Dr. Amin Sharobim’s Comprehensive Guide to Skin Treatments & Procedures

By Hilary Diack

Fully deserving the very best care we can give it, the skin is our body’s largest organ. It works incessantly to help regulate our body temperature, shield our bodies from bacteria, and is a good indicator of our general state of health. Unfortunately our skin also bears the brunt of environmental conditions and the ravages of time, so it is small wonder then that cosmetic procedures have carved out a sizeable niche in the beauty industry. Cairo East Magazine met with dermatologist Dr. Amin Sharobim to learn more.

CEM: What are the best procedures and treatments for maintaining a youthful appearance in lieu of plastic surgery?

AS: It really depends on each individual patient’s needs. Every case is different so we tailor the treatments accordingly. That said, it should be noted that Botox is still one of the most widely used in-office procedures. Of course, some cosmetic improvements can only be handled by surgery so a patient must be made aware of what can be achieved with each option. There is also an increase in popularity of laser therapy like Fraxel and filler treatments using hyaluronic acid.

How effective are Fraxel and heat activated collagen treatments?

Again, it depends on each patient’s requirements. Fraxel is a first generation non-ablative fractional laser treatment, and is used for dealing with fine lines, wrinkles, acne and surgical scars, stretch marks, and crow’s feet. Non-ablative fractional lasers use laser energy micro-beams to coagulate areas of affected tissue that extend through the epidermis into the dermis. This procedure keeps the outer layer of skin in place for faster healing and recovery. The benefit lies in the minimal ‘down-time’; it does not disrupt the patient’s routine. Alternatively ablative laser procedures use laser beams that deliver heat in small vertical columns and vaporize the affected tissue. This requires a longer period for healing while the body creates new, healthy tissue to replace the areas of affected tissue, resulting in healthier, younger-looking skin. These machines all serve to stimulate collagen renewal so are aiming at the same type of result.

What about the new filler treatment Voluma, and how does it differ from Botox?

They are two totally different treatments, for very different purposes. Botox is used as a muscle relaxant and targets dynamic wrinkles. It is highly popular and we even see a lot of younger patients coming for preventative sessions, to pre-empt formation of wrinkles. There are always new developments in this field and it gives good results when done correctly.

Voluma is a heavy filler and should be used carefully, it is not for everyone. It is primarily for augmenting cheeks that have lost their natural volume and should not be used for lips.

What should we know about Ulthera, the ultrasound non-surgical face-lift?

There are several types of machines for brow lifts and wrinkle treatment, but to date only Ulthera has been FDA approved.  The procedure delivers heat and ultrasound to stimulate collagen production. The person handling the treatment can actually visualize the layers of the skin through this ultrasound. A new treatment that has proven to give good results is Fractional Skin Resurfacing, a unique skin treatment utilizing bipolar radiofrequency energy to rejuvenate aged and wrinkled skin. It improves the texture and tone of the skin while tightening it through deep dermal heating that reaches the collagen fibers, creating an immediate and long term tightening effect.

What is Mesotherapy and how good is it?

Mesotherapy uses multiple injections of pharmaceutical and homeopathic medications, plant extracts, vitamins, and other ingredients into skin, and occasionally subcutaneous fat. The aim is to target skin components. It can give good results, but they vary according to the situation. Any treatment plan should be discussed in full with the doctor to get an idea of what result can be anticipated. It definitely is a trending procedure, but should be used only when required.

What are the most effective methods for removing liver and age spots from our skin?

Again, each case must be looked at individually. In more serious instances we would use a Q-switched laser, a technique by which a laser can be made to produce a pulsed output beam. Other cases can be handled by peeling or bleaching creams, depending on the severity. It is essential to remember to use sun-block and avoid exposure during the hotter part of the day.

What can be done for sensitive skin that is prone to prickly heat rash and irritations in summer?

