Kids Skin Health Site

Math, reading, writing, dermatology. It’s back-to-school time, and any medical student will tell you it’s never too early to start learning dermatology. Here is a website from the American Academy of Dermatology to teach the little dermdocs in your house. It has information kids can use for homework, tips for healthy skin, and even a few games. Thankfully they didn’t require me to submit my “Skintastic Game” score to get into derm.

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True or False (answers below):

1. Botox and laser treatments are easy and can be done by an aesthtician or spa staff.

2. A physician must be present at all times in a spa that performs procedures.

3. Chemical or facial peels are safe and can be done in a beauty salon.

The term “spa” is derived from a town in Belgium where healing waters have been used to promote health since Roman times. “Spa” is now loosely used to describe any relaxing environment or beauty salon where rest, health and beauty are promoted.

At one time it was easy to distinguish among a beauty salon, barber shop and a doctor’s office. Not anymore. As cosmetics has become more medical and medicine has become more cosmetic, the two have met in the ubiquitous Medi-Spa. An establishment labelled a medical spa or medi-spa is generally one where medical procedures are performed or medicines are administered in the pursuit of beauty.

There is nothing inherently wrong with extending the field of medicine to include the state of beauty. Nor do I think it is problematic for the field of cosmetics and aesthetics to use medicine and surgery to accomplish its goals of making you more beautiful. But as a consumer, the burden is upon you to know what you are buying and from whom.

The allure of income from cosmetics is great, and physicians of all specialties have incorporated it into their medical practices. Gynecologists offer Restalyne, opthamologists offer Botox, family practice physicians have laser hair removal in their offices.

You do not need to be a dermatologist or plastic surgeon to perform cosmetic medicine. In Southern California there is even a pediatrician who treats cellulite (on adults, of course). This does not mean that he is unqualified to perform your cellulite treatment — he might be quite good at it.

More concerning is the fact that many people with no medical license are performing procedures. Ultimately, it is your responsibility to ask what qualifications and experience people treating you at the medi-spa have so you can make an informed decision.

Anytime an injection is given, a prescriptive device (such as a laser) is used, or a drug is prescribed, a licensed physician must be responsible for your care. Only licensed providers such as registered nurses, nurse practioners, or physician assistants can perform procedures. Other staff such as medical assistants or aestheticians are not licensed and are prohibted from practicing medicine.

The next time you go to the spa, be sure to ask the following questions for your safety:

1. Who is performing the procedure?
2. What is his or her license?
3. What experience has he or she had?
4. What are some complications or bad outcomes that have occurred?
5. Is a physician present in the facility or nearby to assist if there is a problem?

Photo: Axel Hecht

Answer to questions 1-3: false.

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• Summer is over. What should you do with all that left-over sunscreen? Don’t eat it. Nano particles in some sunscreens can be harmful to your insides according to the fabulous Beauty Brains.
• Are you a dirty girl or is it just your makeup that’s dirty? Dr. Baumann gives you tips on keeping cosmetics clean.
• Ewwwwh! Bedbugs are everywhere. What the heck are bedbugs anyway? And no, they are not from undocumented immigrants.
• Bad, bad, Botox. Bella Sugar breaks down Botox maker’s bad behavior. How often do you think Big Pharma goes too far in marketing their drugs?

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Itchy butts are part of my everyday. It shouldn’t be part of yours.

Itching on your bottom is usually a minor annoyance, but it can be debilitating. A patient of mine was unable to work because his derrière itching was so intense. A common cause of itching bottom, called pruritus ani, is allergic contact dermatitis.

Places where your skin transitions from outside to inside, such as lips or anus, are susceptible to dermatitis because your skin’s barrier is limited in these locations. Without a thick layer of keratin, irritants on the outside easily get into your skin. Moist toilet tissues, such as baby wipes or towelettes, might seem to get you cleaner than old-fashioned toilet paper, but chemicals in the wipes cause a rash in some people.

Preservatives such as methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) or kathon CG are often used in packaged toilet wipes and are a common cause of allergic contact dermatitis. Many patients who have itching on their behinds fear that they are unclean, use more cleaning wipes, worsening their dermatitis. It becomes a vicious cycle. Avoiding all commercial wipes or towelettes usually resolves the rash and itching. If not, then see your dermatologist before you find yourself on extended medical leave.

Have you ever had an itch so bad that you thought you’d go mad?

Photo: RLHyde

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Having a high quality doctor’s visit takes effort on my part and on yours. Here are 10 tips to get the most out of your next dermatology visit with me or any other dermatologist.

