Posted in Beauty, dating, disease, fashion, Health, news, sex

Women Are Digging the Beard….But Only If It’s Clean

Beards are in and ladies will like…..unless they think its dirty and full of “lice.”

A study from the University of Queensland and University of Sterling interviewed 919 heterosexual women and found that they preferred the more masculine looking face (narrow eyes, prominent brow, cut jawline) including a beard, unless they had a personal eversion to ectoparasites such as lice and fleas.  This eversion to critters made them less attracted to a beard.

However those who were less concerned with critters but more concerned with bacteria and viruses, preferred the beard.  Ironic, but in nature hair, such as those in one’s nose, protects one against infectious disease, so instinct may be kicking in.

A Man’s Beard Found to Be Dirtier Than Dog Fur

For those of us who find beards sexy, this study might sway us a tad.

A recent study published in European Radiology found human hair to be dirtier than a dog’s.

Study authors looked at 18 men and 30 dogs and compared the bacterial load in CFUs (colony forming units) from both beards and dog fur.  Then they examined MRI scanners used for both dogs and humans and compared the bacterial load to those only used for humans.

The results were:

Hence bearded men harbor “significantly higher burden of microbes and more human-pathogenic strains than dogs.”

Last year, researchers out of Manchester University found 47% of beards tested contained fecal matter that contained deadly pathogens.

This study was also coauthored by Fragrance Direct, and found despite cleaning habits of study participants, enterococcus was found on 47% of beards swabbed and cultured.

Enterococcus is a bacteria commonly found in the colon and feces and has over 17 types, the most common being E. faecalis and E. faecium. These may cause infections in the urinary tract, abdomen, pelvis, wound and even blood (sepsis).



This study followed one done in 2015 by Quest Diagnostics in New Mexico, in which a microbiologist swabbed beards and grew out cultures finding bacteria that commonly colonize our colon.

Bacteria like to hide on the skin but need cover, and beard hair offers a nice warm, moist shelter.  Oral sex increases one’s chance of being “contaminated” with pelvic and rectal bacteria.

A spokesman for Fragrance Direct states, “Caring for your beard is essential for its health, helping it stay fresh to keep the bacteria at bay.  Everyone knows to shampoo their hair, but beards need some attention too. Men should use beard shampoo when they shower, along with conditioner afterwards.”

So the next time you run your fingers through a man’s beard, sanitize them afterwards….



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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Beauty, Health, medications, news, sex

Testosterone Therapy: New Guidelines Released

Millions of men take testosterone supplements each year in the U.S.  Low testosterone, or “Low T”, can manifest in a variety of symptoms including:

  • fatigue
  • erectile dysfunction
  • depression
  • lack of sex drive
  • muscle loss
  • loss of strength
  • decrease muscle strength
  • loss of fertility
  • osteoporosis (decrease bone mass)
  • and may contribute to many other issues.



The most popular forms of testosterone are injections and gels. Pill forms are available but are not as effective.

Testosterone slowly decreases with age at a rate of 1.6 % per year beginning in one’s 30’s. A man with significant testosterone loss, however could  signify a more serious health issue such as diabetes.  So many physicians don’t hesitate when it comes to supplementing this vital hormone.

However, its not without its risks.   Risks of testosterone therapy include:

  • Increasing risk of prostate size
  • risk of prostate cancer
  • polycythemia (increase red blood cell levels)
  • mood issues
  • sleep apnea
  • acne
  • and multiple studies have found it increases risk of heart attacks and stroke.


This week the American College of Physicians released new guidelines on testosterone replacement.

They suggest to only use testosterone therapy when treating sexual dysfunction but not for the other aforementioned conditions as the evidence is not supportive.

Recommendation 1a:

ACP suggests that clinicians discuss whether to initiate testosterone treatment in men with age-related low testosterone with sexual dysfunction who want to improve sexual function (conditional recommendation; low-certainty evidence). The discussion should include the potential benefits, harms, costs, and patient’s preferences.

Recommendation 1b:

ACP suggests that clinicians should reevaluate symptoms within 12 months and periodically thereafter. Clinicians should discontinue testosterone treatment in men with age-related low testosterone with sexual dysfunction in whom there is no improvement in sexual function (conditional recommendation; low-certainty evidence).

Recommendation 1c:

ACP suggests that clinicians consider intramuscular rather than transdermal formulations when initiating testosterone treatment to improve sexual function in men with age-related low testosterone, as costs are considerably lower for the intramuscular formulation and clinical effectiveness and harms are similar.