Remember to use an emollient suited to your personal skin type. Keep your skin protected and hydrated, there are some excellent sun-blocks in the market with anti-oxidants and vitamins. If you want to get a light tan choose the hours of the day when the UV rays are at a minimum concentration.

How can we deal with pigmentation?

There are many causes and types of pigmentation. A common cause is over exposure to the sun, but it can also be related to stress, reaction to a new medication, pregnancy or hormonal changes. A consultation with you doctor is essential, he can then prescribe the correct type of treatment.

Are there any new treatments available for acne?

One of the latest topical treatments in the market has a combination of two drugs, Retin A and Benzoyl peroxide. The redness and swelling that can occur with acne are caused by a type of bacteria that can be killed by exposing your skin to different types of light, with blue light being the most commonly used wavelength as a support therapy to medical treatment.

What can be done to alleviate eczema?

Sufferers are genetically pre-disposed to this condition, but there can be many aggravating factors such as skin dryness and reaction to detergents. It is important to keep the skin well hydrated as well as using prescribed medications. Most pharmacies also stock specialized soaps and facial washes to help relieve the symptoms.

Have you seen an increase in pollution-related skin conditions?

Yes. As increasing pollution levels gradually impact the ozone layer we are more exposed to skin damage by excess UV rays. While a certain amount of sun is vital for our health we need to be more aware of ways of protecting our skin.

Which vitamins are important for healthy hair and skin?

Any diet should include food items rich in zinc, biotin, calcium and iron. Anyone who has a pattern of extreme dieting or surgical intervention for weight loss may find they suffer a lot of hair loss and weak nails. Supplements may help, along with adjustments in eating habits.

With so many new techniques for battling the effects of age do you see a danger in treatments becoming an addiction?

It can happen, there is always a danger of a person developing compulsive body disorders with an obsession for chasing perfection. The doctor must consult in depth with the patient before any work is carried out and ensure that a healthy mental attitude is there to support the therapy.

Parenting Skills with Life Coach Sarah Maamoun

By Hilary Diack

When you hold that tiny helpless bundle in your arms for the very first time, can you begin to imagine what the coming years have in store for you? Raising your child to be a happy, well-balanced individual will mean facing challenges as well as enjoying the good times. Cairo East Magazine spoke with Sarah Maamoun, Life Coach and Parenting Advisor to see what advice she could offer.

CEM: Sarah, do you have children of your own?

SM: Yes, I have four lively children, ranging from 7-year-old twins up to a 13 and 14 year old. It gives me plenty of hands-on experience.

What common issues you are asked about?

Parents are often concerned with communication between them and their children, they want to have a better understanding of what is impacting their child and affecting his or her behaviour. They need to know how they can help their children go forward in life.

What are the most effective ways of motivating your child?

First you need to uncover any road-block the child may have. You need to discuss any fears and anxieties that are being unexpressed. There may be a problem with focussing and concentration, especially in the classroom, so find out if your child has to read passages more than once to understand the meaning. Does he or she do well in tests? If they get a poor result despite putting in a lot of effort it can be very de-motivating. Is there a good relationship with the teacher? Do they feel ignored or misunderstood? And what about relationships with classmates, do they have friends? Then you can set some achievable goals, something that will give your child a sense of accomplishment and achievement. Give acknowledgement when these are reached, this will be motivating.

What is the best way to encourage your child to develop his or her best attributes?

Listen and watch your child to see her body language and the glow in her eyes. Catch this opportunity and give attention to that attribute. Before complimenting her, let her see it for herself so she trusts your encouragement. She will then believe in herself.

How do you encourage a child to be more assertive and self-confident?

We teach a child emotional intelligence, and work on a new vocabulary to help them in their self-expression. If they know how to describe what they feel and what they need from each individual relationship in their lives they will be more outgoing, without confusion, aggressive behaviour or withdrawal into silence. Each relationship has its own dynamic, different things are needed from each parent or sibling, whether it is understanding, attention or simply companionship. Kids need to feel trust and affection, then they can develop their autonomy through the stages of growing up.

