a piercing specialty store and medical piercings purchased at a medical institution.
Dr. Suetake : It seems that most regular earrings are made of stainless steel.High-quality earrings are also available in XNUMXk gold.It seems that titanium earrings are also on sale.Medical earrings are made of titanium or XNUMX-karat gold plated nickel to prevent melting.For this reason, it is a highly safe material that does not cause metal allergies other than gold allergies.Second, medical rods are designed to create clean piercing holes, and are thicker than the rods for piercings purchased at regular piercing specialty stores.For the first piercing, we recommend medical piercings as they are less trouble-prone.
Mr. A : There was such a difference.I did not know.

“A piercing gun doesn’t hurt that much!”
Mr. A : Who will pierce my ears?
Dr. Suetake : In most clinics, nurses perform the treatment.There is no problem under the Medical Practitioners Act if it is considered to be equivalent to an injection, but it is a gray area if considered as a treatment.I have doubts about leaving the piercing to the nurse.At our clinic, I always perform piercings in person.When performing the piercing, check the position and pay close attention to ensure that the hole is not diagonal to the earlobe.If your earlobes are too thick, we will advise you to shift the piercing position.If you force the piercing, the metal on the back called the catch, which is the clasp of the earring, may get stuck inside the earlobe and require incisional surgery.The correct piercing method for her is that the doctor is responsible.
Mr. A : Do I need anesthesia to get my ear pierced?
Dr. Suetake : No anesthesia required.The reason is that the anesthesia injection is much more painful than the piercing. Anesthesia is not used and is not necessary because it is laborious, time-consuming, causes great pain to the patient, and may cause bleeding.
Mr. A : Will my piercing bleed when I change it?
Dr. SuetakeNo bleeding whatsoever.The reason is that medical piercings are instantly attached using a piercing gun, and the hole and rod of the piercing are in close contact, preventing blood from flowing outside.
Mr. A : Is there any pain when getting pierced?
Dr. SuetakeThere is almost no pain during piercing if it is done with a piercing gun.Many people say that it was less painful than they expected, or that they didn't feel any pain at all.The piercing rod instantly penetrates your earlobe, so you won't feel any pain.
Mr. A : It doesn't hurt much with a piercing gun.I did not know.

“Tell me about any troubles after piercing.”
Mr. A : Please tell me about any problems you experience after piercing.
Dr. Suetake : The most common infection is centered around the piercing hole.Bacteria may increase from the holes that have not become epithelialized and the infection may spread to the entire earlobe.To prevent infection, we recommend cleaning your piercing hole more than disinfecting it.If an infection occurs, you will be given oral antibiotics immediately.If the infection is not controlled, the piercing will be removed.Unfortunately, most of the piercing holes close after that.Other than infection, it is a buried earring in the earlobe.This happens if your earlobe is thick and the earlobe gets pinched between the earring head and the earring catch, and the pressure causes poor blood circulation and skin necrosis at the pressure site, causing the earlobe and the earring head to become buried in the earlobe.In this case, a small incision will be made to remove the buried piercing.
Mr. A :Can I get my nose pierced too?
Dr. Suetake : Of course you can.In the case of the nose, the cartilage is pierced, so instead of using a piercing gun, the piercing hole is created after anesthesia with a special Surflo needle, which has a double structure. It will finish in XNUMX-XNUMX minutes.Then, put on the earrings of your choice.
Mr. A : Can I wear a piercing on my tongue?
Dr. SuetakeSince this is an intra-oral piercing, we recommend that you use earrings that are not mixed with titanium or stainless steel.We will administer anesthesia, create a hole with a special double-walled needle called Surflo, and then attach the earrings you brought with you.Tongue piercing is virtually painless.There is almost no infection in the oral cavity, so disinfection is not necessary.
Mr. A : Do I disinfect my tongue after getting it pierced?Doesn't it fester?
Dr. SuetakeThe oral cavity is full of bacteria, of course, but it is a moist environment that is good for wound healing, the area where the piercing hole is always washed away with saliva, and the tongue has abundant blood flow. The chance of infection occurring is extremely low.This is an area that cannot be disinfected and is not necessary.
Mr. A : Earrings can be worn in many different places, so I'd like to hear more about them.

