Confidence Beyond the Skin-Making the Most of Your Doctor’s Appointments in 2012!

 Happy New Year!

We all made it through 2011 and it is time to establish your lofty New Year’s resolutions! Of course, the most common resolutions are always to lose weight, quit smoking, or spend more time with your loved ones. In my opinion, the most important resolutions are the ones that focus on taking care of oneself, with an emphasis on living a happy and healthy lifestyle. For example, many of us tend to procrastinate on our routine health check-ups, but wouldn’t it be nice to start the year off with a clean bill of health? Personally, I like to schedule my own check-ups in December and January so that I can start the new year with a sigh of relief and feeling great!

Whether you decide to schedule your annual medical appointments now or later in the year, it is important to learn some basic tips and consider some common situations, that will allow you to get the most out of your appointment with your medical provider.  For example, Doctors do not like to run behind schedule, but so often we as patients find ourselves sitting for hours in the waiting room, which can be irritating and lead to a tense encounter with our provider. On the other hand, many patients have a lot of anxiety about seeing their doctor and forget to mention some of their major concerns at the time of the visit. Here are some tips that will allow you to clearly express what is going on with your health and still allow your doctor to have adequate time to examine you.

1. Make sure that you are seeing a qualified professional. You want your medical provider to be board certified in the specialty that they are practicing. This has become more of a concern with the increase of Medi-spa cosmetic treatments and discount offers like those available through Groupon.

2. Write down the concerns that you want to discuss with your doctor so even if you are nervous, you won’t forget something you wanted to share.

3. Try not to have more than 2-3 concerns to discuss during one office visit. Doctor’s typically do not schedule more than 15 minutes for a routine visit, which allows for 2-3 concerns to be addressed adequately. If you have more than 2-3 concerns, schedule an additional visit to allow the doctor enough time to thoroughly assess all of your concerns.

4. For each of your medical concerns the doctor will want to know these key points:

(Use the acronym WWW FARE to help you remember)

What is the problem – Is it itching, pain, burning, etc?

Where is the problem (head, stomach, etc)?

When – How long have you had the problem?

Frequency – How often do you have the pain?

Aggravating Factors – What makes it worse?

Relieving Factors – What makes it better?

Effect on Function -Is it limiting your normal activity?

Don’t forget to mention any medications or supplements that you currently take and any medication allergies. If you are a new patient, make sure to update your new doctor about your general health status.

If you are able to answer the above questions briefly, your doctor will have a good idea of what direction to take with his/her questions and exam. Make sure that you feel comfortable to ask any questions at the end of the exam.

I hope 2012 brings you much health and happiness, and that you will not need to spend much time in a doctor’s office! Because I am having so much fun with this newsletter/blog, I have decided that one of my resolutions will be to write  bi-monthly articles which will launch on the 1st and 15th of each month! Please send me any ideas that you have for additional topics and feel free to share the blog articles with your friends and loved ones!

Blog topic suggestions can be emailed to

I have been asked if I receive any financial incentive to mention products in my newsletter/blog and the answer is no. I only comment on products that I have used myself or that I recommend to patients because they have unique benefits.  However, I am a clinical trainer for both Medicis (Dysport/Restylane) and Allergan (Botox/Juvederm).

For my fellow tech-y followers, I have started daily tweets on Twitter! To stay up to date on the latest, you can follow me @kaseydamatopac . For those Facebook fanatics out there, I have also created a FB fan page! Go ahead and “like” the page to stay up to date on the latest in skin care!

Confidence Beyond the Skin-Preventing Dry Skin in the Winter

Is the Winter Weather Making Your Skin Feel Like an Alligator?

 I have to start this month’s newsletter/blog article with an apology about my last article “Holiday Makeovers”. I wrote that article while sick with the stomach flu, and in my feverish delirium hit the “publish” button before I had  chance to proof read what I had written.  This decision resulted in the article going live with some significant grammatical errors.  I didn’t even realize what I had done, until the next morning when I received horrified voicemail messages from my mother (the college professor) and my sister (the English major), who called to chastise me for what I had done. I have since had a chance to edit the article, and I sincerely apologize to all of my other critical reader/subscribers! I learned a valuable lesson about writing when feeling under the weather, and am making a pledge to my loyal readers to never let that happen again!

