I’ve Been Named A Top Doctor in San Diego Magazine

I’ve been named a top doctor by San Diego magazine.

I’ve been named a top doctor in San Diego Magazine. No, that’s not me on the cover. My hair is much shorter.

Truly, though, it’s an honor. My dermatology peers voted for me, and I am humbled.


Why Twitter Is Bad For Your Health

The paradox of Health 2.0 is that along with unlimited access to medical information comes unlimited exposure to medical misinformation.

Social networks like Twitter and Facebook are replete with marketers in sheep’s clothing, pseudo-doctors (I hate to be a stickler, but a doctor should be a doctor and not just be a cool moniker like Queen is to Latifa), and friends who happen to be dumb.

When you combine these characters, finding truth is difficult in a sea of social media untruths. In this way, Twitter is bad for your health. Using social media sites to help with your medical problem means you’re getting lots of medical misinformation.

A study published in the American Journal of Infection Control proved this point. The authors looked at tweets and retweets about using antibiotics to treat a cold. They discovered that inaccurate or misinformed tweets were rampant and exposed 850,000 or more people to bad advice or wrong information about antibiotics.

I decided to do my own quick study. I searched eczema on Twitter; from the first 100 tweets here’s what I found:

  • A whopping 84 were spam.
  • There were sneaky spammers like a real-looking person who tweeted “Grandson 2 yrs horrible eczema tried all specialist not any better steroids no help?” and linked to a scary-bad-English site where you can buy drugs online without a prescription.
  • A real person who advised that eczema was caused by drinking coffee. (He must know something I don’t).
  • Three “natural doctors” (Queens?) with books and videos that promise to “CURE YOUR ECZEMA NOW!” (They obviously went to better medical schools than I, because I never learned the cure for eczema).
  • Patients giving medical advice to other patients. One link to a discussion went: “My 1 year old daughter has terrible keratosis on her arms and legs. Help?!” Discussion response: “Your daughter has keratosis pilaris. Use Eucerin Intensive Repair Lotion.” This is bad for several reasons. It’s inappropriate for anyone to give medical advice online, even a physician. I would never make such a diagnosis without seeing the child. I doubt keratosis pilaris is the correct diagnosis in a one-year-old. Lastly, Eucerin Lotion has alpha-hydroxy acid which is inappropriate to put on an infant (it might burn her skin).
  • Several links to a “Toothless Fish” that eats skin and will cure your eczema. Seriously.
  • An at-home LED light device that apparently we doctors don’t want you to know about. It treats your eczema AND acne AND wrinkles! Whew, I’ve been keeping that in for so long, it feels good to tell you. Now you know about the secret LED, and a burden has been lifted off my shoulders.
  • A twitterer with a potty mouth that I’m not gonna repeat here.

How do you know that the information you’re getting is accurate? Can you trust your friends? Social media and Health 2.0 are here to stay and have the potential to benefit patients and physicians. So how should you navigate to avoid bad advice?

  • Always question the source of the information. Both well meaning people and spammers can harm you — if it sounds too good to be true, it’s probably not true.
  • Always see your physician for diagnoses and medial advice. Use social media only to supplement your knowledge or to connect with other patients or health providers.
  • Always remember, you really don’t know who is posting information online — I could be a dog, after all, and you’d never know it.

Photo: Caricaturas (from flickr) and Peter Steiner, The New Yorker (from wikipedia).

iPhone App Claims to Treat Acne. Does it?

I love my iPhone. (No, that’s not me in the photo.)

My iPhone is teeming with apps that help me get through my day (like Doodle Jump for instance). An emerging iPhone trend is the development of apps that diagnose and treat diseases. For example, there is the stethoscope app to help diagnose heart murmurs. In dermatology, there is an app designed to treat acne.

We know that specific wavelengths of light can have medicinal effects such as killing bacteria (red light) and reducing inflammation (blue light). This app produces light at those wavelengths to treat acne. The claim is that by holding the iPhone to your face, the light produced from the app will treat your acne.

Although it scores a 10 on 10 in the coolness factor, it scores a 0 on 10 for proof of efficacy. The studies that looked at treating acne with light used much more intense light than an iPhone uses. The studies with more powerful light exposed faces for 60 minutes every week, which is about 8 minutes on each side every day. Even then, light treatments for acne have not been shown to be consistently better than standard acne treatments such as antibiotics and tretinoin.

So does the acne app work? Well, there are no studies to tell us. Given that the light intensity is low and that most people would not do the treatment — try holding your phone for 2-5 minutes on each side of your face every day for months — I doubt it works.

Acne is common and naturally gets better and worse at times no matter what you do. It is unfortunate that products like this are sold that do not have any proof that they work. There will be people who buy this app and believe that it helped them, (“My acne was clear in just THREE DAYS!”) but the two bucks is better spent on Doodle Jump.

See also:

Can an iPhone App Clear Up Your Acne?

In Light and Heat, Gadgets Claim to Fight Acne

Better Skin to the Touch?

Can You Treat Acne With an iPhone App?

A study to determine the effect of combination blue (415 nm) and near-infrared (830 nm) light-emitting diode (LED) therapy for moderate acne vulgaris.

Photo: Aye Shamus (flickr)

Is Your Physician Board Certified?


Is the milk you drink rBST-free? Is your physician board certified?

Many people take the time to buy hormone free milk, but they don’t make an effort to choose a physician who is board certified. That’s a shame.

Asking a friend or family member might be a good way to choose a hairdresser, but it is not a good way to choose a physician. Medicine is difficult. The same way that you want the pilot of your next flight to be maintaining his or her skills and knowledge of flying, you also want your physician to maintain his or her skills in medicine. The truth is, you are much more likely to die from your doctor’s mistake than from a pilot’s mistake.

Being board certified is no guarantee that your physician is good (or nice!), but it does assure you that your physician is committed to continuing education and is learning advances in medicine. It also assures you that your physician has completed the necessary training and passed a certification exam for the field of medicine he or she is practicing. Having a license means only that they completed the minimal requirement to practice medicine. Maintaining active board certification means that your physician has undergone yearly continuing education and has passed a re-certification exam every few years.

Certainly there is more to being a good physician than completing residency and passing written and oral examinations. But studies show that high exam scores do correlate with practicing better medicine.

There are 24 board specialties. You can check to see if your physician is board certified by going to the American Board of Medical Specialties site at ABMS.org, registering, and putting in your physician’s name. It is a free and confidential service. You can have a nice glass of rBST-free milk in the meantime.

Post written by Dr. Jeffrey Benabio, Copyright The Derm Blog 2009.

Photo: Ingrid Taylar (flickr)


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