1. Write down all the questions you have and things you want to discuss with me. Be sure to list any spots you’d like me to check or any moles that have changed. Have a loved one lightly mark spots on your skin they are concerned about.

2. Know your family history: Has anyone in your family had skin cancer? What type? Patients often have no idea if their parents have had melanoma. It matters. If possible, ask before seeing me.

3. Know your history well: Have you had skin cancer? What type? If you have had melanoma, then bring the detailed information about your cancer. Your prognosis depends on how serious the melanoma was, that is its stage, 1-4. You need to know how it was treated, if it had spread, and how deep it was. The answers to these questions determines the risk of your melanoma returning.

4. If you have a rash, there are a few things I’ll need to know: Have you changed any of your medications? Soaps? Moisturizers? Cosmetics? Do you have a history of eczema? Asthma? Hayfever? Does anyone in your family have a skin disease? Take a picture of your rash at its worst with your phone; the rash might be improved by the time you see me.

5. If you are seeing me for acne, come prepared. Keep a journal of when your acne is worse. Is it around your period? When you are stressed? In summer or winter? What products or cosmetics are you using? What treatments have you tried? Have you had dryness or burning with previous treatments?

6. If you are seeing me for hair loss, then collect your hairs that fall out and count how many you lose in one day. It’s normal to lose 100-150 hairs per day. Make a list of other symptoms or health problems that you think might be related to your hair loss.

7. Always be honest with me. I’ll never judge you even if you are an avid tanner or a picker. I’m here to help, and I can only help if I know the whole story.

8. Have you read something online that you’d like to discuss with me? Print it and bring it. Sometimes patients will tell me they saw something about their disease on the web; without knowing the source, I cannot say if the information is valid or helpful.

9. Am I leaving too soon? Stop me. My time with you is yours. If you see me heading for the door, then tell me that you still have things you’d like to cover. If we are out of time, then ask me if you can set up a follow-up appointment to continue the visit.

10. Don’t leave empty handed — I’m not talking about the freebie hand lotion or drug samples. For every doctor’s visit, you should leave with printed or written instructions about what we discussed and what you should do next. Patients who receive hand-outs from their doctor are more likely to have positive outcomes.

Have you had an excellent or not-so-excellent dermatology visit you’d like to share? Do you have any tips for us?

Photo: Maggie Osterberg

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Last week a popular TV talk show featuring a bunch of doctors (I’m not naming names) discussed how coffee grounds can improve cellulite. They explained how rubbing coffee grounds into your skin imparts caffeine into the cellulite thereby improving the circulation and drawing the toxins out.

This is a great tip except that rubbing coffee grounds on your skin does not impart any caffeine into it, and there are no toxins in cellulite.

Cellulite is a normal secondary sex characteristic of women. It is the result of thin connective tissue in women’s skin. Massaging the cellulite (with coffee, tea, grapes, cream cheese, or chocolate frosting) pushes the fat back into the skin, temporarly improving the appearance. There is no science behind using coffee to treat this normal condition.

Scientific studies have shown, however, that carrying a wet coffee filter filled with grounds into your bathroom will burn more calories because you’ll spend 20 minutes later cleaning up the mess in your shower.

Photo: NiallKennedy

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1 – Drinking water will help your dry skin.

It doesn’t. Drinking water is important to stay hydrated, but if you have dry skin you need to water the outside of your skin, not the inside. Drinking lots of water no more moisturizes your skin than taking a bath quenches your thirst.

2 – Sunscreens with sun protection factor (SPF) of 100 are twice as good as sunscreens with SPF of 50.

As you can see from the graph, there are large differences in sunscreen protection at low SPF; however, there is not much difference in protection once the SPF is at least 30, which is what most dermatologists recommend.

3 – Sweating will make my acne worse.

Sweating does not make acne worse — in fact, sweat is your natural antibiotic. Keeping tight, wet gym clothes on after a workout can clog your pores which can flare acne. So can too much sun. Cover up. Go for a run. Shower. (And if you live in the southeast in August, shower again).

Did you already know these? What skin question would you like answered? Comment here or ask me on Twitter @Dermdoc

Photo: 96dpi

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“All natural. Certified organic. Made from natural ingredients. Pure botanicals. Chemical free.”