Recommendation 2:

ACP suggests that clinicians not initiate testosterone treatment in men with age-related low testosterone to improve energy, vitality, physical function, or cognition (conditional recommendation; low-certainty evidence).

They also prefer intramuscular forms over transdermal preparations due to cost.

Testosterone therapy linked to blood clots

In 2016 researchers found a 63% increase risk of blood clots within the first 6 months of testosterone therapy.  These are deadly as they increase risk of heart disease, stroke, pulmonary embolism and organ damage.  They form in veins, deep veins, and thus have an obstructed path to reach vital organs and prevent blood flow.  This is not the first time venous thromboembolism (VTE) has been linked to testosterone therapy. Back in 2014 the FDA recommended warning labels on testosterone products.

According to researchers at Icahn School of Medicine at Mount Sinai in New York City state the overall risk is still low, one case per 1000 men a year, but could be of huge concern for those at risk of blood clots.  Lead researcher, Dr.Carlos Martinez, states, “Risk peaks rapidly in the first six months of treatment and lasts for about nine months, and fades gradually thereafter.” So a promising finding is the risk falls as time passes since therapy.

  • Risk factors for VTE include:
  • genetic predisposition
  • prior blood clots
  • cancer
  • prolonged immobility (long flights, hospitalization stays)
  • pregnancy (women)
  • smoking
  • and of course risk increases with age.

Study author Dr. Mark Creager states, “My advice is to review the patient’s underlying risk factors for VTE, and weigh that risk against the potential benefit of testosterone therapy,” Creager said. “These individuals should at least be made aware of the fact that their risk would be even higher with testosterone.”

This study was published online 11/30/2016 in the BMJ (British Medical Journal)


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is a Board Certified Family Physician

Posted in Beauty, disease, Health, news, sex

Bigger the Breasts? Bigger the Cold…..

For those of us who think big-breasted women are lucky, think again.  A study published in Archives of Sexual Behavior finds those with larger breasts may suffer a cold longer than those who are smaller cupped.

Authors looked at 163 young, non-pregnant, non-lactating, Caucasian Polish female students, and after an extensive study design with surveys, hormone levels and measurements concluded that larger breast size correlated negatively with respiratory health, “breast size was positively related to respiratory infections and two of its components, average duration of illness and frequency of antibiotic use (Table 1, Fig. 2), indicating that women with larger breasts experienced longer episodes of respiratory diseases and took antibiotics more frequently.”

This mirrored previous studies linking large breast size to diabetes and breast cancer.

One would think that large breasts would put a little more distance between others but that didn’t seem to correlate.  Some hypothesize that the fat stores decrease one’s immunity and can increase antibiotic resistance.  And some believe the breasts provide a trampoline for pathogens to bounce from.

Should Large-Breasted Women have a Reduction to Protect their Health?

Moreover, us large breasted women are always distracted but activities such as straightening our bra straps, covering up when we bend forward, and losing our keys.  It’s difficult to wash your hands thoroughly in the sink when you can’t see them.

Hence, women like myself can overcome this handicap by storing hand sanitizer in our bras.

What is the average breast size in the US?



According to, the average size is 34 DD.  They also list on their site, how countries differ in breast size:

Average cup size in Australia: D
Average cup size in Brazil: B
Average cup size in Canada: DD
Average cup size in France: A
Average cup size in Germany: D
Average cup size in Ireland: D
Average cup size in Italy: A
Average cup size in Japan: A
Average cup size in Mexico: B
Average cup size in New Zealand: D
Average cup size in Russia: B
Average cup size in Singapore: < A
Average cup size in Spain: C
Average cup size in UK: D
Average cup size in USA (Caucasian): > DDD
Average cup size in USA (non-Caucasian): DD

Why Do Breasts Droop Over Time?

As obesity and BMI’s rise, so can cup sizes as well as certain health risks. Bigger does not always mean better…..


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Beauty, Health, news

Cancer Linked to Breast Implants Rising

The FDA reports this week a rise in the number of cases of BIA-ALCL, anaplastic large cell lymphoma by 9%.

On their website they report the following:

After a thorough data analysis, we are reporting that, as of September 2018, the agency has received a total of 660 total medical device reports regarding BIA-ALCL cases in the U.S. since 2010. Of the 660 MDRs, our in-depth analysis suggests that there are 457 unique cases of BIA-ALCL, including 9 patient deaths.