How can you teach a child to handle bullying?

Research shows that children with high self-worth and developed social skills are less likely to be bullied. In my sessions I help the bullied child verbalise the impact of the whole experience.  I assist the parents in truly understanding what the child is going through. It is important to let the child find his own solution, this in itself will be empowering. Resist the temptation to interfere directly, you cannot be with your child all the time, and it can sometimes result in the bullying becoming greater. By asking your child how he feels and showing empathy you are giving them a good coping mechanism.

What should a parent do if their child starts stealing or lying?

These are done for different reasons. Each behaviour is trying to achieve something. Stealing is often an attention-seeking activity, it is not just about the object. The child knows that he or she will get caught. Lying generally comes from fear, or feeling under pressure. Close-ended questions that demand a ‘yes’ or ‘no’ response may elicit a lie. If he or she does lie, try to see the reason behind it, but also make it clear that it is not acceptable to do this.

It is better to re-word a question in such a way that the responsibility of the response is placed on the child. Give your child sufficient space to communicate on the subject, it is important to know how they perceive the situation. This will set a healthy pattern for later in life.

How can we encourage our children to develop empathy for others?

By really understanding your child, without being judgemental. They need not agree or disagree with someone, but should learn how to consider the individual circumstances of others. Set an example by letting your child know that you understand them, but set behavioural guidelines where necessary.  When your child appreciates that he is understood he will be able to open up more to others.

How can we help a child be his own person and not succumb to peer pressure?

We live in a peer-oriented society, and children are aware of this. They attach to their peers and can be influenced by them, sometimes to the extent of appearing like clones. Parents often expect their kids to develop independently, but in reality they really need guidance and support in developing until they are at least 18 years old. They often really want to be unique and have a clear identity, but just need to feel that they have their parents’ empathy and support in finding the path. Under the protective wings of the family, children will develop their confidence and learn to leave the nest as self-actualized young adults.

Dr. Amit Negi De-mystifies the Process

By Maggie Balbaa

We hear many people talk about meditation and its effect on emotional and physical health. But what exactly happens to us when we meditate? Cairo West Magazine met up with yoga expert and naturopath, Dr. Amit Negi for more insight.

CWM: What is meditation?

AN: Meditation is a process of purifying the mind and making it focused, inward, and tranquil. Through the method of meditation, the mind will help you to fathom the deeper levels of your being and lead you to the highest state of realization. Meditation is when the mind is cleared of everything except the object of meditation. It becomes the only thing that shines in the mind. While meditating, the mind becomes devoid of all thoughts, even the ones of yourself. That state is called Samadhi in Indian, which means absorption. A person attains this state when he forgets himself while meditating.

What are its benefits?

Meditation has a lot of benefits psychologically and physically. It helps greatly in reducing stress and fighting depression. It also helps in the case of physical problems or illnesses; after all, a relaxed, healthy mind results in a relaxed, healthy body, and vice versa. Meditation also allows you to detox your body, mind and soul.

What can help set the mood for meditation?

Set a place at home for meditation.  It is best to have a special room for meditation, but if this is impossible, as it is for most of us, try to separate off a portion of a room, reserving it solely for your practice if you can. Maintain it as a space to be used only for meditation, clean and tidy, free from distracting vibrations and associations. You can also add up some scented candles and crystals to this area to enrich the meditation experience and the positive energy of the place.

Adjust your sitting position so you are seated in a comfortable steady posture, with spine and neck straight but not tensed. A comfortable cross-legged posture provides a firm base for the body. You can also use Yoga Asana such as padmasana, the classic lotus posture or siddhasana, the half-lotus position, or any simple cross-legged position.

