Does Your Dermatologist Wear a White Coat? Does Your Aesthetician?

In the United Kingdom, the iconic white coat worn by physicians for over a century has met its end. Citing the tendency to harbor infection, the government has started to phase them out.

Here in Southern California, where casual wear is standard for many physicians, the white coat is an endangered species. Ironically, at my local farmers’ market there is a woman selling organic cures for illnesses; she is a naturopathic physician and invariably wears her embroidered, knee-length white coat while standing amidst her jars of thyme and huckleberry. The same long white coats are worn by cosmeticians and medial assistants at cosmetic centers everywhere.

Why is it that just as physicians are tossing their coats, ancillary health care providers are donning theirs?

Growing up, our family physicians were always dressed impeccably, and always in white. In medical school it was a hard-earned honor to wear the short white coat on the wards. As a physician I will only see patients while I am dressed properly: a shirt, tie, shined shoes that click on the marble floors, and a long white coat.

Do patients actually care if their doctor wears a white coat? Should they care?

The Benabio Guaranteed* 2008 Acne Cure (*If You Use It, That Is)

Do you use Proactiv®? Many of my acne patients have tried it. Some felt it helped, others felt it didn’t. Proactiv was developed by two dermatologists; its success lies not in the actual product but in the way they have you use it.

It is an absolute truth that almost any acne treatment works and almost every acne treatment fails. It depends on one thing: Do you actually use it?

Continue reading “The Benabio Guaranteed* 2008 Acne Cure (*If You Use It, That Is)”

Coming Soon: At Home Laser Hair Removal

Hair removal is big business with sales in the billions of dollars. Now there is a new laser (currently undergoing FDA scrutiny) that will provide a safe way for women to do laser hair removal at home. Dr. Tina Alster conducted a study of 20 women who underwent treatment of underarm, forearm, bikini, and leg hair removal. The women had hair reduction of 40-75% after 3-4 treatments performed at 2-week intervals. The results were apparently better on the legs as compared to the underarms and bikini area.

The Silk’n hair removal device made by HomeSkinovations, Ltd. is expected to cost about $800 — similar to a laser hair treatment in a dermatologist’s office.

Severe Psoriasis Linked to Increased Risk of Death

Psoriasis is an autoimmune skin disorder characterized by red skin lesions often covered by a thick silvery scale. It affects as many as 7.5 million Americans. The severity of the disease varies markedly: some people don’t even notice that they are affected, others have widespread, debilitating disease.

We have known for years that psoriasis has a significant impact on people’s quality of life; new research indicates it might actually shorten their lives.

People with severe psoriasis had a 50 percent increased risk of death compared with people without the inflammatory skin disease …. Men with severe psoriasis died an average of 3.5 years earlier than men without the condition, while women with severe psoriasis died 4.4 years earlier than women without psoriasis.

The reason for this increased risk of death is not clear. It might be that the same chronic inflammation that underlies the skin lesions and the arthritis in psoriasis patients might also lead to increased inflammation in their cardiovascular system. If you have psoriasis, then resolve in the new year to take control of your health — eat a healthy diet, exercise, and see your internist regularly.

If you are a physician and have patients with psoriasis, then you should check their cholesterol, blood pressure, and blood sugars regularly; consider them a high risk for cardiovascular complications.

A Proper Shave

It is a truth universally acknowledged that women are in want of men with a close shave. To get that baby soft cheek you have to start with a proper shave.

First, determine the type of beard you have. Do you have fine, straight hair, or thick curly hair?

Most men with thick or curly hair should not shave against the grain. Doing so causes the hairs to be cut below the surface of the skin. When the hair regrows it becomes trapped and instead of growing out, curls back on itself and grows inward. This causes inflamed, red bumps (a condition called pseudofolliculitis barbae), that are further injured the next time you shave.

Men with fine, straight hair can shave against the grain, getting the closest shave possible.