Last year the FDA reported 9 women had died from anaplastic large cell lymphoma (BIA-ALCL) possibly associated with their breast implant use.  At the time, the FDA received 359 reports of BIA-ALCL,  a rare type of non-Hodgkins lymphoma, 9 of whom died as of February 1, 2017. This year the FDA reported 457 cases, up from 415 cases last year.

In 2017 a study from the Pennsylvania State University College of Medicine linked textured breast implants to this malignant cancer.

Although a rare cancer. researchers believe the lifetime risk is 1 out of every 30,000 women with breast implants and if the numbers are underreported, could be as common as 1 out of every 4000 women with implants.

Although the implants are used to augment breast tissue, the malignancy is not a breast cancer but rather a lymphoma.

Lymphomas make up the most common of the blood cancers.  The cancer begins in the lymphocytes, cells crucial for maintaining one’s immune system. Two main types of lymphoma are Hodgkin’s and Non Hodgkins.  Non Hodgkins is more common, and anaplastic large cell lymphoma is a subset if it.




According to the American Society of Plastic Surgeons , there were currently 195 cases in the US and a total of 521 worldwide as of March 21, 2018.  Updated numbers are not available.

This is not the first time a link has been suggested.  6 years ago the World Health Organization suggested a link.  Then in 2011, the FDA identified a possible association between the two.  In 2016, the  Australian Therapeutic Goods Administration reported 46 confirmed cases with 3 deaths relating to breast implants.

The report last spring suggested that BIA-ALCL affected both smooth and textured implants. According to the FDA report, 231 of the 359 cancer cases provided information on implant type.   203 were reported to be textured implants and 28 reported to be smooth implants. When it came to silicone vs. saline implants, the FDA said 312 of the 359 reports provided these specifics and of those 186 reported implants filled with silicone gel and 126 reported implants filled with saline.


So neither implant type appeared immune to the risk of BIA-ALCL but it appears the silicone, textured implants carried the most risk.

Now the cancer occurred within the breast and the FDA advises physicians to consider the possibility of BIA-ALCL if there appears to be a seroma (fluid filled cavity around the implant) or a contracture (pulling of the skin and tissue) near the implant.

In most cases the cancer is treatable, with removal of the implant and the surrounding tissue curative.  In some cases however, radiation of the area or chemotherapy is required.

Although 50,000 cases of non-Hodgkins lymphoma occurs annually in the US, it is unknown how many cases of BIA-ALCL occur each year.  Moreover, many countries may not have avid reporting systems of breast implant related cancers as we do.  According to the American College of Plastic Surgeons, close to 300,000 women receive breast implants each year, some of which for breast reconstruction after mastectomy for breast cancer.

The FDA reminds us that BIA-ALCL is rare and prophylactic breast implant removal is NOT recommended. However we need to be aware and evaluate if one develops swelling, pain, new lumps or asymmetry in the breasts….just as we do for those without implants.

For healthcare providers, they recommend the following:

  • Prior to implantation, provide all patients with the breast implant manufacturer’s labeling, including the patient-specific labeling, as well as other educational material prior, and make sure they are aware of the benefits and risks of the different types of implants. Most confirmed cases of BIA-ALCL have occurred in patients with textured surface implants, although there are known cases in patients with only smooth-surface breast implants.
  • Consider the possibility of BIA-ALCL when treating a patient with late onset, peri-implant seroma. In some cases, patients presented with a mass or masses adjacent to the breast implant. If you have a patient with suspected BIA-ALCL, refer the individual’s case to a multidisciplinary team for evaluation.
  • Collect fresh seroma fluid and representative portions of the capsule and send for pathology tests to rule out BIA-ALCL. Diagnostic evaluation should include cytological evaluation of seroma fluid or mass with Wright Giemsa stained smears and cell block immunohistochemistry/flow cytometry testing for cluster of differentiation (CD30) and Anaplastic Lymphoma Kinase (ALK) markers.
  • Develop an individualized treatment plan in coordination with the patient’s multi-disciplinary care team. Consider current clinical practice guidelines, such as those from the Plastic Surgery Foundation or the National Comprehensive Cancer Network (NCCN) when choosing your treatment approach.
  • Report all confirmed cases of BIA-ALCL in individuals with breast implants to MedWatch, the FDA Safety Information and Adverse Event Reporting program.
    • Health care personnel employed by facilities that are subject to FDA’s user facility reporting requirements should follow the reporting procedures established by their facilities. Prompt reporting of adverse events can help the FDA identify and better understand the risks associated with medical devices. In some cases, the FDA may contact you for additional information. The FDA will keep the identities of the reporter and the patient confidential.
  • Submit case reports of BIA-ALCL to the Patient Registry and Outcomes For breast Implants and anaplastic large cell Lymphoma etiology and Epidemiology (PROFILE) Registry to contribute to a better understanding of the causes and treatments of BIA-ALCL.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Beauty, Health, news