Sitting on a cushion will help the thighs relax and bring the knees closer to the ground. In these sitting positions, a triangular path is created for the flow of energy, containing it rather than allowing it to disperse in all directions. Metabolism and breathing slow down as concentration deepens. Elderly or less able people may wish to sit on a comfortable chair. Lying down is not recommended because you relax completely and may find it almost impossible to ward off sleep. The mild muscular contraction necessary to hold the back upright in a sitting position keeps you alert. Try to relax the rest of the body as much as possible, especially the muscles of the face, neck and shoulders. The chest should be open, with the rib cage lifted to encourage abdominal breathing. Initially, you may find it difficult to keep the back straight for more than a few minutes. The practice of asanas (yoga postures) for as little as thirty minutes a day will strengthen your back, making it easy for you to sit comfortably over a long period of time.

Should you avoid meditating if you feel stressed or upset, or can it help you get a better perspective on things?

Meditation can help in taming those feelings. As I said before, it is a great stress relief emotional detox tool.

by Marcus O’Neill MSc RD

Nuts are a staple in diets throughout the world.  They are popular in Middle Eastern cuisines where they’re often included in mezzes, desserts and other sweets. But from a nutritional perspective, how much do you really know about them?

Nutritional Benefits of Nuts

There is a lot of nutrition packed into these little gems. Nuts are high in protein, fibre, monounsaturated fats (MUFA’s) and numerous vitamins and minerals. It’s no wonder that a diet including a variety of nuts has been shown to promote good heart and gastrointestinal health as well as reduce the risk for developing certain types of cancer.

Let’s take a look at the benefits of certain kinds of nuts:

Almonds – Almonds are high in calcium, which makes them a great option if you are unable to consume dairy products. They are also a good source of vitamin E and contain high amounts of flavonoids.

Peanuts – Peanuts are one of the most versatile nuts out there. They are loaded with protein and are an excellent source of niacin and manganese.

Walnuts – Walnuts are packed with antioxidants, particularly Omega 3 fatty acids, which means they’re great for reducing your risk of developing heart disease and certain types of cancer.

Pistachios – Pistachios are the only nuts that contain lutein and zeaxanthin; two antioxidants that play an important role in good eye health. They are also high in vitamin B6 and potassium.

Hazelnuts – Hazelnuts are a great source of folate, which is an important vitamin for promoting good heart health. Folate is important for pregnant women as it minimizes the potential of certain birth defects.

Potential Downsides

When it comes to eating nuts, there are a few things you should note. First, by volume nuts are quite high in calories. Depending on the type, ¼ cup (60ml) of nuts contain anywhere from 160 to 250 calories. This is certainly something to keep in mind if your goal is weight loss.

Another potential problem with nuts is that they’re often mixed into foods that are loaded with sugar, fat and sodium. Trying to increase your intake of nuts by eating things like baklava with pistachios, chocolate covered almonds, bbq-spiced peanuts or Nutella often defeats the purpose of eating nuts in the first place.

Let’s not forget the prevalence of nut allergies here. Nut allergies are one of the most common food allergies that exist. If you suspect you may be allergic, it is important to avoid consuming nuts and be tested by your doctor.

Best Ways to Eat Nuts

To get the most nutritional benefit of nuts without the downside of added sugar, fat and/or sodium, try incorporating unsalted nuts into salads, stir fries or curries. You can also add nuts to plain yogurt, with a touch of honey or fresh fruit for a tasty breakfast or even dessert. If you’re less adventurous (or skilled) in the kitchen feel free to eat a small handful of nuts along with a piece of fruit for a snack. And finally, nut butters (ie. peanut butter) and milks (ie. almond milk) are a great option for those who find nuts alone unpalatable.

The bottom line is nuts are a great way to get more protein, fibre and healthy fat in your diet. Just keep in mind the total calories and try to minimize the amount of added sugar, fat and sodium you’re getting along with your nut intake.

Marcus O’Neill is a Registered Dietitian from Canada, currently residing in Maadi. He can be reached by email at marcusoneill79@yahoo.com, or you can follow him via Twitter (@marcusoneillrd), or his website (www.dietitianabroad.com).