All around the country, we are all experiencing seasonally dry weather this time of year, which can lead to dry, flaky, and itchy skin. These skin conditions can be exacerbated by airplane travel and the extra heat used to heat our homes and businesses. Most commonly the back and lower legs are affected, but any part of the body can become dry and itchy. Personally, I notice my lips and cuticles are especially dry this time of year. To help you combat the itchy, flaky alligator skin of winter, here are some tips and products that you might find helpful:

1. Take shorter and cooler showers-Hot water exposure causes moisture to evaporate from your skin. so shorten the time you are in the shower. Limit shower times to 5-8 minutes and keep the temperature on the cooler side.  Be sure to avoid harsh drying deodorant soaps, and stick to moisturizing soaps and body washes  like Dove.

2. Use a good moisturizer cream or lotion immediately when getting out of the shower. Studies have shown that if you towel off and apply moisturizer right away when skin is still damp, you can prevent some of the moisture from evaporating and keep it in your skin. Keeping your skin more hydrated can help prevent that annoying mid-back or lower-leg itch that so many of us experience. Some great winter moisturizers are, Eucerin Calming Cream, Amlactin Lotion, and Cereve Cream.

3. Be careful with household chores-Hands and cuticles can take a beating this time of year if you often find yourself up to your elbows in hot suds. With all of the holiday partying, most of us will be spending more time doing dishes and house cleaning for guests than we typically do throughout the rest of the year. The extra water contact and chemical exposure from cleaning products will contribute to the problem of hands feeling dry, and possibly even lead to cuticle skin cracking.  Your first line of defense is to wear gloves for dishes and cleaning. You can shop for some cute and fashionable gloves called Gloveables online. Also, before you go to bed, you can use Vitamin E oil on cuticle skin. Aquaphor ointment is also great for dry cuticles. Aveeno has an Intense Relief Repair cream hand cream that I use on my hands every night before going to bed.

4. Prevent chapped lips-Remember that you still get sun exposure on your lips during all of the fun outdoor winter time activities. When I ski, I am careful to apply lip sunscreen at least a few times a day. I like Blistex DCT lip treatment when outside in the winter.  At night after skiing, I apply Aquaphor ointment to my lips and a little inside my nose. This can help prevent those dry skin nose bleeds.

5. Do you experience chest bumps and itching?-If you experience itchy bumps on your chest, you may be suffering from a condition called Grover’s Disease. It is more common in the winter and among middle-aged males, but it is possible for females to be sufferers too.  The itchy bumps that result from Grover’s Disease can be very annoying and a little unsightly. If you are among the sufferers of Grover’s disease, you can try Aquanil HC lotion for a couple of weeks. This lotion has a little cortisone that can help minimize the inflammation and the bumps. Be careful not to use this more than a few weeks because it can start to cause a rash from overuse of cortisone. Any rash persisting more than a week or so should be evaluated by a qualified professional.

I am really looking forward to the winter weather! I love to ski and bundle up with a good book in front of the fireplace!  It is nice to slow down a little over the holidays and catch up with family and friends. This is the time of year to tell everyone in your life how special they are to you.  I am heading to the  east coast to Maine over the holidays to be with my family, and then we are driving up to Canada for a skiing adventure over New Years! I will be practicing my French in St. Sauveur, a small ski village just outside Montreal!

Wishing everyone a very happy holiday season and a wonderful New Year! See you in 2012!

I have been asked if I receive any financial incentive to mention products in my newsletter/blog and the answer is no. I only comment on products that I have used myself or that I recommend to patients because they have unique benefits.  However, I am a clinical trainer for both Medicis (Dysport/Restylane) and Allergan (Botox/Juvederm).

For my fellow tech-y followers, I have started daily tweets on Twitter! To stay up to date on the latest, you can follow me @kaseydamatopac . For those Facebook fanatics out there, I have also created a FB fan page! Go ahead and “like” the page to stay up to date on the latest in skin care!

Confidence Beyond the Skin – Holiday Makeovers

This is a special holiday edition of my newsletter/blog! As you know, my goal is to write an article around the first of every month highlighting a new topic. I made an exception for this edition and I am writing 2 articles this month! This time of year, I am frequently asked about the benefits of minor cosmetic procedures because people want to look their best for their upcoming holiday parties. Whether you have a small office party, a large family reunion, or a fundraising galla to attend, everyone wants to look their best for the season!