“Piercings vary depending on where you wear them.”
Mr. A : Can I have nipple piercings?
Dr. Suetake : Many people choose to pierce their nipples as a form of body piercing.Although anesthesia is required, piercing can be done in a simple procedure of XNUMX-XNUMX minutes.Piercing is possible for both men and women.However, pregnant or breastfeeding women cannot do it.
Mr. A :Can I have my vulva pierced?
Dr. Suetake : The labia minora, labia majora, clitoris and foreskin can all be pierced.You can safely pierce areas where the piercing will not rub against your underwear and cause pain.Anesthesia is required, but you can take a bath the same day and there is no downtime.
Mr. A : Can I wear a piercing on my tongue?
Dr. Suetake : Since it is a piercing in the mouth, it is recommended to pierce with a piercing that does not contain titanium or stainless steel.Anesthesia is applied, a hole is made with a special double structure needle called Surflo, and the piercing you brought is attached.Tongue piercing is virtually painless.There is almost no infection in the oral cavity, so disinfection is not necessary.
Mr. A : Can I get my penis pierced?
Dr. Suetake : It is possible to pierce the foreskin, but the corpus cavernosum part of the penis cannot be pierced.It damages the penis itself and causes bleeding, so only the foreskin remains.Piercing the glans is possible, but there is a lot of bleeding after the procedure, and it is an irreversible procedure that damages the penis, so we do not perform it at our hospital.
Mr. A : Can I also get piercings in my eyebrows and lips?
Dr. Suetake : Although there are not many needs, piercing is possible.Anesthesia is required, but you can wash your face and take a bath on the day of the procedure.It is installed to avoid running through arteries and nerves.
Mr. A :There are various types depending on where you put it on!

“Earrings should be neither too thin nor too short!”
Mr. A : Does navel piercing require anesthesia?
Dr. Suetake : Anesthesia itself The pain is very little, and once anesthesia is administered, the procedure is painless. Since we use an anesthetic with PH adjusted by mixing Meiron with XNUMX% xylocaine, there is almost no pain during injection.Anesthesia takes effect immediately after the injection.
Mr. A : What kind of belly button piercing should I get first?
Dr. Suetake : At our hospital, a medical rod is made of resin and a piercing hole is created and inserted after anesthesia.If you like the design, you can wear it all the time.We recommend earrings with rods that are neither too thin nor too short.
Mr. A : Can earlobe and ear cartilage piercings be worn the same way?
Dr. Suetake : In general, earlobe piercings require no anesthesia using a piercing gun, while ear cartilage piercings are performed after anesthesia.Piercing in the cartilage area is painful, so the piercing is performed under anesthesia.
Mr. A : At what age can you get piercings?
Dr. Suetake : We offer treatments to high school students and above with permission from their parents.Our clinic does not perform piercings on infants or children.
Mr. A : Thanks to my teacher, I now know a lot about earrings!

“I’m scared of cancer in my mole…”
Mr. A : At what age can a mole be removed?
Dr. Suetake : There is no age limit, but patients must be old enough to stop moving during anesthesia and removal.Mole removal is generally performed under local anesthesia and is not performed under general anesthesia.For this reason, the patient is old enough to suppress body movements and maintain a stable posture during anesthesia and removal, so generally the patient is in the upper grades of elementary school.We do not remove moles on infants.
Mr. A Q: Do I need to go to the hospital after mole treatment?
Dr. Suetake : As a general rule, you do not need to go to the hospital.However, if the mole is large and requires treatment, or if a histological diagnosis is performed through pathological examination, you will need to come in to hear the results.In the case of excision surgery, stitches must be removed, so at least one hospital visit is required.For removal using electrolysis or thulium laser, there is no need to visit the hospital.
Mr. A : Will it hurt after mole removal?
Dr. Suetake : After removing the mole, we apply a medical seal to the wound and perform moisturizing therapy, so the nerve endings will not dry out and cause pain.Very few patients complain of pain after surgery.
Mr. A : I'm afraid of mole cancer...
Dr. Suetake : There is no such thing as cancer in moles.There are very few cases where a mole itself turns into cancer, and even though it looks like a mole, it can be a malignant tumor called malignant melanoma, basal cell carcinoma, or squamous cell carcinoma.Moles can be diagnosed to some extent using a diagnostic device called a dermascope, but a definitive diagnosis can only be made after removing the tissue and performing a histopathological examination.Malignant melanoma is one of the cancers with a poor prognosis, but it can be completely cured if complete surgical removal is performed early.Early detection is important.Basal cell carcinoma has little chance of metastasizing, but because it grows and destroys surrounding tissue, it must be completely removed when discovered.Squamous cell carcinoma can also develop from a precancerous condition called actinic keratosis.A reddish mole in the elderly?If you find a tumor that appears to be a tumor, you need to be careful and consult a specialist.
Mr. A : Will playing with a mole cause cancer?
Dr. Suetake : Even if you touch or irritate a mole, it will not turn into cancer.There is a malignant tumor called malignant melanoma that looks like a mole, so it may be best not to mess with it unnecessarily.
Mr. A : Is there a difference between a mole and a wart?
Dr. Suetake : Both mole and wart are common names and are not official medical terms.Just as there are different types of moles, there are also different types of warts.It is necessary to diagnose whether the wart is caused by a virus, a benign tumor called soft fibroma, or a senile pigmentation spot, a type of aging stain.Treatments vary, so initial diagnosis is very important.
Mr. A : The beginning is the most important thing!

