Acupuncture, Endometriosis, Fertility and Pregnancy, For Providers, Menopause and Beyond, Neuropathy, Prism Blog, Scar Reduction, Surgical Recovery, Transgender Wellness

Acupuncture for Scar Treatment

Why Should We Treat Scars?
Scars may not only be cosmetically undesirable, but may also have an impact on the health of the individual. This is especially true for very large scars; scars with abnormal coloration, lumpiness, numbness, tingling, itchiness, heat or cold sensations, achiness or pain, tenderness to touch, and muscle restriction.
Such scars and associated adhesions can indicate or lead to nerve and blood vessel damage, decreased range of motion and muscle strength, increased likelihood of future injury, and chronic pain (especially pins and needles, tingling, and numbness). Scars are especially notable on the torso, where underlying adhesions can impair bowel function, chronic pelvic pain or infertility, depending on the site of the scar.
In Chinese medicine, significant scars are considered to block the flow of the meridians, (similar to the nerve and blood vessel damage pointed to by Western medicine) causing not only pain and decreased circulation, but also potentially impaired internal organ function depending on the meridian affected.

Scar Treatment with Acupuncture and Herbs
Scars that are at least two weeks old can be treated with acupuncture and herbal medicine.
A 2014 study used local acupuncture (“surrounding the dragon“: using needles directly around and through the scar) with distal points (4 gates and ST36). After eight treatments in 5 weeks the scar pain had reduced from a 7/10 to a 1-2/10. Such treatments can not only reduce scar pain, but also help to break up scar tissue and adhesions, increase local circulation, and aid healing. This leads to flatter, smaller, less noticeable scars and a reduction of keloiding.
Moxibustion (a gentle warming treatment achieved by burning dried mugwort), may also be used. Small amounts of moxa may be burned directly on the skin -with a sesame oil cream as a medium to prevent burns- around the scar, or a stick of rolled moxa may be burned above the site to warm the area. Both methods are pleasant and effective.
Topical herbs can also be very beneficial for scar healing. It is generally best to apply your liniment of choice over the affected area before bed and cover with a tshirt (or other clean soft article of clothing depending on the site of the scar), so that it has plenty of time to soak in without washing or sweating which would interfere with product absorption during the day.

Which Topical Should You Choose?
  • Prism’s Scar Oil has frankincense and other essential oils that break up scar tissue in a tamanu oil base, a great oil for reducing the appearance of scars, including keloids.
  • Zheng Gu Shui is beneficial for deep scars that may have adhesions to underlying tissues (for example surgical scars). They can improve local circulation, healing of the scar and the area that was injured, and reduce associated pain. It is better for healing and restoring health to the area than for cosmetic scar reduction.
  • Wan Hua Oil prevents scarring, increases blood circulation, reduces swelling, and helps regenerate damaged tissues. Once the wound closes, massage the oil directly over the scar daily to prevent scarring and promote healing. This option is best to prevent cosmetic scars from surgery. It is also effective for scars from burns.
  • Aloe aids scar healing and reduces infection and swelling. If used during the healing process it can reduce the formation of scars. Be sure to use 100% aloe (fresh is best), not aloe with alcohol or other additives that can dry and irritate the area.
  • Ching Wan Hung oil promotes healing and new tissue growth, reduces scarring, and prevents infection. It is especially effective for scars from burns.
  • You can also use castor oil compresses, to break up deeper scar tissue and adhesions, but I don’t recommend this for new scars that are still healing (or any open wounds).

Note: Many people recommend the usage of Vitamin E on scars, but newer research shows that Vitamin E does not help reduce the appearance of scars, and in the case of surgical scars can actually make scars more visible due to the development of irritation or contact dermatitis.

Providers: read more about acupuncture scar treatments from Skya Abbate, DOM.

Additionally, my colleague, Dena Gold LAc, suggests a Japanese style version of surrounding the dragon that involved needling slightly outside the scar, towards and under under the scar superficially enough that the needle falls rather than roots. Dena also suggests checking the fire points of the channel the scar intersects and if they are tender, needle the metal and water points of that channel before treating the scar directly.

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.

Contact us to see if your insurance covers services at our office!