Some cosmetic procedures require a series of treatments, or a significant amount of recovery time. Since we are only a few weeks away from the holidays, I will highlight a few procedures that have very little recovery.

Wrinkles and lines on the upper face and forehead area can be treated easily with either Botox or Dysport injections. These agents work by relaxing the muscles under the skin that pull to create lines. It is not particularly painful to receive these types of injections because they are administered with a tiny needle. They can cause temporary bruising. It takes about one week before you will look rested and refreshed, so if you want to minimize frown lines for the holidays, act soon!

Laugh and smile lines that shadow around the mouth can be treated very easily using Hyaluronic acid injectable agents like Juvederm and Restylane. These do not require skin testing ahead of time and show immediate results! Be careful! These injectable agents can cause bruising; so , just in case give yourself a week before the big party just in case!

To help avoid the bruising after an injectable procedures, check with your medical provider to make sure it is safe to minimize your intake of anti-inflammatory medications (i.e. Motrin, Aspirin, etc), fish oil, Vitamin E, and wine.  These types of medications will thin your blood slightly and increase the risk of bruising.

Microdermabrasion is a gentle procedure that  exfoliates the skin and minimizes the  appearance of fine lines and pores. This painless procedure will help the skin look and feel great without any down time or risk of bruising!

For that extra pampering, you can make a spa appointment to help you feel truly relaxed and refreshed! Some facials will hydrate your skin and make it appear smoother and more supple. Make sure you go to a reputable aesthetician especially if you have acne prone skin. Facials can flare up acne when they are too aggressive. If you are in L.A., Lauri at Solas in Santa Monica is great!

For a quick, at-home fix, try one of the new exfoliation brush systems such as Clarisonic or Olay. After you  exfoliate the dead skin, you can apply a little sunless tanner or bronzer. This will help minimize that pasty pallor some of us get this time of year.. A few drops of sunless tanner will go a long way to give you that “I just returned from Hawaii and am totally relaxed look”. Don’t forget to shape the arch of your eyebrows and put light shadow just under the brow. This will reflect light and draw attention to your eyes!

If you live in LA or have watched any reality TV lately, you have seen some scary outcomes from cosmetic procedures. We have all seen the frozen faced newscaster or the soap opera star showing off her new duck lips! This is surely not the look you want. It is important to start slow and ease into any procedure to ensure you get the result you are looking for.. You want to ensure that you will look naturally refreshed and not artificial!

I have been asked if I receive any financial incentive to mention products in my newsletter/blog and the answer is no. I only comment on products that I have used myself or that I recommend to patients because they have unique benefits.  However, I am a clinical trainer for both Medicis (Dysport/Restylane) and Allergan (Botox/Juvederm).

For my fellow tech-y followers, I have started daily tweets on Twitter! To stay up to date on the latest, you can follow me @kaseydamatopac . For those Facebook fanatics out there, I have also created a FB fan page! Go ahead and “like” the page to stay up to date on the latest in skin care!

I am off to Maine this week to visit my family for Thanksgiving. I wish everyone a happy, healthy Turkey Day!

Confidence Beyond the Skin – Avoiding Holiday Stress Breakouts!

Seasons are changing,  kids are back into the  school routine, and the holidays are rapidly approaching! What do these three things have in common? STRESS!

This time of year is common for teenagers to have more frequent facial acne breakouts since they are mostly  indoors with less  exposure to the sun than they had during the summer months. Exposure to the sun’s ultraviolet light  has some anti-inflammatory effects on acne, so teens usually experience less acne in summer than during the school year.  Not to mention,  studying for that dreaded calculus test or writing a 10 page history report, which are sure ways to increase stress hormones and lead to inflammation in the skin.

For those of us who are beyond high school and only have nightmares about walking into chemistry class unprepared, we still have the stress of the upcoming holidays to disrupt our hormones and lead to those annoying acne breakouts.  I have been plagued my whole life with stress breakouts and boy are they annoying!

The question remains, short of running away on a vacation to Hawaii, what can we do about our stress acne?

Here are some basic tips:

1. Do NOT wash with a harsh scrub or pick at any pimples! These activities will only irritate and inflame your skin and can lead to scarring!

