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Showing posts with label Infections. Show all posts
Showing posts with label Infections. Show all posts

Scalp Infections - Symptoms, Causes & Natural Options For Fast Relief & Treatment

Tree Allergies

There are many definitions and symptoms commonly described as "scalp infections". There are in fact quite a few quite different reasons why your scalp may be sore, itchy, inflamed burning red or infected. If you are like many people with chronic scalp issues - it may be driving you completely up the wall and not knowing what it is or how to treat the problem effectively after many unsuccessful attempts to eliminate it can make it seem far worse - like you are never going to get to the bottom of the problem. Well that need no longer be so! It can be simple to diagnose and treat it now and for good.

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So if you are dealing with any of these symptoms lets first identify the problem and then some of the underlying causes.


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Firstly, if you want to get to the root of your problems, so to speak, you need to be able to identify what your problem actually is. Of course, many scalp infections & conditions look alike, so here is a brief description of some of the most common scalp conditions:


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Red burning itchy scalp can be characterized as any tingling,burning, prickly, and sensitive to the touch or a fiery hot sensation. Often associated with an allergy, sunburn, chemical burn (sensitization of the scalp),or fungal infection.

Dandruff as most of us know is the process of continual shedding of skin cells on our scalps. Often the cause of dandruff is simply the result of toxins, pollutants and products that have built up on the scalp particularly products like silicone- a cheap commonly used artificial shine enhancer in conditioners sold in supermarkets.

When the natural balance of our scalps is disturbed, this creates the perfect environment for the yeast fungus Melassezia Globbosa to move in and thrive. This is when the natural process of shedding our cells gets a little out of hand resulting in an unsightly condition known as "Seborrhoeic Dermatitis" (fancy name for dandruff) and we see the highly visible tell-tale signs of flaking and crusting.

The accompanying itch and urge to scratch are often made worse by the multiplication of the fungal yeast pityrosporum-ovale (having one big party on your scalp). Another follow on effect of this is that the relentless scratching by the sufferer can cause small lesions which weep and ooze or become infected resulting in scalp infections.

Lumps bumps and sores are also common when the scalp is highly irritated or sensitivity has been aggravated. Candida can be an underlying cause of yeast infections of the scalp.

Ringworm of the scalp (tinea capitols) is a superficial fungal infection of the scalp. Scalp ringworm is caused by mold-like fungi called dermatophytes. Ringworm infection occurs when a particular type of fungus grows and multiplies anywhere on your skin, scalp, or nails. It is far more common in children and symptoms include red, itchy patches on the scalp, leaving bald areas. The skin might itch and be red and peel or be scaly, have swollen blisters or a rash (that can spread) and looks like black dots. The rash is highly contagious. It is normally treated with over the counter products containing miconazole, clotrimazole, or similar. Sometimes prescription anti fungal skin medications, such as ketoconazole are needed to clear it up. There are also products direct from nature's factories that can aid the healing process and act as natural antibiotics, although it must be said that ringworm is an aggressive fungus which needs to be monitored closely and treated accordingly.

Dry scalp can feel "tight", a sensation that is sometimes accompanied by flakiness. It is often the result of natural oils being stripped from our scalps by the frequent use of shampoos, hair dyes and or other hair products.

Dermatitis of the scalp (Seborrheic dermatitis) is an inflammatory disorder affecting areas of the head and body where sebaceous glands are most prominent. It can vary from mild dandruff to dense flakey and greasy scale. Once again it is often an accumulation of toxins and products built up on our scalps that our body is trying to rid itself of.

Eczema of the scalp similar in appearance to Seborrheic dermatitis but instead has the name Atopic dermatitis.

Scalp Psoriasis commonly occurs on the back of the head however multiple areas of the scalp or the whole scalp may be affected. Scalp psoriasis is characterized by thick silvery white scales on patches of very red skin and can extend slightly beyond the hairline. Scalp psoriasis, despite being partially hidden by the hair is often a source of social embarrassment due to flaking of the scale and severe 'dandruff'. Scalp psoriasis may be extremely itchy or on occasion have no itch symptoms. It can also cause temporary baldness on the affected areas. It is a common, chronic, inflammatory skin disease and is associated with increased risk of melanoma, squamous cell carcinoma, and basal cell carcinoma.

Folliculitis of the scalp is a superficial bacterial infection of the hair follicles. It is characterized by pustules around the hair follicles and symptoms include painful brushing of hair and tenderness when rubbing your scalp around the hair follicle sites. Treating with antibiotics for the particular bacteria is the usual course of action but can eventually cause resistance to the antibiotic used. Options include applying Evoclin Foam which is topical. Folliculitis is commonly caused by staph bacteria which also reside inside the nose and sinus cavity. Natural oils such as tea tree and lavender have good antibacterial properties and can also be used to treat this condition.