  1. Wash your face with warm water and soap first. The best time to shave is after you shower; the warm soap and water will soften the hairs, making for a smoother, closer shave.
  2. Lather with a good thick shaving cream, massaging the hairs in a circular motion. If you have one (or hope to get one for Christmas) a badger shave brush helps to lift the hairs, soften them, and spread the shaving cream evenly. Use a quality shaving cream or gel — I like a Neutrogena Men’s Razor Defense, a gel for people prone to ingrown hairs; or, if all your suits are Armani, then you might prefer these excellent shave creams from John Varvatos or from The Art of Shaving.
  3. With a clean razor, shave in the direction of the hair growth. Rinse the blade under warm water after each pass because hairs and shaving cream stuck in the blades will prevent the blade from cutting cleanly and can cause nicks. Look carefully at your beard, the hairs often grow in different directions at the sideburns, the middle of the cheeks, the chin and the neck. In some men, the hair on the neck actually grows in the complete opposite direction as on their face!
  4. If you have thick or curly hair, or if you are prone to razor bumps, then skip this step and go to number 5. If not, then reapply the shaving cream and shave again in the opposite direction. This will give you the closest possible shave but will pose the greatest risk for ingrown hairs.
  5. Rinse your face vigorously with cool water, carefully removing the residue from the shave cream, then pat dry.

Photo credit: FFC, CircaSassy

Dietary Supplements and Skin Cancer

Can supplements prevent skin cancer?

Reports of foods and dietary supplements protecting us from skin cancer are highly exaggerated. There is little rigorous research to support such claims. The World Cancer Research Fund / American Institute for Cancer Research has recently sorted though countless medical studies to help us find truths about cancer and diet. Their recent 500-plus page report has some important findings.

Vitamin A (retinol) might reduce the risk of skin cancer, but can be toxic

Retinol is a fat soluble vitamin that belongs to a family of compounds called retinoids. Other retinoids include beta carotene, isotretenoin (Accutane®) and tretinoin (Retin-A®). Their effects on the skin are profound: they correct wrinkles, smooth brown spots, and treat acne and skin conditions such as psoriasis. In patients at high risk for developing skin cancer, such as transplant patients, high doses of vitamin A (25,000 IU) helps protect them from developing skin cancer, particularly squamous cell carcinoma. Unfortunately vitamin A can also be toxic causing headaches, dizziness, vision changes, and even osteoporosis and liver damage. Doses greater than 10,000 can dangerous and should never be taken without the supervision of a physician.

Do beta-carotene supplements prevent skin cancer?

Beta-carotene is a precursor of vitamin A and is found in sweet potatoes, carrots, kale, spinach, and winter squash. Although good for your health when obtained from natural sources, the report concluded that there was no prevention of skin cancer afforded by taking beta-carotene supplements. We also know that in smokers, taking beta-carotene supplements might actually increase their risk of developing lung and prostate cancer.

Should I take selenium supplements?

Not if you are trying to prevent skin cancer. The study concluded that taking selenium supplements failed to protect against skin cancer and was associated with an increase in skin cancer when taken at 200 micrograms a day. The evidence to support this increase was weak, but there was clearly no evidence that taking selenium was preventative.

4 Tips for Chapped Lips

Dreading the mistletoe this year because of dry, flaky, split, chapped lips? Cold, dry, and windy winter air wreaks havoc on your lips, where the skin is thin and delicate.

Here are four tips to get mistletoe-worthy lips:

  1. Apply lip balm with lanolin or beeswax which creates a protective barrier, sealing in moisture on your lips. Balms containing glycerin actually help further by drawing moisture into your dried out lips. If you wear lipstick, apply the balm first, then apply a moisturizing lipstick. Re-apply throughout the day, especially at first sign of dryness.
  2. Avoid flavored balms as they often contain cinnamates, which are flavorings that can cause an allergic reaction in some people. Plus, tasty balms may lead you to lick your lips — saliva is irritating to your already chapped lips and quickly evaporates, further drying them.
  3. If you’re skiing this winter, then be sure your lip balm has UV protection, with an SPF of at least 15. UV rays are more potent at higher altitudes, and UV light is reflected off of snow.
  4. For deeply cracked or split lips, use a bland ointment such as Aquaphor Healing Ointment or Vaseline Petroleum Jelly. Apply liberally before bedtime, as lips tend to dry out from the heat in your bedroom.