2. Make sure to use oil free, non comedogenic makeups and moisturizers! I really like Neutrogena Skin Clearing makeup and Clinique Acne Solutions makeup

3.  Use a gentle cleanser like the new Neutrogena Naturals for oily skin or Cereve for  dry or sensitive skin

4. Try an over the counter treatment with  Benzoyl Peroxide. Benzoyl peroxide has some antibiotic benefits as well as anti-inflammatory benefits.  One example is Neutrogena On the Spot treatment or Clean and Clear Acne Control kit.

5. Remember, if you are an athlete , it is important to shower off, or splash your face with water  immediately after sweating.

6. Many people don’t realize how much oil is in hair conditioner. If you are breaking out along hairline or on your back, be careful to wash your hair off to the side or switch conditioners altogether.

7. There are a variety of prescription products that can be helpful. Retinoids such as Retin-A micro can help unclog pores and also reduce shiny, oily looking skin. Topical and Oral Antibiotic treatments can help reduce inflammation, and some Birth Control pills can help women who have breakouts during pre-menstrual time or menstrual time.

8. Lately there has been a lot of discussion about the influence  of diet  on acne. One of the most interesting concepts that is being investigated is whether dairy products increase inflammatory acne because of the hormones that are in those foods. It might be worth conducting a personal experiment if you have stubborn acne and go for a month limiting your dairy intake.  Be sure to take a vitamin D and calcium supplement if you cut dairy completely out of your diet.

9. A new product called No-No is gaining popularity. I have not used it myself, but I have a new friend, Grace Gold, who is an expert beauty  blogger from  NY, and she believes that it really works! Here she is discussing it on the Today Show!

10. Lastly….RELAX and REDUCE YOUR STRESS!! Find an activity you enjoy…Yoga, dancing, reading, anything that will relieve some of that predictable  seasonal stress! 

Let’s all make an early new years resolution to find better ways to relieve our stress and take better care of ourselves and our skin! If we start now, we will all begin 2012 with bright glowing skin and feeling great!

I have been asked if I receive any financial incentive to mention products in my newsletter/blog and the answer is no. I only comment on products that I have used myself or that I recommend to patients because they have unique benefits.

For my fellow tech-y followers, I have started daily tweets on Twitter! To stay up to date on the latest, you can follow me @kaseydamatopac . For those Facebook fanatics out there, I have also created a FB fan page! Go ahead and “like” the page to stay up to date on the latest in skin care!

May the color changes of the season lead to the creation of  many happy memories for you!

Promoting Confidence Through Healthy Skin-Sexy Smooth Skin

I know what you are thinking….bikini season is over, who care’s about shaving and smooth skin?  I have seen a lot of patients lately who told me that they never put on a bathing suit all summer because they were too embarrassed by unwanted hair or irritated, bumpy skin from waxing or shaving. So I figured, let’s address this issue now and nip it in the bud before next bathing suit season!

Even though bikini season is over,  most of us still choose to wax or shave even during the cooler months.  Men commonly get irritated along the neck or jawline after shaving and women commonly experience irritation in the bikini area.  Although razor blades are expensive , it is important to use one with multiple blades, and change them frequently to avoid bacteria from growing in them which can cause pimple like breakouts. Some men may find that using an electric razor and not shaving completely smooth  can help prevent ingrown hairs. In my experience, both men and women have appreciated a benefit using a product called bump patrol after shaving to keep the skin smooth.

It is helpful to mildly exfoliate once in a while to eliminate dead skin and allow for a closer shave. Don’t scratch your skin, a soft body sponge  or mild scrub once a week is enough.  Use a shave lotion or gel to allow the razor to glide smoothly across your skin and avoid catching on small irregularities in the skin surface. Neutrogena makes a nice scrub and shave gel for men. Remember, to avoid bumps you should shave in the direction that the hair grows.

At home waxing can be dangerous! Be careful not to burn yourself. This technique is best left to a professional. If you are a little red or itchy after a wax, you can apply over the counter cortisone twice daily for a couple of days.

Sometimes, no matter which hair removal technique you prefer, you cannot avoid a painful ingrown hair. These can be treated at your dermatologist office by injecting a small amount of cortisone to shrink the inflammation or by giving you a short course of antibiotics.