If you have a bump or lump under the skin (commonly a lump behind the ears with no broken skin or rash developing, then this could be a cyst. Cysts are liquid filled pustules which can be painful when they become infected. If you have such symptoms I recommend seeing a doctor to be safe. Doctors can also treat cysts with antibiotics if they have become infected or incise them as a further but uncommon procedure if the antibiotics are not sufficient.

Stress Related Itching Stress can contribute to or worsen scalp itching as it plays havoc with our immune system and hormones which have an effect on production of sebum from your sebaceous glands. Although it can contribute to the problem it is still somewhat of a myth. It may appear that you have a"stress rash", but it is more likely that the problem was already there in a less noticeable way, then aggravated by increased stress levels making it harder for your body to deal with the problem on its own and eliminate the problem. Many of the treatments below include stress relieving properties - like Lavender oil for example which calms the mind and soothes the body.

Solutions - what YOU can do about it

Going to your doctor may be the best way to get an accurate answer to diagnosing your problem, but I understand that many of you may have already done this, been prescribed some form of medication of cream (even "heavy duty" cortisone based ones where the cortisone potency may need to be increased after time).

Often the problem either doesn't go away from the start - or seems to subside but comes back with full a vengeance later leaving you wondering with more unanswered questions and a VERY unhappy scalp! Well the good news is if you don't like using these expensive and often impotent products- or even want to help them along you can use natural remedies and essential oils known to be super effective anti-bacterial busters such as tea tree oil for instance to inhibit or stop the growth of the infection and assist healing/re balancing of the scalp.

Something that is also important to understand in curing scalp conditions and scalp infections - a factor that is missed by so many doctors, and something not disclosed by companies who sell hair products and treatments is the number of people who are allergic or sensitive to commonly used ingredients in shampoos, dandruff treatments and other hair products. In fact MOST hair products (as many as 90%) contain at least one ingredient that is used in engine degreasers, another is a common ingredient in antifreeze.

These ingredients are cheap to produce foaming agents that make shampoo foam up, and do a fantastic job of stripping dirt and oily build up from hair. Problem is that they sometimes do SUCH a good job that they remove all of the natural oils and sebum from the scalp thus removing the scalps natural against bacteria etc. Another little known fact is that the most common ingredient (Sodium laureth sulphate) is used to induce skin irritation in test patients by drug companies to test the effectiveness of their itch relief skin creams. When first produced and for year's afterwards manufacturers did not know that skin was not a barrier but an absorber of ingredients & that they caused skin irritation in so many people.

So sometimes the beginning of a scalp condition can have originated from something as simple as an imbalance to the skins (scalps) sebum or an allergy to an ingredient that can easily be rectified.

Like your immune system, if your skin has an opportunity to rebalance itself and not be subjected to "incoming foreign matter" and the daily stripping of its natural oils that further aggravates the problem you can allow your body to re balance and heal itself. Obviously buying products that do not strip your hair and scalp is an obvious step in the right direction.

Fortunately there are a lot of manufacturers such as Aveda and Akin (Purist Company) who know what consumers are suffering from these issues so have addressed this problem. They have applied this knowledge to produce some amazing products with all of the benefits of natural ingredients, with none of the side effects at a price we can afford (Akin especially). It need not be difficult, nor expensive to make these choices and a move to healthy hair and scalp long term.

So yes you can eliminate harsh shampoos containing sodium sulphates and go for natural Sulphate and paraben free shampoos that contain ingredients such as macadamia, wheat germ or jojoba oils. These oils mimic our natural sebum to some extent to help to re moisturize and nourish our scalp.

Then there are lavender, rosemary and tea tree oils which contain antibacterial, healing properties. Neem oil great for its antiquing and stops itching. You can apply these topically to your skin for fast relief, to assist healing as well as looking out for shampoos with these natural ingredients in them.

Lavender calms the skin (as does chamomile tea cooled and used as hair rinse).

As well as buying quality shampoos containing these ingredients, you can

create your own combinations of remedy or remedies to soothe your scalp.

You can also help it along by using natural remedies to treat your scalp such as this scalp treatment containing natural oils to assist healing, detoxify and stimulate hair growth: (Add to

water (4 parts water 1part oil) and spray onto scalp and you can add to your shampoo and conditioners also).

Oils To Relieve Itching: Lavender, German Chamomile and Eucalyptus Oils

(Mixed together and dabbed locally on effected areas has a soothing effect).

Neem oil is also a very good dandruff preventative which can be added to any of the formulas detailed below and is excellent for psoriasis and eczema & scalp infections.

Scalp massage with lavender oil (not scented - the real oil) is another

wonderful way to relieve the tension from a sore scalp as well as treat the

issue. It also helps to re grow hair and repair the damage done to your

follicles by chemicals in shampoos causing thinning hair. (Lavender is known to stimulate hair growth too).

There are many more powerful scalp remedies you can use to treat your scalp as well as many shampoos that are excellent value, contain no nasties to aggravate your scalp and hair follicles. It can be really simple to treat scalp problems by treating yourself to your own pampering session using natural oils to help heal your scalp infection. And then be kind to your hair and scalp by using only products that nourish your hair and scalp such as Aveda or Akin brand shampoos. You can assist the healing process and help restore balance back to your scalp and you hair will appreciate and reward you for it too by becoming less brittle, stronger and shinier.

