Archive 2005 2006 2007 2008

Q: What do you know about herbal products for breast enlargement? And what about the Brava Breast Enhancement System, now advertised on the Internet? J.W., SEATTLE

A: Dozens of creams, gels, and pills with names like Bloussant, Wonder Cream, Grobust, and Miracle Bust now promise to increase a woman's breast size. They contain various combinations of herbs that are supposed to enlarge the breasts, such as fennel, saw palmetto, wild yam, fenugreek, and dandelion. Potential side effects include bleeding, allergic reactions, and headache. If plant estrogens (presumably the active ingredient in many of these herbs) can make breast tissue grow, they might also stimulate abnormal breast cells to multiply. Apart from the strong likelihood that you are wasting your money, you are taking an unnecessary risk. Don't believe the testimonials, which are backed up with no research. Don't fall for the claims about "studies" posted on websites. There have been no scientific studies, and these products are unregulated.

The Brava Breast Enhancement and Shaping System consists of two plastic domes that fit over each breast. These are attached to a small computer battery pack that regulates the suction action of the system. The domes must be worn 10 hours a day for 10 weeks (held in place by a zip-up bra). The maker claims that stretching breast tissue makes it grow. One study, authored in part by the people who developed the "system," claimed it resulted in a 55% increase in breast size in the 12 women studied and had no side effects.

Ads for the device claim it's FDA-approved. In fact, the FDA has not reviewed it for effectiveness, but allowed it on the market as an unregulated device. Nobody knows how long any increase in breast size would last. Or, indeed, whether the growth of tissue would be healthy. And the kits cost a whopping $2,500.

You have to purchase Brava through a doctor, though it is hard to imagine a reputable doctor selling it. Pregnant and nursing women, plus those who've had breast surgery or breast disease, are advised not to use it. A padded bra would be safer, cheaper, and a lot less trouble.

Q: How can I get rid of liver spots? What causes them?
M.D., TUCSON

A: Cumulative exposure to the sun causes liver spots, also called lentigo or age spots. Like freckles, these dark flat patches are harmless. They have nothing to do with the liver. They appear on sun-exposed skin, such as the forehead, hands, face, and shoulders, usually in people over 55.

Most of us simply learn to live with them, but if you find them unsightly, ask your doctor or nurse practitioner about prescription bleaching creams. (Skip over-the-counter bleaching creams—they are not effective.) Prescription bleaching creams may lighten the spots but must be used over several months. You might also try tretinoin (a form of vitamin A, brand name Retin-A), another cream that lightens the skin. It, too, must be used over several months.

A dermatologist can also use a chemical peel (a mild acid that burns skin and causes the outer layer to peel) or "dermabrasion," which sands away the spotted skin. Spots can also be removed by freezing the area (cryotherapy) or by lasers. These procedures, like the creams, may cause stinging, redness, and permanent discoloration.

You can try to prevent new spots by protecting yourself from the sun with clothing, such as long-sleeved shirts, pants, and a hat, and by using a sunscreen on your hands and face regularly—SPF 15 or higher. Apply sunscreen 30 to 40 minutes before going out in the sun to allow your skin time to absorb it. And don't use perfumes or after-shave lotions before sun exposure—they may increase your sensitivity to sunlight. Though liver spots do not turn into skin cancer, it's wise to ask your doctor to have a look at any new spots that appear on your skin. Your risk for skin cancer rises as you grow older.

Q: Will the herb cat's claw help the immune system?
C.V., VIA THE INTERNET

A: The herb contains many interesting compounds, but as with most herbal remedies, there have been no good studies on its effects in humans. It's hard to predict what the cat's claw supplements (capsules, tablets, creams, teas, and liquids made from various parts of the plant) sold in health-food stores will do.

Known as cat's claw because of its clawlike thorns, this woody vine is native to the Amazon, where it has been used medicinally for centuries. There are several species; two (Uncaria guianensis and Uncaria tomentosa) are supposed to have thera--peutic effects.

Some of its compounds are alleged to help boost certain aspects of the immune system, have anti-cancer effects, reduce inflammation, inhibit blood clotting, or lower blood pressure. That sounds pretty miraculous, but the evidence comes only from test-tube studies and animal research, and the results have not been consistent. In Germany, where the herb is standardized, some doctors prescribe it for certain people with compromised immune systems, such as those undergoing chemotherapy for cancer.

As with many herbs, there are as many potential risks as possible benefits. High doses may cause diarrhea, bleeding gums, excessive bruising, and a dangerous drop in blood pressure. Do not try it if you are pregnant (or may become pregnant), breastfeeding, have HIV, or are taking a drug that affects blood clotting. Cat's claw may also interfere with certain widely used prescription medications.

Because it is untested, unpredictable, and risky, we don't recommend cat's claw.

UC Berkeley Wellness Letter, November 2001