Laser Hair Removal is rapidly gaining popularity across the country.  This is the only way to permanently reduce hair.  It is fast, safe and effective for dark hair and can be used for any part of the body. Be prepared for 3-6 treatments and the occasional touch up treatment. Expect costs between $100-800 per treatment depending on the size of the area you want to treat.  The only effective way to permanently remove blond or grey hair is with electrolysis. Electrolysis is a slower process where one hair at a time is treated. Electrolysis is great for delicate areas like eyebrow shaping or eliminating nose hairs.

While you may not be in a bathing suit in the next month or two, you can test out these smooth skin tips with your spouse or significant other. Let them be the ones to appreciate the new smooth and sexy you! 

Personally, I am ready to put aside the bikini(or tankini in my case) and prepare for fall. I welcome the cool crisp days.  This is my favorite season. Time to get out the scarfs, watch the leaves change color and get ready for the long winter months ahead!

I hope you are enjoying the beginning of the change of seasons, and I wish you a happy Halloween!

Promoting Healthy Skin- Mosquitos, Mites, Bed Bugs..Oh my! Are you being eaten alive by summertime bugs? Learn how to protect yourself from these pesky insects

The last few weeks of summer are a popular time for camping trips and outdoor activities!  Many people are squeezing in the last family vacation before school starts for the year. Insect bites are a real nuisance and can put a damper on these summertime memories.

Here are a few tips to avoid the most common insect offenders:


 1. Mosquitoes are found  in most parts of the US. We  have all experienced the annoying buzz of a mosquito in our ear at some point in our life.

They are common around bodies of water and  are especially active at dusk.  The American Mosquito Control Association (AMCA) recommends to use repellents containing ingredients such as diethyl phthalate, diethyl carbate; N, N-Diethyl-3-Methylbenzamide (DEET), metofluthrin, oil of lemon-eucalyptus, picaridin and ethyl hexanediol.  For many years, DEET has been the gold standard in mosquito repellents and it still the standard  today. People who prefer all natural repellents should try Oil of Lemon Eucalyptus.  Repellents do not kill mosquitoes and other insects, but they will help deter them from biting people. Citronella candles can be effective if you are outside in an open area and of course long pants and  long sleeve clothing will help protect your skin. The itch from the bite may be relieved with topical Benadryl or cortisone creams applied  for a few days. Many people don’t realize that Mosquito bites can cause various infections;  the West Nile Virus is the most common in the U.S.  Around the world, mosquitoes can transmit some dangerous infectious diseases such as Malaria,  Dengue fever, various forms of Encephalitis and Yellow fever. Mosquito bites can also cause Heartworm infections in dogs. An equestrian friend of mine who spends a lot of time in the stables around Southern California reminded me that a light spray of AVON Skin So Soft can help prevent flies and mosquitoes around horses and dogs. Check with your vet to see if this is an appropriate way to protect your four-legged friends.   For more detailed information about Mosquitoes check out the The American Mosquito Control Association website.  



2. Ticks and Spiders-These two notorious critters can cause some real harm.  Infected ticks can potentially transmit Lyme Disease to humans.

 There are various spiders that have poisonous bites and often times people mistake Methicillin-resistant Staphylococcus aureus (MRSA), a bacterial infection that can be life threatening, for a spider bite. Use DEET repellent when hiking and camping to prevent tick bites, but if you suspect you have a tick or spider bite, please get an evaluation from a qualified medical professional to be sure you do not need systemic treatment.





 3. Mites-Everyone loves to watch birds in a feeder or baby birds hatching in the nest, but here in Southern California that could lead to hundreds of itchy bites.  Mites typically live on small rodents and birds.

 These mites are so small that they are difficult to see from the naked eye. If you have any exposure to rodents (rats, squirrels, mice, etc) or birds (bird’s nest close to the house or bird feeders), you could be the victim of mite bites. These are not the type of mites that live in your skin, they only use you as a source of food. The mites are so small that they can fit though holes in a screen door. Mite bites are very itchy and it is difficult to get rid of the mites on your own without a professional exterminator evaluating the situation and removing the source(i.e. rodent or bird or nest).