As with all natural remedies please patch test first. It is not intended for this information to replace a doctors medical advice, so please see your doctor for diagnosis and treatment. The responsibility of obtaining doctors diagnosis and using remedies is yours.


Scalp Infections - Symptoms, Causes & Natural Options For Fast Relief & Treatment


Tree Allergies


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Walgreens, CVS, and Rite Aid - What RE Investors Should Know in 2011

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Walgreens, CVS or Rite-Aid: Which Tenant Is Best in 2011?

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There are 3 major drugstore chains in the US: Walgreens, CVS, and Rite Aid. Below are some key statistics about the 3 major drugstore chains as of July 2010:


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Walgreens
ranks #1 with market cap of .33 Billion, .25 Billion in revenue, and S&P rating of A+. According to Walgreens, 75% US population lives within 3 miles from its stores. On Oct 1, 2009, Walgreens opened its 7000-th store in Brooklyn, New York. In April 2010, it acquired 258 Duane Reade drug stores in New York Metropolitan area.
CVS
ranks #2 with market cap of .09 Billion, .1 Billion in revenue (CVS revenue alone is less than Walgreens if revenue from its Caremark group is taken out), and S&P rating of BBB+. CVS opened its 7000-th store in Little Canada, Minnesota on October 5, 2009 and currently operates 7025 drug stores..
Rite Aid
ranks #3 with market cap of 9 Million, .53 Billion in revenue, 4780 drug stores and S&P rating of B-.





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Investors purchase properties occupied by these drugstore chains for the following reasons:


The drugstore business is very recession-insensitive. People need medicine when they are sick, regardless of the state of the economy. Both rich and poor people in the US have access to medicine. Some even argue that low-income people use more medicine due to free or low-cost drugs offered by government-assisted programs. So the tenants should do well during tough time and have money to pay rent to landlords.
The drugstore business has a good prospect in the US:

People are living longer and need more medicine to sustain longevity, e.g. Actonel for osteoporosis, Aricept for Alzheimer's symptoms. Older people tend to use more medicine than younger ones as they often have more medical problems. As the 78 million baby boomers are getting closer to retiring age starting from 2008, the drugstore chains anticipate the demand for medicine to increase in next 20 years.
The drug market continues to expand as the US population will continue to grow. More and more Americans suffer from various diseases. The number of Americans suffers from seasonal allergies doubled in the last 15 years to 37 million people per Fortune magazine. They spent .4 Billion in 2009 for allergy drugs. As their waist lines balloon (75% of Americans are forecasted to be either overweight or obese by 2020), more Americans are diagnosed with diabetes, high cholesterol at younger and younger ages. In addition, doctors also recommend treating various diseases sooner than later due to better understanding about the diseases. For example, doctors now prescribe antiretroviral drugs for patients soon after infected with HIV virus instead of waiting for the infection to become AIDS. More doctors combine insulin with oral medicines to treat type-2 Diabetes instead of just oral medicines alone. All these factors increase the size of the drug market.
Advance in genetic engineering has introduced various new genetic DNA testing kits which allow the genetic diagnosis of vulnerabilities to inherited diseases and disorders. Genetic testing is currently the highest growth segment in the diagnostics industry. Some of these genetic tests will probably transform into direct-to-consumer testing kits available in drug stores in the near future. Upon FDA approval, these new products will potentially bring in additional revenue for drug stores.
The passage of Health Care Reform Bill on March 23, 2010 provides insurance coverage to an estimated 33 million more American. This is a major present to the drugstore industry.
