How Many Friends Do You Have? I’ve Got a Few Trillion.

The next time you feel lonely, remember this: you always have a few friends with you. No, not your Tweeple, your bacteria.

You have lots of them with you at all times; so many in fact, you’re like a walking planet. There are far more microbes living in and on you then there are people on earth! According to an article in The Economist, there are 100 trillion microbes living with you — 10 times the number of cells you actually have (so technically, you’re 90% bacteria, 10% human).

We are only now starting to comprehend the importance of this relationship with our lowly microbe friends. The disease model used to be simple: If you are infected with bacteria, you are sick. If you are bacteria free, then you are healthy. Not so anymore.

In fact, it is probably more true that losing a few billion of your bacterial friends leads to sickness, rather than to health. A better health model is that it’s not important to be free of bacteria to be healthy; rather it is important to have the right balance of microorganisms living with you to be disease free.

The first place we are likely to see the importance of healthy bacteria in skin disease is in eczema. Eczema, or atopic dermatitis, is a chronic itchy rash that often occurs in childhood and can last for years. It appears that one of the problems in patients with eczema is that they have an overgrowth of unwanted bacteria and a loss of other, good or healthy bacteria. Restoring this bacterial balance might ironically calm the immune system, improving eczema.

Look for new therapies in the upcoming new year such as creams and probiotic pills that don’t kill bacteria, but rather give you good bacteria. Future technologies will likely be able to detect imbalances of bacteria to diagnose disease and to foster health. It’s also another example of how Eastern medicine, with its principles of balance and natural remedies, might have gotten it right all along.

Photo: Tom@HK


Are you taking your medications? Probably not.

In a recent dermatology study, a mere 50% of adults and 30% of children were still using their medications 8 weeks after they were prescribed.

But what if I sent you a text to remind you? Would you be more likely to take your meds or use your creams?

Taking medications or applying creams takes effort and discipline. Unless you form a new habit and apply your medication or take your pills at the same time everyday, it is unlikely you will persist. It is similar to exercising — if you exercise at different times and different days, then it is much more difficult to stay exercising than if you developed a habit and did it as part of your daily routine.

There might be a new way to help encourage people to get into a habit of taking their medication everyday: text them.

A recent study presented at a Society for Investigative Dermatology meeting showed that texting patients actually improves compliance (that is, the likelihood that they will take their medication). In the study, 70 cell phone users were randomized to receive a text message reminder to apply sunscreen everyday or to not receive the text reminder.

At the end of 6 weeks those who received the text reminder were more likely to apply their sunscreen as compared to those who did not receive the text. In the text group, people used the sunscreen 56% of the time while in the control group they used it only 30% of the time.

The researchers cleverly attached the weather forecast to the text message to make the message more useful and to encourage people to open the message and read it. The act of opening and reading the message everyday helped them get into the habit of applying the sunscreen everyday, improving their compliance.

In my practice more and more patients use email to communicate with me. Texting might be another way to communicate with patients to help them be more compliant with their therapy.

You can’t text me, but you can twit me if you like.

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Photo: Sintex

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