Professor Dr. Abdel Nasser Omar on Improving Communication with your Children.

By Hilary Diack

Parenting is tough. It’s never been a breeze, but with the goal posts being moved at an alarming rate, the times we live in present a whole new set of challenges. Cairo East Magazinesat with Dr. Abdel Nasser Omar, CEO of Al Mashfa Hospital, to learn more about keeping family communication positive and supportive.

CEM: What are the subjects parents tend to avoid discussing with their kids?

AO: Sex, sex and sex. It has always been a taboo issue within a traditionally conservative society that has strict guidelines as to what is acceptable behaviour, especially before marriage. Now, as part of a global culture, with access to virtually unlimited information young Egyptians are more aware and ready to challenge the old mind-set. Economic circumstances have delayed the chance to marry young for many, so it is inevitable that there is an increase in physical relations prior to marriage. Although it is generally recognized that this situation exists many parents are in denial, preferring to avoid any mention of it, so long as a daughter retains that all powerful fragment of flesh, the hymen, symbol of ‘purity’.

We also increasingly see young people wanting to question religion. With so much turmoil in the world spotlighting religious differences it is no surprise that our youth seek more insight and philosophical discussion on the subject. This does not always sit well with parents who have been raised in households were religion was an integral part of family life and never queried for any reason. It should be noted though that in most cases when a young person appears to have withdrawn from his or her faith, they generally revert back to the family religious observance                               patterns after a period.

How damaging can it be to avoid talking about these matters?

It widens the gap between parent and child. No matter how much a parent would like to preserve the status quo it is becoming an impossible task. In many cases the parents feel at a disadvantage when their kids exhibit a much broader knowledge than them due to internet access and freer discussions with their peers. A parent can feel intellectually inferior and through lack of maturity can refuse to be pulled into a situation where they feel they would lose face.  Again, it depends on the level of                  parenting skills.

How would you classify the different parenting styles?

There are already very clearly defined categories for this. The first type is defined as ‘authoritarian’, where the head of the family, or both parents, maintains a situation where he defines the rules of the household and will not accept any deviance. The family members are expected to submit to this unquestioningly. This can either disempower their children,                              or alienate them.

The second group is known as ‘authoritative’, where the parents have a clear leadership role, and display competence in providing a secure and democratic environment for the family. This differs from the previous group in that the children feel secure and protected, but still have room to develop themselves and take on responsibilities as individuals. Without this self-actualization process they in turn would not be able to form a healthy parent/ child relationship in later years.

We then go onto the over-protective family. Parents try to shield their kids from the realities of life, stifle their freedom, and control their lives in minute detail. No matter how well-intentioned, this behaviour is very harmful, and does not prepare a child for a normal adult existence where he or she  will eventually need to take decisions and accept responsibilities.

Unfortunately we increasingly see an increase in submissive or neglectful parents. They basically prefer not to face up to the job of parenting and preparing their children for a productive role in society. In many cases they find it easier to supply their kids with an unrealistic amount of money and allow them free rein to do whatever they like, even if it means being absent from home or school. Children then quickly learn how to manipulate their parents to get what they want.

Psychologist Abraham Maslow stated that human motivation is based on people seeking fulfilment and change through personal growth. Self-actualized people are those who were fulfilled and doing all they were capable of. For Maslow, a person is always ‘becoming’ and never remains static in these terms.  In self-actualization a person comes to find a meaning to life that is important to them.

The Maslow triangle is an easy to understand and recognized guideline for human developmental stages. Good parenting should follow these goals.

What things do kids usually avoid telling their parents?

Anything that they feel will result in punishment, rejection or restricted personal freedom. This generally includes experimenting with substance abuse, sexual experiences, falling behind with school work, being bullied, and even falling in love. This is where the relationship between parents and a child should be based on healthy respect, where a child feels secure and loved enough to be able to open up and get help with life’s situations without fear of being rejected, judged or chastised If a parent feels their child is hiding something from them it is usually the parent who is at fault.