There are new drugs to treat previously untreatable illnesses, and new diseases, e.g. Viagra for men's unhappiness, Zoloft for depression, Avastin for colon cancer, Herceptin for breast cancer, Nicotine patches for smokers to kick the habit, Tamiflu for a potential bird flu pandemic, vaccine for swine (H1N1) flu pandemic, Tekturna/Rasilez for hypertension and various new drugs for AIDS and Attention Deficit Disorder (ADD). The new medicines are very expensive, e.g. a year's supply of Avastin costs about ,000. Eli Lilly has sold about .8 billion of Zyprexa in 2007 for schizophrenia and yet most people have never heard of this medicine.
There are existing drugs now approved to treat new illnesses and thus increase their sales revenue. For example, Lyrica was originally intended to treat pain caused by nerve damage in people with diabetes. It is now approved by FDA to treat Fibromyalgia which affects 5.8 million Americans per WebMD.
Big advances in genetics, biology and stem cells research are expected to produce a new class of drugs to treat diabetes, Parkinson's and various rare genetic disorders. For example the new drug Ilaris from Novartis targets genetic causes of an inherited disorder that there are only 7000 known cases worldwide. However, Novartis hopes to gradually broaden its drugs to a blockbuster drug to more common disorders caused by similar genetics.
Technology and modern life introduce and require new products, e.g. pregnancy test kits, Lamisil for stronger clearer toe nails, Latisse for longer & thicker eyelashes, Premarin for menopausal symptoms, diabetic monitors, electronic toothbrushes, contact lenses, lenses cleaners, diet pills, vitamins, birth-control pills, IUDs, nutrition supplements and Cholesterol-lowering pills (Americans spent nearly B in 2006 on Cholesterol medications alone per IMS Health, a Connecticut-based consulting company that monitors pharmaceutical sales.) There are also more surgeries: C-sections, Kidney transplants, open-heart triple by-pass, and breast augmentations. More surgeries mean more medicines are needed such as Vicodin for pain management and Warfarin to prevent blood clots in surgeries.
Before the customers can get to the medicine aisles or pharmacy counters, they have to pass by chocolates, sodas, digital cameras, watches, toys, dolls, beers and wines, cosmetics, video games, flowers, fragrances, and greeting cards. Drug stores hope you use the one-hour photos services and exchange your liquid propane tanks there. The stores also carry seasonal items, e.g. Halloween costumes, and "As Seen on TV" merchandise, e.g. Shamwow. As a result, customers buy more than their prescriptions and medicine in these drugstores. Rite Aid sells more 28,000 non-pharmacy items in its stores while Walgreens has 22,000 different items on store shelves. CVS reported that non-pharmacy sales represented 30% of the company's total sales in January of 2007. The figure for Walgreens is 34% and 37% for Rite Aid. Many pharmacy locations are in effect convenience stores especially ones that are in residential or rural areas. And so Walgreens hopes that customers also pick up WD-44, and screw drivers at its stores instead of at Home Depot; Thai Jasmine rice, and fish sauce to avoid a trip to Safeway or Kroger Supermarkets. During the recession, sales of these non-drug items are down as customers buy what they need and not what they want. Walgreens tries to reduce the number of items by 4000. It also introduces its own private label which has higher profit margins.
There are more and more generic medications on the market as a number of enormously popular brand-name blockbusters will lose their 20-year long patents, e.g. Lipitor (best selling drug in the world to lower cholesterol) in 2010, Viagra (you know what it's for) in 2012. Drugstores prefer to sell generic drugs to customers due to higher profit margins than the brand-name medications.
Some people are addicted to pain killers, e.g. Hydrocodone and consume a large amount of medicine, e.g. 30-day dosage in a day to get high. According to testimony from the National Institute on Drug Abuse, US retail pharmacies dispensed nearly 180 million prescriptions in 2007 for opiates, e.g. Hydrocodone. A high percentage of these prescriptions are probably not used for any legitimate medical purposes.
This author estimates that at least 10% of the dispensed prescription drugs are not used at all and sit idle in the medicine cabinets. They are eventually expired and thrown away.