“Can freckles heal properly?”
Mr. A : Will freckles heal properly?
Dr. Suetake : In medical terms, freckles are called sparrow freckles.Treatment methods include laser treatment and IPL treatment, but both of them make the skin much less noticeable, so I think the significance of undergoing treatment is great.It can be removed neatly with laser, but IPL treatment can also remove it in a short time and with almost no downtime.When treating freckles, it is better to use light treatment as your first choice, rather than using topical or oral medications specifically for age spots.
Mr. A : Are freckles hereditary?
Dr. Suetake : Most are dominantly inherited and occur in families.It is more common in red-haired Caucasians, and onset occurs around XNUMX-XNUMX years of age, becoming more noticeable during adolescence.
Mr. A : Is chemical peeling effective for freckles?
Dr. Suetake : It is possible to make it thinner, but it is difficult to completely remove it.Removal down to the basal layer of the epidermis carries the risk of burns, and it is difficult to adjust the concentration, making it impossible to ensure pigment removal.
Mr. A : What kind of laser is most effective for freckles?
Dr. Suetake : Depending on the wavelength of light, there are ruby ​​lasers, YAG lasers, alexandrite lasers, etc., but the Q-switched alexandrite laser, which has a wavelength of XNUMX nm, is considered to be the most effective.
Mr. A : Q-switched alexandrite laser is great!

"What is chloasma?"
Mr. A : What is chloasma?
Dr. Suetake : It is a type of symmetrical skin melanocytosis that occurs after middle age and is not congenital.It spreads from the protruding part of the cheekbones to the cheeks, and in rare cases, pigmentation can also be seen on the forehead and lips.It is a disease that is more common in women and often appears between the ages of XNUMX and XNUMX.It is often triggered by the effects of female hormones, such as childbirth, taking the pill, and menopause.
Mr. A : Please tell me how to treat chloasma.
Dr. Suetake : XNUMX: External medicine: Tretinoin, hydroquinone, vitamin C derivatives, etc. XNUMX: Oral medicine: tranexamic acid, vitamin C XNUMX: Laser toning (normal laser irradiation is contraindicated) is the main treatment, and treatment combined with IPL is also performed.It is difficult to cure with a single treatment.It is necessary to control by combining various treatment methods.
Mr. A : Please tell me what to be careful of if you are diagnosed with chloasma.
Dr. Suetake : As with all stain care, don't rub too much when using cleansing agents to cleanse or remove makeup.It is often seen that those who rub the skin strongly have worsened chloasma.Avoid strong UV rays as much as possible. Please use a UV-blocking sunscreen cream or a foundation containing a UV-blocking agent, and be careful not to expose the affected area to UV rays as much as possible.
Mr. A : Does Shiratama IV drip work for chloasma and spots?
Dr. Suetake : Shiratama drip is a popular name and is a drip made for the purpose of administering a skin-beautifying ingredient that is particularly effective for whitening.Shiratama infusion is a treatment method in which an ingredient called "glutathione" is infused. • Whitening effect by suppressing melanin production • Anti-engineering and allergic effects • Protection of liver function by detox effect Glutaotin suppresses melanin production and brings about a whitening effect.It also supports the work of the liver, which promotes the elimination of waste products and toxins.However, the effect cannot be expected with one infusion.Considering the metabolic cycle of the skin, it is unfortunate that the visible effect cannot be expected until at least XNUMX weeks have passed since the start of infusion administration at least XNUMX-XNUMX times.However, even if it does not have the immediate effect of whitening, it is effective for liver protection and engine care.
Mr. A : Glutathione!I will remember! 

