Please upgrade to the latest version of Flash Player.

Archive for the ‘Skin Health’ Category

An Even Tan Only Comes Without the Sun! Notes from a San Francisco Bay Area Dermatologist

Wednesday, August 11th, 2010

To help answer the question of why different types of skin cancer tend to occur in different parts of the body given they all are caused by UV exposure, researchers at the University of Edinburgh recently conducted a “tanning” study published in the Journal of Experimental Dermatology.

The study exposed the backs and buttocks of 100 volunteers to six doses of UVB rays.  A week later their skin was analyzed, revealing that the buttock area remained lighter in color and was much more resistant to tanning than the back area, despite the same level of UVB exposure.  In the UK’s Telegraph, Professor Jonathan Rees (Unviersity of Edinburgh) reported the reason being that the skin on bottoms is thicker than other areas of the body.  Part of the defense mechanism of a tan is to thicken the skin in a given area to protect its lower layers from UV damage.  Areas where the skin is already thick, like our bottoms, is less likely to tan as a defensive response to UV exposure.

What is the take home message?  If you are seeking an even, all-over tan, then you are chasing an impossibility.  The skin is not physically able to tan in this way and this study is simply more evidence to discourage tanning through UV exposure at all!  The still safest and most effective way to get an even tan is through topical tanning products like lotions, tan towels and shower bars.

 

Still Tanning Despite the Risks? Notes from a San Francisco Bay Area Dermatologist

Sunday, July 18th, 2010

Excessive sun exposure and tanning bed use increases the risk of getting melanoma, basal cell cancer and other non-melanoma cancers.  We have several patients who, despite having been treated for serious skin cancer, continue to tan.  Why?  Well, it turns out that they may suffer from a tanning addiction.  They suffer uncomfortable physical and mental symptoms when they try to stop.  Many repeat tanners exhibit addictive behaviors similar to those exhibited by people addicted to substances such as meth and alcohol.  In a recent study (Arch Dermatol 2010 Apr;146:412) 70% of study participants who visited tanning parlors met criteria for addiction to indoor tanning.  Study participants who met criteria for addiction also had greater anxiety and greater alcohol and marijuana use.  Tanning addiction seems to involve the same drives as other  forms of substance related  disorders.  Of course , it is important to distinguish addicted from non-addicted tanners.  It is hoped that lessons learned from treating other addictions can be translated into concrete interventions to reduce risky tanning behavior.

 

Do Sunscreens Cause Cancer? Are they safe? Notes from a San Francisco Bay Area Dermatologist

Tuesday, July 13th, 2010

The latest question on patients’ minds this summer is the safety of sunscreen.  A few websites have posted articles scaring people into questioning whether or not they should use sunscreen.  The bottom line is that sunscreens protect us from skin cancer and here’s why:

What do we know?

Numerous studies have looked at this issue, and none have confirmed any link between sunscreens and skin cancer. Some researchers have speculated that since sunscreens allow users to stay out in the sun longer they may increase the risk of skin cancer.  There have also been worries about physical sunblocks zinc oxide and titanium dioxide nanoparticles (micronized).  The worry is that these may pose a danger if inhaled or absorbed through the skin.  A large National Institutes of Health (NIH) funded study found minimal skin absorption of titanium nanoparticles and this has been confirmed by other studies.  It is possible that inhaled nanoparticles may be risky.  So if you use a spray sunscreen keep it away from your face (spray on your hand and rub in) or hold your breath when you spray.

We do know that the sunscreens help prevent skin growths called actinic keratoses.  These are rough scaly patches that can develop into squamous cell cancer.  There  is less evidence that sunscreens protect against melanoma and basal cell cancer.  This may be because these two cancers are strongly linked to sunburn.  Your risk of melanoma doubles if you have had five or more sunburns at any  age or from just one blistering sunburn before the age of 20.  Basal cell cancer seems also to be linked to  the  amount of freckling and number of burns.  In other words excessive sun exposure definitely causes cancer!!

Given that we know the sun can cause cancer and the evidence is nonexistent that sunscreens cause cancer common sense should prevail. Use sunscreen!

Are sunscreens safe for the environment?