Vaginal Scraping Trend Dangerous

Doctors are warning women against “vaginal scraping” in an attempt to rid themselves of any “remnants” of their ex.

Celebrity Mel B, after her split with her ex husband, told The Guardian, “They scraped the inside of my vagina and put new tissue in. It’s almost like a rape victim would do – essentially, you want to scrub yourself clean.”


However gynecologists warn that these types of procedures could increase one’s risk of infection.

In July the FDA issued a warning against vaginal rejuvenation.

Consumers undergo a curette scraping or laser procedure that destroys vaginal tissue prompting regrowth. However this could leave the patient with pain, itching, burning, increased risk of infection and scarring.

The tightening of the tissue consumers are seeking are actually a result of scarring from the laser or scraping treatment, a risk most doctors would not recommend one takes.




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Learning Medical Spanish is Easy!!!


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician


Posted in Beauty, Health, news

Eyelash Extension Cited as Cause of Temporary Blindness

A 20-year-old student this week “lost” her sight for 2 hours after getting eye lash extensions at a salon.

Megan Rixon tweeted on October 19th she visited a new salon in the UK and within hours suffered a severe allergic reaction to the glue, she claims was nail glue.



She tweeted: Girls be very very careful where you get your eyelashes done!!I got my individuals done today somewhere new and it turns out they used nail glue on my lashes. I genuinely lost my sight for 2 hours. Thankfully the swelling has gone down, but there still very sore. Be careful😭

She urges everyone to have a “glue test”, to test for sensitivity and to ask the technician to show you the actual glue being used.

Acrylic and Gel Nail “Allergy” Warning

Skin experts are warning that chemicals used in acrylic and gel nail polish may induce an allergic reaction.

Methacrylates appear to be the culprit, causing rash and itching not only in the fingers but other parts of the body, including genitalia.  Some may experience losing their nail after a reaction.




Once the immune system is triggered, allergic symptoms could surface in other parts of the body.


The British Association of Dermatologists warns 2.4% of the population could be at risk.

The nail industry is a multibillion dollar industry with hundreds of thousands of customers each year.

Methacrylates are used in a variety of industries in adhesives, plastics, paints and even medical and dental devices.

Eyelash glue and home nail kits can also expose users to methacrylate.  Many have reported allergic reactions of their eyelid after having lash extensions applied.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Beauty, Health, news

Vampire Facials Are a Bad Idea

Warning: Graphic Content Below

A spa in Albuquerque, New Mexico had been shut down in September by the NM Health Department when a client contracted a blood-borne pathogen after undergoing a “vampire facial.”

This week we learn of two more individuals who contracted HIV from the center prior to it being shuttered.


What Is A Vampire Facial And What Are The Benefits by Barbies beauty bits



During a “Vampire Facial”, blood gets taken from the client (venipuncture) and then centrifuged to isolate the platelets, clotting factors, creating Platelet Rich Plasma (PRP.)  PRP is then reinjected into the client’s face with fillers as part of a “rejuvenation treatment”, or rubbed directly on the face after a microdermabrasion or micro-needle facial treatment.



Customers of VIP Spa who received this type of service have been urged to get tested for HIV, Hepatitis B and Hepatitis C.

PRP has been used by multiple specialties to help speed up tissue healing in tendon, ligament and muscle injuries.  The Platelet Rich Plasma also has been found to reduce inflammation and pain associated with injuries.  Some cite it may help hair growth which makes we wonder why women would want to add it to their face.



Kim Kardashian most famously had one but then stated in an interview how she regretted it due to it being “the most painful thing ever!”

Blood borne pathogens maybe be bacteria or viruses that enter the blood stream during a venipuncture or injection procedure.  These can be deadly and avoidance of unclean needles or poor sterile procedure is paramount to being protected.



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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.