“What is beauty drip?”
Mr. A : What is a beauty drip?
Dr. Suetake : This is an intravenous drip administered for cosmetic purposes.The contents vary depending on the clinic, but at our clinic, the following ingredients are the basic ingredients.・Amino acids・Human placenta・Alpha lipoic acid・Vitamin C ・Vitamin B1, B6, B12 ・ATP preparations・Glutathione Promotion of skin metabolism We administer drugs aimed at suppressing melanin purification, improving blood flow, and promoting metabolism.
Mr. A : It's good for promoting skin metabolism! 

“I heard that tranexamic acid is effective for stains, but are there any side effects?”
Mr. A : I heard that tranexamic acid is effective for stains, but are there any side effects?
Dr. Suetake : Tranexamic acid is frequently prescribed for the treatment of melasma and is a drug with very few side effects.The side effects of tranexamic acid are thought to include the following symptoms: • Skin itching • Loss of appetite • Nausea and vomiting • Diarrhea • Heartburn • Drowsiness • Constipation My clinical impression is that some patients occasionally complained of constipation, but there were no other side effects.It can be said to be a safe drug that causes almost no problems even when taken internally for a long period of time.
Mr. A : Tranexamic acid! I learned it! 

“What is NMN IV drip?”
Mr. A : What is NMN drip?
Dr. Suetake : The official name of NMN is "nicotinamide mononucleotide." NMN is a vitamin-like substance that is naturally produced in the body, but it is thought that the amount produced in the body decreases with age, leading to accelerated aging of physical and cognitive functions. A research report that shows that ingesting NMN brings about changes in the appearance and function of the body has recently been widely covered in the media, and it has become popular all over the world as a ``rejuvenating drug.''Intravenous NMN is a method of administering NMN directly into the body, which is expected to be much more effective than oral administration.
Mr. A : What is the role of NMN?
Dr. Suetake : NMN is a precursor of the biological substance NAD, which decreases with age.By maintaining its intracellular concentration, it is expected to maintain healthy body conditions. It is said that the amount of NAD in your 50s decreases to half of what it was in your 20s.NAD is a precursor of energy (ATP) in the mitochondria, and all eukaryotic cells (animals, plants, and bacteria) and most bacteria use NAD to make ATP. NAD is an essential coenzyme to make ATP. Without it, living things cannot survive.
Mr. A : Please tell me the effects of NMN drip.
Dr. Suetake : Although research in humans has not yet progressed, the following possibilities have been suggested.Rejuvenating effect and anti-aging effect • Improves dementia • Improves concentration • Recovers from fatigue • Enables you to sleep deeply Beautiful skin effect Improves wrinkles, sagging, and dullness By administering NMN, metabolism improves.It can be expected to improve the luster of the skin as well as improve wrinkles and sagging. It is also said to be effective for neurological diseases, diabetes, eye diseases, and obesity (diet effect).
Mr. A : Does NMN infusion have any side effects?
No side effects have been reported at this time.Since there is no track record of long-term administration, careful administration is necessary, but theoretically it is a drug that is extremely unlikely to cause side effects.
Mr. A : Do you administer NMN intravenously yourself?
Yes, I personally administer XNUMXmg of NMN intravenously once a week.I don't feel any side effects, and I feel less tired.
Mr. A : That's right!
“Please tell me the relationship between NMN and sirtuin genes!”
Mr. A : How often should NMN be administered?
Dr. Suetake : We recommend that you take the treatment approximately once a week, XNUMX-XNUMX times. It is rare that you can notice dramatic changes in your body in just one session. (There are individual differences)
Mr. A : Please tell me about the relationship between NMN and sirtuin genes.
Dr. Suetake : Sirtuin genes are genes that play an important role in controlling aging and lifespan, and are also known as "longevity genes."It is present in many organisms, from bacteria to mammals.Many animal experiments have reported that increasing the expression level of sirtuins can help control aging, and clinical studies on humans are also being conducted.The substance that can activate sirtuins is NAD (nicotinamide adenine dinucleotide). NAD is an essential coenzyme for the production of energy in mitochondria within cells, and has the function of activating sirtuins.The amount of NAD in tissues decreases with age, but if NAD can be increased, it is expected that it will activate sirtuins and have the effect of delaying aging. Methods to increase NAD include exercise and calorie restriction, but in recent years, intake of NMN (nicotinamide mononucleotide, a substance made from vitamin B3) has also attracted attention.
Mr. A : Sirtuin!I learned it!

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