Unfortunately sunscreens are bad for the ocean environment!  They come off in the water and settle down to the coral reefs blocking vital UV radiation. What can you do?  I am a huge proponent of  light weight wetsuits and  UV protective rash guards used for surfing.  I always wear one when I snorkel or windsurf. It is easier to put one of these on your kids and yourself than to deal with suncreening your whole body and reapplication after swimming.  They come in cute colors and styles and are widely available.  You can bolster their UV blocking abilities by washing with SunGuard or a similar product.  They claim they are effective up to 20 washing  cycles or swimming dips!  Apply your sunscreen to your face and hands and cover up  the rest with UV protective clothing!! You save your skin and the ocean!

 

Ugh…is that a Wart? Notes from a San Francisco Bay Area Dermatologist

Wednesday, June 16th, 2010

What’s the deal with warts?  How did I get them and how do I get rid of them?

Questions that I often hear as a dermatologist about one of the most common skin nuisances.

To help keep from catching them or spreading them to others or to other places on your own skin, its important to know the basics.

Common warts seen on the hands and fingers are caused by certain strains of the human papillomavirus (HPV).   These strains are different from the ones that cause potentially serious diseases like cancer of the cervix.  In fact, different strains of HPV even cause different kinds of warts like plantar warts on the feet or smaller, flat warts seen on the face and legs.  With common warts, the virus causes rapid growth of cells on the outer layer of the skin resulting in flesh colored bumps with small black dots in them, which are actually clotted blood vessels.  Warts can eventually go away on their own (sometimes over a 2 year period), but to keep them from spreading, most people try to remove them with over the counter measures or with their doctor.  Warts are harmless, but people find them embarrassing and cosmetically annoying.

Like most viruses, warts spread through person to person contact or by person to object contact (like if you touch something a person with a wart has touched).  A wart may not actually develop until 2 to 6 months after exposure.  Depending on your immune system, you may be exposed to the virus, yet never develop a wart or you may have them as a kid and never develop them again as an adult.  I often joke with my patients that having a wart as adult is a sign of youth, as they are seen most often in children and young adults.  If you already have warts, keep in mind that they can spread through breaks in your skin, so don’t bite your nails or pick around your cuticles, especially after touching the wart!

At home treatments usually include salicylic acid medications or patches, which help peel away the affected layers of skin.  These work best if you can file down the top layers, then apply the medication.  I will often give patients a scalpel to help pare down the skin before using the patches to treat the wart in between visits.  Another at home treatment some patients try is duct tape.  They cover the wart for six days then remove the tape and file down the skin, then repeat the process until the wart dies.  While there is no real scientific evidence that duct tape works, some people give it a whirl.

At a doctor or dermatologist’s office, they may try freezing the wart with liquid nitrogen, which can be uncomfortable.  It causes a blister and the dead cells slough off after it has healed.  Injections of an antigen to stimulate your body’s natural immune process or laser may also be used for more stubborn warts.

If you have a wart, do not pick at it, bite it or shave over it as it may generate new warts nearby.  Do not use any accessory, like a nail file, on the wart and then on other areas.  Make sure to always wash your hands in general and especially after touching any wart.  Keep your hands as dry as possible - warts like a moist environment.  Wear footwear in public places like showers and locker rooms.

And most importantly, don’t despair.  Warts can be stubborn and some may seem like they are not responding to treatment or are taking a long time to go away.  Be persistent and consistent with treatment to get results.

 

Tanning - A New Addiction: Notes from a San Francisco Bay Area Dermatologist

Tuesday, June 1st, 2010

There is no question that exposure to high levels of ultraviolet rays cause skin cancer, not to mention premature aging and pigmentation issues of the skin.  Despite this fact, however, tanning salons and outdoor sun tanning still remain popular, especially among young adults.  So what keeps people returning to those booths and baking on their beach towels when they know the indisputable risks?

Well, Mosher and Danoff-Burg propose that habitual indoor tanning may, in some cases, be best characterized as an addiction with behavioral and physiologic dependency.  Roughly one third of the college students who took screening tests (one that is commonly used to screen for alcoholism and a tanning-specific substance related disorder test) met criteria for addiction to ultraviolet tanning. This subgroup also showed a greater tendency for substance abuse and anxiety, suggesting that habitual tanning may be a predictor of other addictive behaviors, such as alcoholism and cigarette smoking.

Looking at tanning with this mindset and identifying patients who show signs of addiction toward tanning will hopefully give the medical community a new way to approach this topic with their patients and help them avoid this risky behavior before they encounter potentially life threatening conditions like melanoma.