These companies sign very long-term, NNN leases, guaranteed by their corporate assets. This makes the investment in the underlying property fairly low risk, especially for Walgreens with an A+ S&P rating. In fact, these properties are sometimes referred to as investment-grade properties. Once the drugstore chains sign the lease, they pay the rent promptly and timely. This author is not aware of any properties leased by one of these drugstore chains in which the tenants failed to pay rents. Even when the stores are closed due to weak sales (Walgreens closed 119 stores in 2007), these companies may sublease the properties to other companies and continue to pay rents on the master leases.

A typical Walgreens lease consists of 20-25 year primary term plus 8-10 five-year options. During primary term and options, there will be no rent increases in most of the leases. This is the main disadvantage of investing in Walgreens drugstores.
A typical CVS lease consists of 20-25 year primary term plus 4-5 five-year options. The rent is normally flat during the primary term and then there is a 2.5%-10% rent increase in the in each 5-year option.
A typical Rite Aid lease consists of 20-25 year primary term plus 4-8 five-year options. The lease often has a rent increase every 5-10 years.


Investment Risks: Although the pharmacy business in general is recession-insensitive, there are risks involved in your investment:


The main downside about investing in pharmacies is there is little or no rent bump for a long time, e.g. 20-50 years, especially for Walgreens. So the rent is effectively reduced after inflation is factored in. This is one of the main reasons these properties do not appeal to younger investors.
The 3 drugstore chains now have a new formidable competitor, Wal-mart. Wal-mart sells prescription drugs in more than 4000 Wal-mart, Sam's Club and Neighborhood Market stores in 49 states. The retail giant is known for launching in 2006 a highly-publicized generic prescription drug program which now sells 350 generic medications for a 30-day supply. The actual number of medications is less as the medications with different strengths are counted as different medications. For example, Metformin 500 mg, 850 mg, and 1000 mg are counted as 3 medications. Wal-mart probably makes very little profits on these medications if any. However, the marketing campaign--created by Bill Simon, the President and CEO of Wal-mart US, generates a lot of publicity for Wal-mart. Wal-mart hopes to draw customers to its stores with other prescriptions where it has higher profit margins. In an unscientific survey with just one brand-name prescription of Lyrica, this author finds the lowest price at Costco, the highest price at Walgreens and Wal-mart at the middle. Other drug chains try to counter Wal-mart in different ways. Target now offers the same 350 generic medications for for a 30-day supply. Walgreens has a Prescription drugs club with membership fee which offers 1400 generic medications for as little as /week. CVS says it will match any offers from its competitors.
Chief Business Correspondent Rick Newman from US World & News Report predicted that Rite Aid might not survive in 2009. While Rite Aid is still around in 2010, dire predictions continue. The study by Audit Integrity gave Rite Aid about a 10.5 percent chance of filing for bankruptcy in 2010.
Drugs are also sold in thousands of supermarkets, Target stores, and Costco warehouses. However, there are no drive-thru windows at these stores or Walmart to conveniently drop off the prescriptions and pick up medicines. Customers will not be able to pick up their prescriptions during lunch hour or after 7PM at Target stores or supermarkets. They need to have membership to buy medicines at Costco. Others may not fill their prescriptions at Walmart because they don't want to mingle with typical Walmart customers who are in lower income brackets. And some babyboomers don't want their prescriptions filled at Target or Walmart because there are no comfortable chairs for them to sit down to wait for their medicines.
Many leases in areas with hurricanes and tornados are NNN leases with the exception of roof and structure. So if the roof is damaged, you will have to pay for the expenses.
The tenant may move to a new location down the road or across the street when the lease expires. This risk is high when the property is located in small town where there is low barrier for entry, i.e. lots of vacant & developable land.
The tenant may ask for rent concession to improve its bottom line. The possibility is higher if the tenant is Rite Aid and if the store has low sales revenue and/or higher than market rent.
More Americans are walking away from their prescriptions, especially the most expensive brand-name medicines. This may have negative impact on the sales revenue and profits of drug stores and consequently may cause drug store closures. According to Wolters Kluwer Pharma Solution, a health-care data company, nearly 1 in 10 new prescriptions for brand-name drugs were abandoned by people with commercial health plans in 2010. This is up 88% compared to 4 years ago just before the recession began. This trend is driven in part by higher and higher co-pays for brand name drugs as employers are shifting more insurance costs to their employees.

Among 3 drugstore chains, Walgreens and CVS pharmacies in general have the best locations-at major intersections while Rite Aid has less than premium locations. Walgreens tends to hire only the top graduates from pharmacy schools while Rite Aid settles with bottom graduates to save costs. When possible all drugstore chains try to fill the prescriptions with generic medications which have higher profit margins

Walgreens: the company was founded in 1901 by Charles Walgreen, Sr. in Chicago. While the company has existed for more than 100 years, most stores are only 5-10 years old. This is the best managed company among the three drugstore chains and also among the most admired public companies in the US. The company has been run by executives with proven track records and hires the top graduates from universities. Due to its superior financial strength--S&P A+ rating-- and premium irreplaceable locations, properties with leases from Walgreens get the highest price per square foot and/or the lowest cap rate among the 3 drugstore chains. In addition, Walgreens gets flat rent or very low rent increase for 20 to 60 years. The cap rate is often in the low 6% to 7.5% range in 2009. Investors who buy Walgreens tend to be more mature, i.e. closer to retirement age. They are looking for a safe investment where it's more important to get the rent check than to get appreciation. They often compare the returns on their Walgreens investment with the lower returns from US treasury bonds or Certificate of Deposits from banks. Walgreens opened many new stores in 2008 and 2009 and thus you see many new Walgreens stores for sale. It will slow down this expansion in 2010 and focus on renovation of existing stores instead

CVS: CVS Corporation was founded in 1963 in Lowell, MA by Stanley Goldstein, Sidney Goldstein, and Ralph Hoagland. The name CVS stands for "Consumer Value Stores". As of 2009, CVS has about 6300 stores in the US, mostly through acquisitions. In 2004, CVS bought 1,200 Eckerd Drugstores mostly in Texas and Florida. In 2006, CVS bought 700 Savon and Osco drugstores mostly in Southern California. And in 2008 CVS acquired 521 Longs Drugs stores in California, Hawaii, Nevada and Arizona for .9B dollars. The acquisition of Long Drugs appears to be a good one as it CVS does not have any stores in Northern CA and Arizona. Besides, the price also included real estate. It is also bought Caremark, the largest pharmaceutical services company and changed the corporation name to CVS Caremark. When CVS bought 1,200 Eckerd stores, it formed a single-entity LLC (Limited Liability Company) to own each Eckerd store. Each LLC signs the lease with the property owner. In the event of a default, the owner can only legally go after the assets of the LLC and not from any other CVS-owned assets. Although the owner loses the guaranty security from CVS corporate assets, this author is not aware of any incident where CVS closes a store and does not pay rent.