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For more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”


Prism Blog, Transgender Wellness

The Masculinizing Diet

This is a follow-up post to my post, “Nutritional Guidelines for Transgender Patients.” See the original post here. This article is an excerpt from my research paper, “Nutritional Guidelines for Transgender Patients,” which was written for practitioners of TCM who can use this information as part of a holistic diet tailored to client’s constitutions. It is not intended to function as medical advice. Because every body can respond differently, before beginning or changing your diet always consult a healthcare provider. I have included a few gems in here for practitioners, if you don’t have an understanding of TCM theory you may skip over the italicized portions.

To start, proper general nutrition is important, including plenty of healthy fats, avoiding animal products raised with hormones and processed or refined foods, and adding more fresh fruits, vegetables, and high quality protein.

As long as there are not contraindications based on your underlying constitution, a testosterone supportive diet should be high fiber, low carb and include a lot of vegetables and a moderate amount of protein.

This diet along with herbs and acupuncture can cause a slight elevation in testosterone levels in some people. However, please note that these diets alone will not have a significant effect.

Table 2: Trans-masculine Dietary Suggestions

  1. Limit carbohydrates -especially starches- and increase fiber, fruits and vegetables.
  2. Add white mushrooms, bee pollen, royal jelly, and/or celery. Meat in general is more yang, but especially poultry, lamb, wild game, tuna, lobster, salmon, and shrimp are beneficial for a masculinizing diet.
  3. If taking testosterone, add brazil nuts and garlic, and avoid salt.

A mildly yang nourishing diet is generally safe for most people however care should be taken in following this diet long term if yang deficiency is not present. It is important to note that trans men who have just begun taking testosterone often have some degree of yin deficiency, and this diet would be inappropriate in that case. Always talk to your healthcare provider when making dietary changes.

A yang tonifying diet includes more warming, sweet, pungent foods (Pitchford, p. 54), and avoiding raw and cold temperature foods (Pitchford, p. 95). Meat, especially poultry, lamb, wild game, tuna, lobster, salmon, and shrimp are especially good, but if the client experiences side effects from the testosterone, especially high red blood cell counts, meat should be cut down. Once taking testosterone, a yang tonifying diet would have to be greatly modified and monitored by a TCM practitioner or discontinued since testosterone tends to create more yin deficiency and blood heat rather than yang deficiency.

Lowering Estrogen:

A high fiber diet can decrease blood estrogen levels by removing estrogen from the body before it can be reabsorbed in the bowel (Griffith, p. 158). Carbohydrates and especially starches should be limited as well because high blood sugar and associated high insulin levels can in turn raise estrogen levels. In addition, trans men should always avoid animal products raised on hormones (Cole and Han, p.75), since these hormones are estrogenic.

Anyone taking hormones should include sulfurous foods like garlic, dark leafy greens, and egg yolks, as well as lemons and limes, shiitake, reishi, dark leafy greens and cruciferous vegetables (cooked only if taking estrogens), to detox the body. Sulfur gives the liver the ability to get rid of toxins such as synthetic hormones (Duvall), tonifies the kidneys, warms yang, and benefits the skin (Caruso-Radin). Cruciferous vegetables, except for brussels sprouts and broccoli, stimulate testosterone production and flush out estrogen (Prodragonist), and celery has androgen like properties (Midnight). Lignans in sesame and whole grains -also in flax but that has an estrogenic effect- (Petersen), interfere with the enzymes that are involved with the production of estrogen (Duvall). Methionine, which aids estrogen breakdown (Marz, p.85), is found in many animal products; especially tuna, cheese, salmon, wild game, and shrimp, and also nuts, especially walnuts (Marz, p. 86), so protein should come especially from these sources. It is also important to balance excess methionine with glycine from bone broths (Caruso-Radin).

White button mushrooms also prevent testosterone to estrogen conversion (Prodragonist), and bee pollen and royal jelly may increase testosterone levels (Balch, p. 457). Acidophilus in lactofermented foods breaks down metabolites of estrogen (Balch, p. 588), as well as soothing the digestive tract which can be irritated by hormones. DHEA -via combining wild yam and cholesterol as described above is known to cause acne, hair loss, facial hair, and deepening voice in female assigned people (Griffith, p. 158-159), reminiscent of many of the effects of testosterone, and these “side effects” could be used to the client’s benefit. However, as DHEA can be converted to either estrogen or testosterone, it is important to monitor your hormone levels with a doctor when using this method.