If it is simply the “tan look” that people seek, tanning alternatives continue to improve and are a great way to get a glow without any risk.  Our staff and patients are currently loving the products by TanTowel.  The self-tanning towelettes are easy to use, with a simple swipe on action.  Streaks and discolorations are easily avoidable with the towelette.  They also have a great self-tanning soap that is used conveniently in the shower to supplement your towelettes or to achieve a more gradual glow.  The towelettes and soap along with their self-tanning lotion give the most natural looking color that I have found among sunless tanning products.  Check with our office today for more information on the Tan Towel products and to give yourself a summer glow without the harmful UV rays!

 

Skin Cancer Awareness Month: Notes from a San Francisco Bay Area Dermatologist

Wednesday, May 5th, 2010

Welcome, May!  One of my favorite months because the campaign to encourage people to get skin checks and think about their summer sun protection plans is in full force.  Keep these tips in mind for the months approaching and, of course, all year round too!

  • Seek the shade, especially between 10 A.M. and 4 P.M.
  • Do not burn.
  • Avoid tanning and UV tanning booths.
  • Use a sunscreen with an SPF of 30 or higher every day.
  • Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours.
  • Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
  • Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
  • Examine your skin head-to-toe every month.
  • See your physician every year for a professional skin exam.

And remember, if you notice any moles, freckles or red spots that are new, have recently changed or catch your eye as being unusual, do not delay in seeking medical evaluation.

 

Keep Your Makeup Fresh! Notes from a San Francisco Bay Area Dermatologist

Sunday, April 11th, 2010

Most people do some sort of “spring cleaning” around this time of year with the clothes in their closet, but what we often forget to sort through is our makeup drawer.  Facing all those old lipsticks, eyeshadows and blushes of disappointments past can easily make you want to keep that drawer shut.  Now is the time however to get rid of the old and bring in some new, especially because makeup can harbor bacteria and become spoiled even before its expiration date, especially if not properly handled and stored.

Here are some guidelines to help you get started on lightening your load and keeping your skin and makeup more healthy.

Mascara:  Mascara should be discarded after 3 or 4 months, even if the tube is not empty.  It is a favorite home of bacteria.  Also, just twist the brush in the tube to wet the applicator.  Pumping the wand only dries out the mascara more quickly.

Eyeshadow:  Powder eyeshadows can last up to three years if not exposed to moisture - like using water or spit to double its use as an eye  liner.  Better to purchase a thin, flat brush for this purpose and use it dry instead.

Eye Liner:  Can also last up to three years, but should be sharpened after each use.

Lip Liner:  Also can last up to three years if sharpened regularly.

Blush:  Six months.

Concealer:  Up to one year.

Powder:  Pressed powders can last up to two years.

Foundation:  Water based foundations are good for up to one year, whereas oil-based up to a year and a half.  Also, use applicators like makeup sponges to apply instead of your fingers.

Lipstick:  I generally hold onto lipstick for one to two years.  After that the color can sometimes change and bacteria tends to grow.  If the lipstick has a funny smell throw it out!

Brushes:  Wash your brushes every couple of months or whenever they become saturated.  Use a mild shampoo or makeup brush cleanser, rinse, squeeze out excess moisture, reshape and allow to dry overnight before use.  Not only will your this extend the life of your brushes, but your makeup will go on better and colors will stay true as you won’t mix shades.

Liner Sharpeners:  Wiping it down with rubbing alcohol or leaving it for a few minutes in a rubbing alcohol bath, will keep this tool clean.

Other common sense, but sometimes overlooked tips include washing your hands before applying your makeup and taking time to properly close all compacts and bottles.  Use a sharpie to write the date you purchased your makeup on the label.  Time goes by quickly and something like a less often used shadow will hit 3 years old before you know it.  These steps will greatly extend the health of your makeup.   If you have any makeup that has changed color, texture or has a funny smell, discard right away.

I always prefer the use of mineral based makeup like that made by Jane Iredale and Colorescience.  Because of their high mineral content, they are even more hygienic and their colors are beautiful.  You can find both brands at our office.  Stop by and see what new colors would be right for you!