Rite-Aid: Rite Aid was founded by Alex Grass (he just passed away on Aug 27, 2009 at the age of 82) and opened its first store in 1962 as "Thrif D Discount Center" in Scranton, Pennsylvania. It officially incorporated as Rite Aid Corporation and went public in 1968. By the time Alex Grass stepped down as the company's chairman and chief executive officer in 1995, Rite Aid was the nation's largest drugstore chain in terms of total stores and No. 2 in terms of revenue. His son, Martin Grass, took over but was ousted in 1999 for overstatement of Rite Aid's earnings in the late 1990s. Rite Aid is now the weakest financially among the 3 drugstore chains. In 2007, Rite-Aid acquired about 1,850 Brooks and Eckerd drugstores, mostly along the East coast to catch up with Walgreens and CVS. In the process, it added a huge long term debt (currently owes over .69 Billion) and is the most leveraged drugstore chain based on its market value. The integration of Brooks and Eckerd did not seem to go well. Revenue from some of these stores went down as much as 20% after they change the sign to Rite Aid. In 2009, Rite-Aid had over 4900 stores and over Billion in revenues. The figures went down in 2010 to 4780 stores and .53 billion in revenue. On January 21, 2009 Moody's Investor Services downgraded Rite Aid from "Caa1" to "Caa2", eight notches below investment grade. Both ratings are "junk" which indicate very high credit risk. Rite Aid contacted a number of its landlords in 2009 trying to get rent concession to improve the bottom line. In June 2009, Rite Aid successfully completed refinancing .9 Billion of its debts. However, it continues to struggle in 2010 as same store sales decreased 2.5% in June, 1.7% in May, 1% in April,.1% in March, 3.2% in February, and 2.1% in January..

Things to consider when invested in a pharmacy

If you are interested in investing in a property leased by drugstore chains, here are a few things you should consider:


If you want a low risk investment, go with Walgreens. In stable or growing areas, the degree of safety is the same whether the property is in California where you get a 6% cap or Texas where you may get a 7.5% cap. So, there is no significant advantage to invest in properties in California as the property value is based primarily on the cap rate. In 2010, the offered cap rate for Walgreens seems to come down from 7.5%-8.4% in 2009 to 6.5%-7.5% for new stores.
If you are willing to take more risk, then go with Rite-Aid. Some properties outside of California may offer up to 10% cap rate in 2010. However, among the 3 drug chains, Rite Aid has 10.5% chance of going under in 2010. Should it declare bankruptcy, Rite Aid has the option to pick and choose which locations to keep open and which locations to terminate the lease. To minimize the risk that the store is shuttered, choose a location with strong sales and low rent to revenue ratio.
Financing should be an important consideration. While the cap rate is lower for Walgreens than Rite Aid, you will be able to get the best rates and terms for Walgreens. A 7.25% cap Walgreens with 5.25% interest rate on the loan will generate more cash flow than a 10% cap Rite Aid with 9% interest rate (if you could find a lender for Rite Aid).
If you are not a conservative investor or risk taker, you may want to consider a CVS pharmacy. It has BBB+ S&P credit rating. Its cap rate is higher than Walgreens but lower than Rite Aid. Some leases may offer better rent bumps. On the other hand, some CVS leases, especially for properties in hurricane areas, e.g. Florida are not truly NNN leases where landlords are responsible for the roof and structure. So make sure you adjust the cap rate down accordingly. Some of the CVS locations have onsite Minuteclinic staffed by registered nurses. Since this clinic idea was introduced recently, it's not clear having a clinic inside CVS is a plus or minus to the bottom line of the store.
All 3 drugstore chains have similar requirements. They all want highly visible, standalone, rectangular property around 10,000 - 14,500 SF on a 1.5 - 2 acre lot, preferably at a corner with about 75 - 80 parking spaces in a growing and high traffic location. They all require the property to have a drive-thru. Hence, you should avoid purchasing an inline property, i.e. not standalone and property with no drive-thru windows. There is a chance that these drugstores may not want to renew the lease unless the property is located in a densely-populated area with no vacant land nearby. In addition, if you acquire a property that does not meet the new requirements, for example a drive-thru, you may have a problem getting financing as lenders are aware of these requirements.
If the pharmacy is opened 24 hours a day, it is in a better location. Drugstore chains do not open the store 24 hours day unless the location draws customers.
Many properties may have a percentage lease, i.e. the landlord can get additional rent when the store's annual revenue exceeds a certain figure, e.g. M. However, the revenue used to compute percentage rent often excludes a page-long list of items, e.g. wine and sodas, tobacco products, items sold after 10 PM, drugs paid by governmental programs. The excluded sales revenue could account for as much as 70% of store's gross revenue. As a result, this author has seen only 2 stores in which the landlord is able to collect additional percentage rent. The store with a percentage rent is required to report its monthly sales to the landlord. As an investors, you want to invest in a store with strong gross sales, e.g. over 0 per square foot a year. In addition, you also want to check the rent to revenue ratio. If the figure is in the 2-4% range, the store is likely to be very profitable so the chance the store is shut down is low.
It does not matter how good the tenants are, avoid investing in declining and/or low-income areas or small towns with less than 30,000 residents within 5 miles ring. In a small town, it may be the only drug store in town and captures most of the market share. However, if a competitor opens a new location in the area, revenue may be severely affected. These properties are easy to buy now and hard to sell later. In 2009 where the credit market is tight, you may have problems finding a lender to finance these properties.
Many properties have an existing loan that the buyer must assume. If you have a 1031 exchange, think twice about buying this property. You should clearly understand loan assumption requirements of the lenders before moving forward. Should you fail to assume the existing loan (assuming an existing loan is a lot more difficult than getting a new loan), you may run out of time for a 1031 exchange and may be liable to pay capital gain.
With few exceptions, drugstore chains do not own the stores they occupy for several reasons. Here are just a couple of them:

