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Monthly Archives: February 2017

8 Ways to Reduce Wrinkles

Are you tired of waging a war against wrinkles? Scott Gerrish, MD, of Gerrish and Associates, PC, a non-surgical skin care specialist with offices in Virginia and Maryland states, “Don’t give up yet. There are steps you can take to lessen and even reverse one of the biggest signs of aging: wrinkles.”

8 Simple and Smart Skin Care Steps to Reduce Wrinkle

1. Avoid sun exposure. Try to wear white or light colors, and wear a hat when you’re outdoors. Also, don’t use tanning booths, which can be worse than the sun.

2. Wear sunscreen. For the best anti-aging protection, Dr. Gerrish strongly recommends, “Apply sunscreen with at least an SPF 15 (sun protection factor) thirty minutes before sun exposure to protect your skin from harmful UVA and UVB rays. Look for one with zinc or titanium oxide in the ingredient list.”

3. Avoid environmental pollutants. Ozone, smoke, and gasoline fumes are just a few of the pollutants that can age skin and cause premature wrinkles.

4. Start an anti-aging skin care program. June Breiner, MD, an internist in Maryland suggests, “Consult with a non-surgical skin care doctor. There are many products available that thicken your skin and reduce wrinkles.”

5. Avoid smoking and second-hand smoke. Smoking takes away oxygen and nutrients, and it also increases the number of free radicals in your body’s cells, a main cause of skin aging. “The amount of cigarette consumption and the number of years you have smoked are correlated with an increase in premature wrinkles,” states Dr. Breiner.

6. Wear sunglasses. Other than staying indoors and away from windows, sunglasses are the best way to protect the thin, sensitive skin around your eyes from UV radiation.

7. Sleep on your back, if possible. Sleeping with your face pressed against the pillow can cause sleep lines, which can turn into wrinkles. Satin pillow cases can also help in the anti-wrinkle fight.

8. Use moisturizer. A good moisturizer will keep skin hydrated and soften wrinkles.

Dealing With Adult Acne

Women whose breakouts are associated with their menstrual cycle usually find that they get pimples or blackheads about two to seven days before the start of their period. That problem tends to go away after menopause, so you can look forward to some relief! However, you may still break out occasionally during the transition.

Fluctuating hormones could indeed be the problem. Although doctors don’t really understand what causes acne, they do know that an increase in androgens (male sex hormones) is an important factor. And, as you know, you do experience a change in the estrogen-androgen ratio during the menopause transition. In studies, women who had acne have higher levels of circulating androgens than women without acne. Similarly, women who had acne during adolescence also often get it again at midlife. Other possible causes: greasy makeup, medications (such as lithium for bipolar disorder or barbiturates used to control seizures) and even resting your cheek on your hand (a source of bacteria).

Contrary to myth, chocolate, fried foods, and dirty skin do not cause acne. Neither does stress, but it can aggravate acne, so try to relax more.

If pimples are really troubling you, try over-the-counter acne medications containing benzoyl peroxide, resorcinol, salicylic acid, or sulfur. These break down blackheads and whiteheads and reduce oil production in your skin. But don’t slather them on as you might have done when you were a teenager. Put the medication just on the spot—not on the area around it. Your skin is drier now, so you need to be careful. You should look for products made for adults, including some specifically formulated for menopausal women.

If you’re still not getting relief, see a dermatologist for antibiotics or other prescription medication. Oral contraceptives and menopausal hormone therapy may also help.

In the meantime, wash your face gently; don’t scrub or rub it. That will only exacerbate the problem.

Most of the controversy over hormone therapy at menopause has centered on the risks of cancer and heart disease. But many women who use estrogen say they like it because it makes them look younger. What’s the science behind their claims? Estrogen therapy does not alter the effects of genetic aging, and it can’t reverse the damage from sun exposure or smoking.

It has no effect on the risk of skin cancer. But clinical trials have shown that systemic estrogen may have some benefits for skin. It appears to limit collagen loss, maintain skin thickness, improve firmness and elasticity, and decrease wrinkle depth and pore size. Researchers say the data aren’t convincing enough to recommend taking estrogen for this reason alone and it’s not FDA-approved for this purpose.

Many Teen Girls Using Tanning Beds

Despite the risk of skin cancer, including deadly melanoma, nearly 30 percent of white female high school students use tanning beds and nearly 17 percent use them often, a new report finds.

Among white women aged 18 to 34, nearly 25 percent use tanning beds and 15 percent use them frequently, according to the U.S. Centers for Disease Control and Prevention.

“The high rates of indoor tanning among this population is very concerning,” said report coauthor Gery Guy Jr., of the division of cancer prevention at the CDC.

Moreover, there have been no significant changes in the prevalence of indoor tanning in recent years, he said.

“Indoor tanning has been associated with skin cancer, particularly melanoma,” Guy said. “The risk is increased among younger users and those who use it frequently.”

Guy said young girls should be educated about the risks of ultraviolet ray exposure. Indoor tanning also should be restricted to adults, and claims about its benefits should be discredited, he said.

In addition, changing the perception that tanned skin is healthy and attractive would go a long way in reducing the use of tanning beds. “Tanned skin is damaged skin,” he said.

The report was published online Aug. 19 in the journal JAMA Internal Medicine.