Countering Side Effects:

Side effects from testosterone include high blood pressure, high red blood cell count, and high cholesterol. High blood pressure may be prevented somewhat by following a low salt, sugar, and caffeine diet, including avoiding foods with preservatives, aged meat, anchovies, avocado, fava beans, and pickled herring (Balch, p. 438). High blood pressure, if it occurs, can also be eased by selenium (Balch, p. 437), which is found in brewer’s yeast, brazil nuts, pork, eggs, liver, lamb, beef, tuna, and lobster (USDA). Selenium astringes yin, anchors yang, and calms shen (Caruso-Radin), allowing it to calm liver yang rising causing hypertension. High cholesterol, another potential side effect of testosterone use, can be helped with apples, cold water fish, dried beans, garlic, olive oil, carrot juice, and limiting sugars and oils to only unrefined cold or expeller pressed oils and naturally sweet foods like fruit (Balch, p. 442).

Vitamin C in citrus and brightly colored fruits and vegetables boosts testosterone levels, clears heat, stops bleeding, resolves toxins, and calms the shen (Caruso-Radin), potentially helping to stop the menses, prevent toxicity from hormone use, and ease initial mood swings as well as heat side effects, such as hypertension, hives, hot flashes, and acne. Vitamin E can also help reduce hot flashes common with starting testosterone (Balch, p. 512). Vitamin E is found in green vegetables, milk, liver, and nuts, and nourishes the blood and yang from a TCM perspective (Caruso-Radin), potentially countering liver yang rising due to deficient heat. Vitamin A, such as that in grass-fed whole dairy, bright orange and yellow fruits and vegetables and dark leafy greens (Caruso-Radin), is somewhat depleted by testosterone use (Gaby, p.175), so these foods should be increased in the diet.

Overall, a simple high fiber, low carb, moderate protein diet with plenty of vegetables should be followed for trans men. Good proteins to include are tuna, cheese, salmon, wild game, shrimp, lamb, and raw unsalted walnuts, peanuts, and almonds. White button mushrooms, bee pollen, royal jelly, brightly colored fruits and vegetables, lactoferments, beans, cruciferous vegetables, celery, sesame seeds, tomatoes, pears, and apples are great additional foods. If taking testosterone, clients should follow a low salt diet and add brazil nuts and garlic.

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.

Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

Endometriosis, Fertility and Pregnancy, Menopause and Beyond, PCOS, Prism Blog, Transgender Wellness

The Soy Controversy

“Women consuming the equivalent of two cups of soy milk per day provides the estrogenic equivalent of one birth control pill… men who consumed the equivalent of one cup of soy milk per day had a 50% lower sperm count than men who didn’t eat soy. –Chris Kresser’s Paleo Code

Soy is often touted as a natural source of estrogen, but is it safe to use either for this purpose or as a food?

“About two ounces of soy products per day may be sufficient to ward off hot flashes and other symptoms” of menopause (Wright & Morgenthaler, Natural Hormone Replacement for Women over 45). However, as an estrogen source, it may not be the safest food option.

Soy is present in nearly every packaged and processed food in the U.S, in fact, the average American gets up to 9% of our calories from soybean oil alone. Compare this to about 2 teaspoons per day in China and 9 teaspoons per day in Japan, most of which is fermented soy, which neutralizes the toxins (like trypsin inhibitors that inhibit protein digestion and affect pancreatic function, and phytic acid, which reduces absorption of minerals like calcium, magnesium, copper, iron and zinc) that are present in most of the soy we consume in the U.S. (Chris Kresser’s Paleo Code)

Unfermented soy also increases our requirement for vitamin D and B12 (the opposite of fermented soy which provides these vitamins!), and disrupts endocrine function (potentially causing breast cancer and thyroid problems). Processed unfermented soy often actually contains carcinogens as well. (Chris Kresser’s Paleo Code)

It is not fully known how soy consumption may impact synthetic hormones, and it’s nearly impossible to avoid all soy since it’s in most of the food we consume, but it would be wise for most people to avoid eating the major processed soy foods like tofu, soy milk, and soy protein isolate. Fermented soy still contains estrogens, but is not as disruptive (or potentially carcinogenic) to our natural hormones, and is probably a safe food for most people.