They know the pharmacy business but don't know real estate. Stock investors also don't want Walgreens to become a real estate investment company.
Owning the real estate will require them to carry lots of long term debts which is not a brilliant idea for a publicly-traded company.


About 10% of the drugstore properties for sale and typically CVS pharmacies require very small amount of equity to acquire, e.g. 10% of the purchase price. However, you are required to assume an existing fully-amortized loan with zero cash flow. That is, all of the rent paid by the tenant must be used to pay down the loan. The cap rate may be in the 7% range, and the interest rate on the loan could be attractive in the 5.5% to 6% range. Hence, the investor pays off the loan in 10 to 20 years. However, the investor has no positive cash flow. This requires you to come up with outside cash to pay income tax on the rental profits (the difference between the rent and mortgage interest). The longer you own the property, the more outside cash you will need to pay income taxes as the mortgage interest will get less and less toward the end. So who would buy this kind of property?

The investors who have substantial losses from other properties. By acquiring this zero cash flow property, they may offset the income from the drugstore tenant against the losses from other investment properties. For example, a property has 5,000 of rental profits a year, and the investor also has losses of 0,000 from other investment properties. As a result, the combined taxable profits are only ,000.
The uninformed investors who fail to consider that they have to raise additional cash to pay income taxes.


Out of the Box Thinking If you put too much weigh on the S&P rating of the tenants, you may end up either taking a lot of risks or passing up good opportunities.


Good location should be the key in your decision on which drug store to invest in. It's often said a lousy business should do well at a great location while the best tenant will fail at a lousy location. A Walgreens store that is closed down later on (yes, Walgreens closed 119 stores in 2007) is still a bad investment even though Walgreens continues paying rent on time. So you don't want to blindly invest in a drug store simply because it hasa Walgreens sign on the building.
No company is crazy enough to close a profitable location. It does not take a rocket scientist to understand that a financially-weak company like Rite Aid will make every effort to keep a profitable location open. On the other hand, a financially-strong Walgreens will need justifications to keep an unprofitable location open. So how do you determine if a drug store location is profitable or not if the tenant is not required to disclose its profit & loss statement? The answer is you cannot. However, you can make an educated guess based on store's annual gross revenue is often reported to the landlord as required by the percentage clause in the lease. With the gross revenue, you can determine the rent to income ratio. The lower the ratio, the more likely the store is profitable. For example, if the annual base rent is 0,000 while the store's gross revenue is M then the rent to income ratio is 5%. As a rule of thumb, it's hard to make a profit if this ratio is more than 8%. So if you see a Rite Aid with 3% rent to income ratio then you know it's likely a very profitable location. In the event Rite Aid declares bankruptcy, it will keep this location open and continue paying rent. If you see a Rite Aid drug store with 3% rent to income ratio offering 11% cap, chances are it's a low risk investment with good returns. The weakness of corporate guaranty from Rite Aid is probably not as critical and the risk of having Rite Aid as a tenant is not really that significant.
Drug stores with new 25 years leases tend to sell at lower cap, e.g. 7-7.5% cap on new stores versus 8.0-8.5% cap on established locations with 8-10 years remaining on the lease. This is because investors are afraid that the tenants may not renew the leases. Unfortunately, lenders also have the same fear! As a result many lenders will not finance drug stores with 2-3 years left on the leases. The fact that drugstores with new leases have a premium on the price means they have potential of 10% depreciation (buying new at 7.3% cap and selling at 8.3% cap when the leases have 10 year left). Some investors will not consider investing in drug stores with 5-10 years left on the lease. They might simply ignore the fact that the established stores may be at irreplaceable locations with very strong sales. Tenants simply have no other choices other than renewing the lease.


Walgreens, CVS, and Rite Aid - What RE Investors Should Know in 2011


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Douching With Tea Tree Oil for the Vaginal Yeast Infections

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A friend asked me if my yeast infections are also there almost 100% of the time. She just feels as though she is the only person that has gone through this, but it is a relief to know she is not alone. She also asked two questions:

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1) How long should you douche with Tea Tree Oil?

2) Is there a specific allergy test to refer to?