Dr. Melanie Palm, a spokeswomen for the Skin Cancer Foundation and director of Art of Skin MD in Solana Beach, Calif., said the study’s finding are consistent with past research on the use of tanning beds.

More than 30 million Americans use tanning beds every year, Palm said. “There is a disproportionate number of girls and young women who use them,” she said.

Although tanning is a known risk for skin cancer, there is a “cultural disconnect between the risk and the desire for a ‘healthy glow,'” she said.

Parents need to be role models and educate their children about the dangers of UV exposure, Palm said. She said people should get into the habit of putting on sunscreen before going out, and girls and women who want a tanned look should use sunless tanning spray.

Cancer, however, is not the only risk of tanning. Exposure to UV rays ages the skin, making it less elastic, and causes wrinkles and spots, Palm said.

An industry spokesman, however, said the connection between indoor tanning and the risk for melanoma has not been confirmed.

“The body of studies on the relationship between UV exposure and melanoma skin cancer are replete with conflicting information,” said John Overstreet, executive director of the Indoor Tanning Association.

“This study also ignores the many benefits of moderate exposure to ultraviolet light,” he said. “With any human activity, there are risks and benefits, and the key is balance.”

Another expert said many women weren’t told about the dangers of tanning when they were teens.

“Most adult patients that I treat for skin cancers preface their discussion with me by saying that when they were teenagers they were never told that sunbathing or tanning was bad for them,” said Dr. Jeffrey Salomon, an assistant clinical professor of plastic surgery at Yale University School of Medicine.

“If there was a way for teens to be able to talk to their future self, the remedy would be easy,” he said. “But since the cancerous effects of tanning beds take time to evolve into skin cancers, it is hard for teens to personally identify with the risks. It is going to be a combination of parents, teachers and social media that will have to be used to target this audience.”

Injection Makes Laugh Lines Fall Flat

An injection that stimulates collagen production can smooth out nasolabial folds, better known as “laugh lines,” researchers reported here.

In a small, single-center study, a significantly larger proportion of patients had either “much” or “very much” improvement on clinician assessment 9 months after being treated with polycaprolactone (Ellanse) than when they were treated with hyaluronic acid (Perlane), according to Hassan Galadari, MD, of United Arab Emirates University in Dubai.

Galadari reported the findings during a late-breaking session at the American Academy of Dermatology meeting here.

Polycaprolactone has been used for many years, namely for orthopedic surgery and as a suture material, and consists of microspheres in a gel matrix of glycerin and water. The microspheres stimulate tissue production that creates new collagen and replaces the gel carrier and the tissue scaffold.

To assess whether the treatment works against nasolabial folds, Galadari and colleagues conducted a randomized, prospective, single-center study in 40 patients — 37 of whom were women — with moderate to severe nasolabial folds.

Outcomes were assessed via the Global Aesthetic Improvement Scale (GAIS) or the Wrinkle Severity Rating Scale (WSRS), for safety and efficacy through 12 months, though Galadari noted he would be reporting data through 9 months only.

The study was a split-face study, in which half of the face had an injection of hyaluronic acid and the other half was injected with polycaprolactone.

Overall, clinicians used 17.4 percent less product to achieve the desired results with polycaprolactone than with the hyaluronic acid at the initial visit, Galadari said, and they used 13 percent less product in the follow-up “touch-up” visit.

They found that on investigator-assessed GAIS, a significantly larger proportion of patients had “much” or “very much” improved with caprolactone compared with hyaluronic acid at 9 months.

At that time, the researchers noted that “no change” was seen far more often with hyaluronic acid because it typically lasts 6 months, rather than 9 months.

For patient-rated GAIS findings at 9 months, polycaprolactone again had a greater proportion of “much” or “very much” improved, even though patients tended to be “more generous” with their self-ratings.

WSRS scores fell by 1 month and bottomed out at 3 months in both groups, but remained lower with caprolactone through 9 months than with hyaluronic acid, which had started to climb back up at that point. At baseline through that time, patients generally fell from a mean of 3.5 on wrinkle severity scores to about 3 with hyaluronic acid and 2 with polycaprolactone.

Nearly half (48 percent) of all patients reported adverse events — with all of the caprolactone patients complaining of pain, Galadari noted, but all were mild and resolved quickly.

He noted that in normal circumstances, dermatologists will use anesthesia for the procedure, but for the sake of the study it was done without any potential confounders.

Also, patients had unequal inflammation on both sides of their faces given the split-face nature of the study. Galadari said polycaprolactone is associated with edema, so clinicians could identify rather quickly — usually within 2 days — which side of the face carried which treatment.

The reason for the excess edema is likely that the gel carrier in polycaprolactone includes glycerin, which can absorb more water than hyaluronic acid and can cause a more pronounced inflammatory response, although this tends to resolve in about 3 to 4 days, Galadari said.

He also noted that there was one case of unilateral periorbital edema with polycaprolactone.

In conclusion, Galadari said that most of the injections in the study were done conservatively, which meant that the doses of filler used in the study were lower than in other studies, with a relatively low initial and high touch-up volume.

Patient satisfaction scores will also be assessed, he said, to determine whether patients would be satisfied enough to come for a follow-up treatment.