I would generally recommend that people transitioning towards the masculine side of the spectrum avoid soy foods, and for those looking for natural sources of estrogen, there are many safer feminizing herbs and foods out there. For example, “flax contains substances called lignans, which have been shown to have estrogen-like qualities” (Wright & Morgenthaler). A few foods have small amounts of identical-to-human hormones [about 1-2% potency of human hormones] (Wright & Morgenthaler), including:
Rice, apples, date palm, pomegranate (estrone)
French bean seedlings (estradiol)
rice, licorice (estriol)

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.

Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

Prism Blog, Transgender Wellness

Herbs for Transitioning: Masculinizing Herbs

This is a follow-up post to “The Basics.” Also see the feminizing herbs post here.

Hormones and surgery can be expensive or not accessible. Herbs can also be used if you don’t want to use hormones or undergo surgery, but still want to create physical changes in your body, or after being on synthetic hormones for many years to maintain the changes that you have made without the side effects of continued synthetic hormone use. Note: Most are unlikely to have a significant effect without any other transition methods.

Vitex: The Regulating Herb

Vitex is a hormone normalizer that works with the pituitary gland to keep progesterone stable and prevent  it from converting to estrogen or testosterone. This helps to hold secondary sex characteristics that have developed with synthetic hormones. Technically, it increases LH and reduces FSH, which increases progesterone and reduces estrogen and testosterone. This helps it regulate emotions, prevent acne, hormonal edema and bloating, and it can help you transition onto and off of synthetic hormones, as well as stabilize fluctuations in hormones while taking hormones.

These herbs can be used instead of synthetic hormones:

(Ex. to create small changes if hormones are not desired, or after years of taking hormones to maintain changes.)

  • Example combination: pine pollen, ashwaganda, Lu Rong
  • ashwaganda- steroidal precursor to T… and an adaptogen that helps build your immune system!
  • Yohimbe– promotes and supports testosterone levels
  • ginseng/Ren Shen- “yang tonic” in TCM, yang is both the masculine energy in TCM (ex. Ren Shen is sometimes used for impotence), and the energy needed to create change (ex. transition). DO NOT take while on testosterone.
  • sassafrass
  • pine nuts & pine pollen- closest approximation to human androgens
  • wild oats
  • Lu Rong/young deer antler- contains deer testosterone
  • blue cohosh- to stop periods, often taken with black cohosh. ONLY take this herb under supervision of a professional herbalist, it can be dangerous or cause opposite of desired effects if used incorrectly.
  • Blends:
  • Foods:

These herbs can help support synthetic hormones:

(DO NOT combine these with your medications without discussing with a healthcare provider.)

  • buplerum/Chai Hu- for emotional stability
  • stinging nettle– decreases “bound” testosterone and increases “free” or usable testosterone. also provides lymphatic and immune support.
  • white button mushroom- prevents testosterone conversion to estrogen
  • prickly ash- smoothes and eases voice transformation

For side effects of synthetic herbs:

(DO NOT combine these with your medications without discussing with a healthcare provider.)

  • He Shou Wu- for hair growth, prevents male-pattern baldness
  • saw palmetto- prevents male-pattern baldness, especially when combined with 10-30mg zinc daily
  • B5- to prevent acne
  • marshmallow- for constipation
  • motherwort/Yi Mu Cao
  • kavakava, california poppy, skullcap/Huang Qin, lemon balm, aralia or damiana- for emotional imbalances
  • bitters- for digestive symptoms
  • echinacea
  • yarrow
  • turmeric/Jiang Huang
  • nettle
  • dandelion/Pu Gong Ying, milk thistle/Shui Fei Ji-for liver damage
  • garlic/Da Suan- for high cholesterol & blood pressure
  • red root, cleavers, and ocotillo- for lymphatic drainage – to prevent reproductive cancers
  • hawthorne berry/Shan Zha can help prevent cardiovascular problems (which can occur with long-term T use), but can react with pharmaceutical heart medicines and shouldn’t be combined with them.

DON’T combine synthetic hormones with St. John’s wort/Guan Ye Lian Qiao, it stresses the liver. It also encourages bleeding, so avoid before SURGERY too!

References include:

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.

Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

Prism Blog, Transgender Wellness

Androgel: Info for Trans Men

Androgel can be used to initiate or maintain the development of male secondary sex characteristics, as well as virilization (clitoral enlargement) and cessation of menstrual periods.

Though testosterone levels return to baseline 48-72 hours after last dose, most changes (such as cessation of the menstrual period and muscle/fat redistribution) reverse if Androgel treatment is stopped; however, voice changes, facial and body hair, genital growth, and male-pattern baldness persist.

Showering 2-6 hours post-dose decreases testosterone by 13%; using lotion on the application site 1 hour after increases testosterone 14%.

Excess testosterone is converted to DHT (which causes male pattern baldness) and estradiol (a form of estrogen), and can therefore cause adverse effects. This makes finding the appropriate dose and getting hormones checked regularly very important.

It is important to apply gel only to the area of your shoulders that can be covered by a t-shirt, since skin-to-skin contact within 2 hours of application can significantly increase testosterone levels in others (research shows a 280% increase in cis women with skin-to-skin contact vs. only 6% if covered with a t-shirt). Also, remember to wash your hands right away afterwards to prevent transmission as well!

You may experience an increase in urinary disorders or other side effects. It is important to continue to perform regular self chest exams to check for lumps if you still have breast tissue (including tissue near the armpits which often is not removed during top surgery). You should also get your blood pressure, red blood cell counts (to monitor for blood clots), cholesterol and T4 levels checked regularly to monitor for these side effects.

Full Review of Research Follows:

Continue reading

Prism Blog, Transgender Wellness

Chest Binding Safely: Save Your Back!

Interested in binding, or already binding? Here are some very important health tips that you need to know!:

  • Do NOT use an ace bandage or similar homemade device for binding. Wrapping around your chest several times can result in dangerously tight binding that cuts off circulation, breathing, tissue damage, and skin irritation. If you want to make a binder, cut off the top of some control top pantyhose and sew on some straps. This is much safer and still just as cheap!
  • NEVER sleep in a binder (unless you are in a place where it is unsafe for you to sleep without it). Don’t leave your binder on for more than 8 hours at a time. Your body needs time to stretch and breathe. Think about those pictures of women who wore corsets daily and how it changed the shape of their abdominal organs permanently. This can happen so a lesser extent with binding too and tissue damage caused by constant binding can make top surgery more difficult!
  • Wear the right size binder. Don’t wear a smaller size thinking it will be more effective, it won’t flatten your chest more effectively, it’ll just cause more damage to your ribs and make breathing more difficult.
  • If you wear a binder frequently, make sure its made of breathable fabric (not neoprene), or wear a tank top or apply cornstarch underneath it to prevent chafing and breaking out.
  • If possible, take a “day off” at least once a week. Wearing even a tight sports bra once a week instead of a binder can help take some of the pressure off of your ribs.
  • Go braless or wear a loose bra as much as possible. Actually bouncing your chest can help restore circulation and prevent tissue damage. Take your binder off as soon as you can, and spend a few minutes either jumping or just manually moving your chest. This can help prevent issues like breast cancer and tissue damage (and is even recommended for people who wear underwire bras regularly).
  • Binding can change breast tissue, potentially increasing chances of breast cancer. It is important to do regular self exams so you recognize any changes in your body right away. The most important thing is to notice what lumps are normal for you and which are abnormal, immovable, and/or don’t go away.
  • Give yourself chest massages (or get a loved one to do it for you!) to work out any tightness that wearing a binder causes. Pay special attention to the sides of your ribs, collar bone area, shoulders, and use a tennis ball (or two tennis balls taped together) on a wall or the floor to get the knots out of your back and between your scapula.
  • Buy at least two binders so that you can alternate between them. If you give them a day off to regain their shape they’ll last longer! Wash them in special detergent that keeps them stretchy too: you can find soaps for medical braces, swimsuits, or nylons that all work well for this.
  • If you are younger than 20, your body is still growing and changing and this makes binder safety even more important. Don’t wear a binder more than 3-4 times  a week. At younger ages you are more likely to cause dangerous changes to your ribcage and chest tissue by binding more frequently.

Resources for Buying a Binder:
This site has information on fitting, buying, and wearing binders
Low cost binders
T Kingdom
Underworks swim binder
Binder reviews

Binder Alternatives:
Frog Bra Substitutes
Qwear sports bras

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.

Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.