 4. Bed Bugs-Those of us who are frequent travelers get itchy just thinking about these guys!

Bed Bugs have been making national news for a while now. They are becoming a huge problem with tourism as they are invading a wide range of  lodging  facilities  from truck stop motels to fancy 5 star resorts.  There are a few ways you can protect yourself when traveling.  Bed Bugs like to live in cracks and dark spaces, so make sure to always look for evidence of the bugs or feces in between mattresses and box springs especially near the headboard of the bed.  Never put your luggage on upholstered  furniture or on the bed . Always use the luggage stand for your suitcase and keep it zipped. Carefully inspect inside dresser drawers and wipe with a damp tissue to make sure there are not bed bugs hiding in the corners. Bed bugs are the size of an apple seed and can have a sweet or musty odor in the room.

                                                                                    A Bed Bug Bites a Person

They do not fly, they get around by walking  and they survive on blood. They can actually live for months without a food source. If you are feeling itchy and  have new bites, along with small blood stains on your sheets, you should  inspect the room for bed bugs.  If you get bit by a bed bug, the bite will usually resolve within 2 weeks. The most  important thing to be certain of is that you do not have a stowaway bed bug in your luggage that makes it into your house! They can be very difficult to eliminate from your home, even with professional assistance.

 I like to use online travel resources such as Expedia, Travelocity,  and Trip Advisor before traveling to a new hotel to make sure other people have not experienced problems with bed bugs during their stay. There is also a Bed Bug Registry where you can research a hotel before you go. WebMD has a nice summary of the headaches associated with beg bug exposure.

I sincerely hope that you had a fantastic summer and that you made it through the past few months without being a victim to any of the above offenders!  Soon, we will be getting into fall with shorter, cooler days and the beginning of a new foliage season.  I am looking forward to a long weekend  in Maine with my family to close out this summer,  and I am wishing everyone your own safe and happy Labor Day adventures along with wonderful back to school season!!

Promoting Healthy Skin – Sunscreen

Q. How do I know which sunscreen is best?

A. Summertime is here! Everyone is excited for outdoor B-B-Qs and fun at the beach! The FDA recently released new sunscreen label guidelines for 2012 which will change how we all shop for sunscreen products starting next year. I am routinely asked about my favorite sunscreen and the truth is there are many good sunscreens to choose from.  I thought I would pass along these tips to help protect your skin:

1. Sunscreen helps protect skin from sunburn, but all sun exposure increases the risk of skin cancer, even with sunscreen. Remember, you are still exposed to harmful rays during a cloudy or foggy day.

2. Always use SPF 30 or higher with “broad spectrum” coverage to protect yourself from both  UVA and UVB damage.

3.  Look for Zinc or Titanium Dioxide ingredients for the best physical block.  Neutrogena’s Helioplex  also provides good protection.

4.  A golf ball size amount of sunscreen is required to protect your entire body

5.  No Sunscreen is waterproof. Be sure to reapply after any prolonged water exposure,  sweating,  or every 2 hours in  direct sun. The new FDA guidelines will only allow the term “Water Resistant” when refering to water exposure. Starting in 2012, products will be rated after 40 mintues and 80 minutes of water exposure.

6.  Apply all sunscreen in front of a mirror 30 minutes before sun exposure to ensure an even application to your entire body

7.  Be careful with spray sunscreen. You need to be generous with the spray to prevent blotchy “skipped” areas.  They can be difficult to apply in a windy environment. Currently there are investigations into the safety of accidental inhalation of the spray sunscreens during application, so try to hold your breath when applying spray sunscreen to avoid potentially inhaling the chemicals.

8.  Hats and Sun protective clothing are important to use along with sunscreen. Look for sporty sun protective clothing at L.L. Bean where they have mens and womens clothing with SPF 50. Many other manufacturers have also developed clothing and hats with SPF protection.

9.  The only “all natural” type of sunscreen is Zinc. Beware that Zinc will often leave a white film on your skin.

10. One of my favorite sunscreen manufacturers is Neutrogena. They have a wide selection of sunscreen products and many options for sensitive skin. I love their new lightweight UltraSheer liquid lotion that has SPF 55. Another great sunscreen choice is Anthelios by La Roche Posay. Le Roche Posay has developed an Anthelios Mineral Sunscreen with Titanium Dioxide which provides great broad spectrum coverage. California Baby or Aveeno Baby Natural are both good choices for little ones! Newborns should avoid direct sunlight and should not use sunsreen until about 6 months of age.

Whether you are in Maine or California-Enjoy the great outdoors but be safe and protect your skin!

To read more about the recent FDA guidelines for sunscreen labeling, you can read this official press release from the FDA :