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Well, I had the infection 100% all the time and it was so stressful! The other thing I have to mention is that you may want to be tested for diabetes and hypoglycemia. Chronic yeast infections can also be a sign of blood sugar problems, which candida can help cause, too. It is especially if blood sugar problems run in your family like mine.


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Regarding the tea tree oil, personally I was using it once or twice a week for about a month. You might want to ask a naturopath what would be right for you. I also bought the depositories at the health food store, and that seemed to help as well.

As far as the allergy test, the one I took was the sage test, but I think there are other tests you can do. You could do it naturally on your own, but it would take tons of time and planning. The test I took tests 50-100 common foods and it tests for delayed reaction, meaning that you find what could be a problem a few hours to a day later which is harder to detect. I was blown away to find out I was allergic to Spinach! There were some other good ones to know. When I stopped eating them, the yeast pretty much stopped. I find it funny that the yeast is now my indicator for when I am eating something bad my body will be saying "no way!"


Douching With Tea Tree Oil for the Vaginal Yeast Infections


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Dog Ear Infections

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Show the same care and love yourself for your children. Aware of signs that can prevent ear infections in dogs, and treat it as if the animal was infected. A dog ear infection can be frustrating and painful. Have your dog examined by a veterinarian to determine the drug or treatment.

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Most infections are harder to get rid of her.


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Your veterinarian must ensure that the eardrum is not damaged, certain medications can causeHearing loss, when a pet with a perforated ear drum since. Obtain a sample of the material in the channel for microscopic examination by the veterinarian in charge of determining the causative agent of infectious diseases carried. If there are more bacteria and broad-spectrum antibiotics may be needed to make visits to your vet to make sure the treatment is effective and are better. With proper diagnosis and treatment of ear infections your dog can be cured.





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Dog Ear Infectionsbe caused by several things. Wet ears not dried after swimming or bathing, the development of ear wax, grass seeds and walk fox tail brush, ear mites, untreated cotton-tipped ears and to clean false growths in the ear canal all lead to an infection. However, if the dog ear infections, an underlying problem, such as poor diet, allergies or thyroid disease, the cause.

You need to be verified.

If the dog is excited,Scratching the ears, rubbing them, if the ears look bloody, waxy or swollen, if a foul odor from the ear, or if your dog cries when his ears are affected contractions, and they are all signs of infection of the ear dog. Keep your pet's head as still as possible and then to the side or down and shook his head and mouth open. Dogs can become dizzy, with poor balance and coordination, as the infection progresses to the inner ear. Dogs can run in circles, and vomiting.

Dogs are not treatedEar infections progress deeper into the ear of the dog. Otitis media usually results in the spread of infections of the ear canal of the middle ear. Otitis media can be difficult to solve, with weeks passing before the infection disappears. Limit the activity of your pet may need.

The causes of ear infection in dogs include bacteria, yeast ear infections cause redness, swelling, discharge and odor.

The dog's ears are particularly vulnerable becausestructure. Dogs with floppy ears get less air circulation in the sun, and have more problems than dogs whose ears stand up. Yeast loves dark, damp areas. The fresh air and sunlight are enemies of the yeast.

The internal structure of the ear of a dog can be included water, will keep everything inside the ear so much more humid. Dogs must be avoided in the best position to recover and yeast ear infections if their immune system is healthy. Dogs are more unhealthysusceptible to infection or infestation of their healthy counterparts. A healthy diet greatly increases the immunity of your dog.

Dust mites are very contagious, so the transfer between organisms, including humans can.

Otodectes cynotis known better known as ear mites, visible to the control of small parasitic creatures that live in your dog's ears or more at any point in the series has caused severe itching of the body, inflammation andInfection.

Treatment includes medications and products used for flea control. For serious infestations in multi-animal households, insecticides are sometimes used to treat the environment.

A concern for dogs that are professionally prepared is the practice of tearing the hair of the dog's ear. The serum is then expelled through the pores is a breeding ground for bacteria, a common cause of ear infection. Veterinarians generally discourage plucking the ears of the dog.

UsuallyTreatment of drug delivery dog ​​ear infections and ear cleaning day for 1-2 weeks. Remember, your pets ears are painful, uncomfortable and, probably, slowly and carefully. Ask if you do not know how to clean.

Allergies can play a role in inflammation and subsequent infection of the dog's ears, especially atopic dermatitis, food hypersensitivity and dogs (allergic dermatitis). Dogs with these conditions often develop inflamed ears. The ears are itchyCreating a cycle "itch-scratch-itch" that causes scabs around the ear, hair loss, brittle, rough skin and a brown wax in the ear canals.

Familiarize yourself with your dog's ears so that you notice signs of an early warning of infection.

Avoid dog ear infections by practicing prevention - particularly important for animals with floppy ears, a lot of hair in the ears, allergies or other health issues that dogs make them susceptible to ear infections. A weekly cleaning earswith an approved cleaning solution may reduce or prevent ear infections in dogs.


Dog Ear Infections


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