You might guess I’m standing in the farmers market. Nope. I’m in the health and beauty aisle at Target. The ubiquitous all-things-natural trend has overtaken the cosmetic industry. How do you know what is real and what is marketing hype? Here are 5 things you should know about organic beauty product labels:

1 – Labels that say “natural ingredients” or “botanicals” are not certified organic. These statements are not regulated. Most natural ingredients used in beauty products are actually modified in a lab. Truly botanical ingredients, like you’d pick in your garden, are usually unstable and would spoil like food.

2 – Natural doesn’t always mean better. Would you buy: Poison Ivy Eye-Cream? Stinging Nettles Anti-Itch Gel? The most toxic and allergy-inducing ingredients are naturally occurring substances, not manufactured ones.

3 – There are many standards of “organic.” USDA Certified Organic is the gold standard. Products with this label must be at least 95% organic and must not contain toxic ingredients. Products that are less than 95% but at least 75% can be labelled “made with organic ingredients.” If your product is not certified by the USDA, then inquire who certified it — some businesses will certify a product for a fee, which some people find improper.

4 – Organic products can still contain non-organic ingredients that are harmful. Your shampoo might be mostly organic, but it can still contain preservatives or fragrances that can cause a rash.

5 – All natural and organic beauty products are not necessarily more effective. The most potent skin care ingredients are prescription products, which are not organic.

There is value to choosing beauty products that are labelled organic — they may be better for you, and they’re probably better for the planet. Ultimately, the choice is yours. So now that you know what “organic” means on a label, at least it will be an informed choice.

Which of your products are organic? Do you think they are better? Why?

Photo: Rick Harrison

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HealthCamp is coming to San Diego, September 7th, 2010 at theTown and Country Resort and Convention Center. It will be in coordination with the 2nd International mHealth Networking Conference.

HealthCamp is a collaborative experience that focuses on social media, interactive health technology and mobile health (mHealth) for better health care.

HealthCamp is a user-organized “un–conference” that brings together consumers, health providers, payors, health industry experts and technology professionals for a one (1) day session to exchange ideas informally and openly. Participants themselves provide the content. The crowd determines the break-out sessions which are posted on a grid and people attend any of the sessions they desire throughout the day. Anyone can present or host a session.

Past healthcamps have been in Boston, Philadephia, Washington, DC, Nashville, San Leandro (San Francisco Bay area), Maryland and the UK. For an overview of healthcamp, click here.

Please consider joining me and many other leaders in health care social media this inaugural event in San Diego.

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I’ve been seeing a lot of jocks lately. The anatomical area, not the athletes. Summertime means heat and humidity, sports, and itchy groins. Jock itch is a general term for an itchy rash in the area. Heat, sweat, and skin rubbing on skin can leave the area looking like you slid into second base, groin first.

There are three main causes of an itchy groin. Classic jock itch is caused by a fungus, the same fungus that causes athlete’s foot. This fungus often causes a red scaly rash on the inner thighs. It tends to be dry and can have bumps or pimples. The fungus is often spread from your feet or from contaminated sports equipment, towels, etc. It can be treated with topical terbinafine cream 1% twice a day for 2-4 weeks. Severe cases can require oral anti-fungal medications, especially if the fungus has spread to other areas on your body.

The second cause of an itchy groin is a yeast infection (yes, the same yeast that can cause a vaginal yeast infection in women). The yeast grows well in warm, moist areas and causes a bright pink, moist, irritated rash. Unlike the fungus, yeast can spread onto the scrotum. It can be treated with topical clotrimazole cream 1% twice a day for 2-4 weeks.

The third common cause of a jock itch is a bacterial infection. Certain bacteria take advantage of the irritated skin and warm environment causing a rash called erythrasma. This can be treated with miconazole 2% cream twice a day for 2 weeks.

For all causes of jock itch it is important to keep the area clean and dry. Sometimes washing your groin with anti-dandruff shampoo such as zinc or selenium sulfide shampoos can help clear unwanted organisms. Hydrocortisone 1% cream can be added to any of the above treatments to reduce the redness and itching while the infection is being treated. Use it once to twice daily.

Remember, it is important to keep the area dry. The standard way is to use powders (some of which are medicated for an added bonus, such as Gold Bond). Once the active infection is resolved, treating your groin with your underarm antiperspirant can help keep this area dry, thereby making it less inviting for fungus and other organisms to return.

However, I don’t recommend spraying antiperspirant on your groin if you’re in the midst of a raging jock itch — you’ll spend the entire day scratching an area that shouldn’t be scratched in public.

Photo: jkstrapme (flickr)

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