 

Derm Terms II: Notes from a San Francisco Bay Area Dermatologist

Friday, April 2nd, 2010

Another commonly seen, but non-cancerous growth found on the skin is known as a seborrheic keratoses (SK).  SKs can grow anywhere on the skin, except the palms of hands and soles of feet.  They can begin as small, rough bumps but become thicker over time and appear almost like someone pasted them on your skin.  The color ranges from brown to tan or black and the size can be from a pin-head to a quarter.

Sample of SK

The exact cause of SKs is still unknown, although their may be a familial component to their appearance.  Typically patients will notice and seek removal of SKs around age 30 and up.  More can appear as you get older.  While treatment is not required, SKs can become annoying as they can start to catch on clothing or jewelry and also lead to more aged skin appearance.

Removal of SKs is usually quite simple and may involve freezing the spot with liquid nitrogen, using an electric needle to sand it down, or scraping off the growth.  There is little downtime and these methods are quick and nearly pain-free.

I always say that the less things you have hanging off your skin, the better you will look and feel.  So if you start to notice these growths, or have already collected a few, see a dermatologist for easy removal.  Should you notice a sudden growth spurt of many or should any SK become itchy, bleed, change color or become irritated, please have a dermatologist check to make sure a more serious issue is not present, such as melanoma skin cancer.

 

Derm Terms: Notes from a San Francisco Bay Area Dermatologist

Sunday, March 28th, 2010

In dermatology, there are lots of terms for various spots and lesions that may appear on the skin.  These terms can be confusing, especially if you aren’t sure which are the “bad” kinds and which are less of a worry.

One of the most common terms is actinic keratoses or AKs, which are most often seen on the face, ears, lips and backs of hands, but can appear on any sun damaged area of the skin.  AKs are spots where the top layer of skin is dividing too rapidly.  They usually show up as a dry, scaly and rough textured patches of skin.  They may be brownish, red or flesh colored.  Some may even be crusty..

AKs tend to arise more frequently after age forty, but if you are fair skinned with light colored eyes and have had average to heavy sun exposure they may appear earlier.

AKs are also called “precancers” because if left untreated, they have the potential to progress into squamous cell carcinoma, a potentially deadly form of skin cancer.  Because of this potential, it is important to have any AKs treated as they come up.  Cosmetically, they make the skin appear more aged and makeup doesn’t cover them very well.

Treatment may include cryosurgery (freezing the spot with liquid nitrogen), numbing the area and scraping the lesion off or use of a prescription cream that targets the damaged cells and destroys them.  Luckily, most AK treatments are fairly inconspicuous and the recovery time is minimal.  For more extreme cases or areas where there are too many precancers to treat individually, we may use PDT or photodynamic therapy treatment.  This process involves a light microdermabrasion to the skin, followed by the application of a chemical that is activated by a laser to eradicate the errant skin cells.  This treatment requires you to stay indoors 24 hours afterward.  The result is skin that will look, feel and be much healthier.

To prevent AKs and skin cancer, sun safety is always your best bet.  Always apply and re-apply sunscreen to exposed areas of skin and do your best to stay out of the sun!

I can never say enough about the benefits of topical retinoids like Retin-A, Refissa, Atralin or Retin-A Microgel, but yet another positive point is that they can actually help the skin ward off AKs.  Their exfoliating properties keep these damaged cells from taking hold and help the skin stay smooth.

As always, if you notice any new spots or moles that have changed, have a dermatologist look at them for any potential issues.  Be sure to check in with the blog as more derm terms will be discussed!

 

“Jersey Shore” Tanning Intervention: Notes from a San Francisco Bay Area Dermatologist

Tuesday, February 23rd, 2010

Having two teenagers, you learn to stay up on what today’s youth is watching, listening to and surfing for, especially if it can impact them negatively.  A recent trend among the younger set is watching the MTV reality show “Jersey Shore.”  While I can’t say I’ve actually watched this show myself, I’ll admit to being familiar with images of the cast that I’ve seen on magazines and television excerpts, mostly because of the shock and concern I feel for them and their overly tanned skin.  When I learned of the “tanning intervention” that the TV show “Extra” had with the cast, I was delighted.  These young adults are not only ruining their skin and dramatically increasing their chances of skin cancer with their tanning habits, but they can potentially influence viewers into thinking tanning is “cool” - a dangerous trend.  Check out this clip from Extra and share it with someone who needs to know about the dangers of tanning!

 

Please upgrade to the latest version of Flash Player.