Do you see psychological problems arising from avoidance of certain issues?

Parents can often lack confidence in their roles and avoid responsibility in taking decisions. This is even more evident in societies where the extended family shows an active interest in matters, so ignoring an issue and sweeping it under the carpet can be the popular option. Equally, should a parent attempt to assert dominance over their child in a certain matter and be disobeyed it is a challenge to their parental authority and will play out in other facets of the child/parent dynamic.  It is important for parents not to betray a child’s trust, it is difficult to regain once lost.

How honest can you be with your child, especially on sensitive topics?

If a child asks questions a parent should know how to answer appropriately, giving an honest response at a level consistent to the child’s age and maturity. Never underestimate their intelligence. Children come up with questions as they develop, and if a parent is not there to respond they will find out from other sources anyway. Sex and reproduction can be discussed in simple terms starting from 5 years of age if a child seems curious, drugs and the dangers can also be discussed in an easy to understand way. It is important for children to learn not to try substances offered to them as well as to avoid being molested. They must know at an early stage what is inappropriate touching by any person, no matter how close. By being involved in their children’s lifestyles and monitoring their development parents can gauge the best time to open up important subjects for discussion.

What is the best time for families to have discussions on topics that are important?

Lifestyles have changed, and more time is spent on individual activities. It is vital to set aside at least twice a week where the family get together without TV, or electronic diversions, purely to reconnect. It should also be an opportunity to reinforce shared values through conversation while instilling in children the ability to make reasoned and objective analyses.

What positive ways are there to talk to and listen to your children?

Share experiences, listen to their anxieties and show them by example how you deal with life’s challenges. It will encourage them to deal with things in a pro-active and self-actualized manner.

What are the best ways to get a kid to open up and talk and strengthen the relationship between you?

By making sure that enjoyable shared activities are inserted into the weekly agenda parents will build a natural bond that will make it easier to converse. Find out about your kid’s leisure activities and join in where possible, it should be fun for                  both of you.

Are there times parents should hide personal information from their kids?

Children should never be exposed to any signs of marital discord. Any domestic disturbances and disagreements should be resolved in private. In the case of separation and divorce it is a big no-no to criticize the other parent or malign them; the basis for a healthy family relationship is respect, in spite of any differences that may have arisen.

What are warning signs in behavior patterns that a parent should be on the lookout for?

Don’t let your child shut himself away for extended periods. Everyone needs some privacy, but self- isolation from the family unit may be an indication of depression. Any aggressive or anti-social behavior should be addressed quickly. Other indicators may be development of phobias or bedwetting, a good heart-to-heart talk should help you to get to the root of the matter.

How can you detect that there may be serious psychological issues to be addressed rather than just normal ‘growing-up pains’?

A certain level of misbehaviour can be considered normal in the maturing process. If this is a one-off or sporadic occurrence it should be dealt with through discussion and parental guidance. However, if this is a consistent pattern, without any indication of remorse it may mean that more serious personality patterns are at play, such as conduct disorder (CD), a psychological disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate norms are violated. According to DSM-5 criteria for conduct disorder, there are four categories that could be present in the child’s behavior: aggression to people and animals, destruction of property, deceitfulness or theft, and serious violation of rules. This may be a sign of a psychopathic personality so professional evaluation should be sought.

It can be noted that almost all adolescents who have a substance use disorder have conduct disorder-like traits, but after successful treatment of the substance use disorder, about half of these adolescents no longer display conduct disorder-like symptoms.

Does Al Mashfa offer counselling services, and if so, what is the youngest age you accept as patients?

We handle consultations for children from as early as 4 years of age, in addition to our  centre for adolescent counselling for children aged 11 to 18 years. Our team of highly qualified professionals are experienced in interacting with children; parents are welcome to contact us should they have any concerns about their child’s psychological health.