Tag Archives: treatment

iPhone App Claims to Treat Acne. Does it?

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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)

Extract from White Birch Tree Relieves Itch

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The forest is full of things that make you itchy: poison ivy, poison oak, mosquitoes, chiggers. But for the wise adventurer, the forest also provides a way to heal your itch. The remedy might be found in the beautiful white birch tree.

White birch trees are ubiquitous in cold climates. A photo of the white tree against white snow is iconic of New England winters. A bark extract called Betulin (a terpene like tea tree oil) has been shown in animal studies to be antimicrobial, anti-inflammatory, and to aid in wound healing. Research presented at the annual congress of the European Academy of Dermatology and Venerology showed that a cream containing betulin significantly reduced itching in red, irritated skin in psoriasis and eczema patients.

The study is only preliminary, and betulin will need to be tested in rigorous trials to see if the extract makes a cream much better than placebo cream; however, betulin is already available in creams in Europe.

So how do you get the extract out of the bark if you’re  itchy while hiking in a forest? I’ll wait for Bear Grylls to show us on a future episode of Man Vs. Wild. No doubt a fire and half a plastic bottle will be needed.

Photo: Nicolas T

Depressed? Maybe Your Psychiatrist Will Prescribe Botox.

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Botox makes you happy. So does a new Lexus, but I can’t prescribe that.

Botox® temporarily freezes dynamic lines such as crow’s feet and forehead wrinkles. When Botox is done well, it can raise your eyebrows and make your face appear well rested, younger, happier. Botox also makes it difficult to furrow your brow or frown.

Too much Botox freezes your face, making it expressionless (which could be seen in both winners and losers at the recent Golden Globes: Were they happy? Sad? Shocked? Who could tell?).

Because Botox can make people look better, it’s no surprise that people who get Botox are happier afterwards. A review in the Journal of Drugs in Dermatology actually looked at the cost of treating depressed patients with Botox. Here’s the reasoning: If you cannot frown because of Botox, then your mind will interpert this as you feel less angry or sad. Preliminary studies showed that people treated with Botox had more positive emotions and felt less depressed after their treatment.

While the logic is easily followed (and is emphatically supported by people who ordinarily pay cash for their Botox), the science is absent. There are no studies that show Botox improves depression as compared to placebo, therapy, or antidepressants. Much more research would have to be done to show that there is a real benefit (it would be  interesting to compare Botox to simply giving people $500 in cash and teaching them to frown less).

Depression is a disease and is never fixed quickly. Treating depression always requires effort, often requires therapy, and sometimes requires medication. I doubt that medication will be Botox. Or a new Lexus.

Photo: Geekadman Flickr.com

Weak, Split, Torn, Brittle, Frustrating Fingernails

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Ever have a beautiful woman walk up to you, thrust her fingernails in your face and say, “Why do my nails keep splitting like this??” I have.

One of the rare hazards of being a dermatologist is being accosted with skin, hair, or nail questions at social settings. Broken, split, weak, or brittle nails are common, so I get this question a lot.

Nails are an appendage of skin and are made up of protein. Nails need moisture to stay healthy and pliable. They dehydrate much like your skin dehydrates. Dry nails are brittle: instead of flexing, they fracture and split from the tips backward. Once a nail is split, it is difficult to stop the split from spreading. Nail splitting occurs more frequently in winter when your skin and nails are  dry.

Nail polish can help protect your nails; however, nail polish remover worsens dryness. Therefore, the more frequently you paint and remove polish, the more your nails dry out. If you paint your nails, then touch up chips rather than remove the polish frequently. Keep the polish on for as long as you can before removing.

What else can you do to strengthen weak nails?

Apply to your nails a moisturizer with urea, like Eucerin Hand Creme. This puts moisture back in the nails and keeps them pliable.

Avoid excess washing. Soap and water dry your skin as well as your nails. (I can write you a doctor’s note that says you are not allowed to wash the dishes. If you must, then wear gloves).

Remember that once a nail is split, it cannot be repaired. The key is to keep the base of the nail healthy so when it grows out to the tip, it stays strong and intact. Fingernails grow 3 mm each month, so a 2-3 mm split will take a month to grow out.

There are lots of products that promise to strengthen or harden nails. Most of them are a waste of money, for example,  gelatin tabs. Gelatin tablets are animal collagen derived from bone. The collagen is broken down into protein by your digestive system. As such, taking gelatin tabs is no better than eating a piece of chicken or any other protein. Eat plenty of protein as part of a complete diet, but don’t bother with supplements.

Don’t waste money on calcium or other “mega-nail” vitamins. There is no calcium in nails and loading up on vitamins will not make nails grow faster or stronger.

There is some evidence that taking biotin, a B-complex vitamin, at 2.5 mg each day can help weak nails by improving protein synthesis. Remember though, if you start taking biotin today, it will be June before you see improvement because you can only improve nail that hasn’t yet grown.

Just like trimming dead ends can help your hair, trimming split ends can help your nails. Try to clip off the split part, but avoid being too aggressive because you can spread the split farther. With a little effort and a lot of patience your nails will be hard as nails.

Oh, and next time, a least buy me a drink.

Photo: KW Sanders (flickr)

Brown Skin Spots

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spots horse pat hensen

Ever notice brown spots on your skin after a rash or an injury? Brown spots on your skin are often blamed on the sun, but any damage to your skin can result in skin spots.

Skin color is caused by pigment-producing cells called melanocytes. Anything that excites these cells will cause them to release brown pigment into your skin. Sun causes them to release pigment, but so can an infection, a  rash, and even acne.

When you have an infection, injury or a rash,  inflammation develops to protect your skin from harm and to repair damage. This inflammation is apparent as redness, scaling, swelling, pus, pain, or even itching.  Inflammation triggers the melanocytes to make brown pigment which is dispersed and sinks into the deep layers of your skin.

Long after the inflammation is gone, the pigment remains and the brown spots stay visible. People with darker skin tones release more pigment when their skin is inflamed, which leads to more noticeable brown skin spots.

Brown spots such as these are called post-inflammatory hyperpigmentation because they appear after inflammation resolves. Unfortunately, once that pigment is deposited in the skin, it is very slow to fade. Over-the-counter bleaching creams such as hydroquinone 2% can lighten brown skin when used for weeks to months. More potent prescription creams such as Tri-Luma® can remove brown spots, but are expensive and generally are not covered by health insurance.

It is much easier to prevent than to remove brown skin spots:

  • Minimize inflammation as quickly as possible by treating the underlying problem
  • Avoid sun which could make the spots even darker
  • Be patient — some brown spots can last for years and treating them excessively can lead to inflammation making the problem worse.

Photo: Pat Hensen