Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Three Products That My Dermatologist Says Are “Of The Devil” – And Other Skin Tips

This actress keeps her dermatologist on speed dial too.

As a light skinned, be-freckled woman with a history of pre-melanoma, I have been sternly instructed to keep my dermatologist on speed dial. Every six months I dutifully return to his office for inspection – nervously eyeing the biopsy tray as I sweat through my paper gown, legs dangling from a vinyl exam table.

In preparation for my most recent trip, I decided to be “an empowered patient” and arrive with a list of general dermatology and skin care questions that could be answered during my skin check. Judging from the near-syncopal episodes that I induced in my dermatologist while describing some of my hygiene practices, I’m not being very good to my skin. In fact, he wanted me to know that at least three products that I currently use are “of the devil.” Just in case you are inadvertently engaging in demonic skin care practices as I was – I thought I’d share what I learned:

1. Dryer sheets. According to my dermatologist, dryer sheets contain “a horrible chemical that no one can pronounce” that becomes “slathered all over your clothing” during the drying process. Although I was fond of the fresh scent and soft texture of my gym clothes, he assured me that heat and moisture was the best way to re-activate the irritating chemicals on delicate skin, virtually guaranteeing a contact dermatitis of the nether regions. So if you’ve been experiencing any unpleasant post-work out skin “issues” – consider dryer sheets as a potential cause.

2. Antibacterial ointments. Personally, I find that over-the-counter antibacterial ointments do a great job of preventing razor bumps. However, my dermatologist says that repeated or excessive use of these products can lead to allergies and colonization with antibiotic-resistant organisms. So… unless you want to be giving MRSA a “come-hither stare,” you might want to opt out of the Neosporin.

3. Battery-operated exfoliating brushes. I’ve seen so many ads for Clarisonic-type products that I figured they would be a reasonable choice for facial exfoliation needs. In fact, this topic may be somewhat controversial since I know other doctors who recommend these products. However, my dermatologist says that they are overkill and might do more harm than good to delicate facial skin, especially if you use any products that have an exfoliating acid included in their ingredient list, or if you use scrub creams. In other words, if you wash your face regularly, you probably don’t need to use additional aggressive cleaning measures.

In addition to the information provided about evil products commonly used by innocent people across America, my dermatologist offered these general tips for healthy skin:

1. You don’t need so much moisturizer. “You don’t need to put on moisturizer every night just because your mother told you to,” he said, bow tie looming large at eye-level. “Women think they need to apply moisturizer multiple times a day, but there is enough moisturizer in sunscreens and anti-oxidant serums to make additional products unnecessary.”

2. Throw away your 10x mirror. “Honestly, no one sees your skin at 10x, so why should you worry about what it looks like so close up? The best way to make your pores look smaller is to quit looking at them under a magnifier.”

3. Use physical block sunscreen every day. Most of the cheaper, spray-on sunscreens use chemicals to scatter light, but zinc-based sunscreens physically block incoming UV radiation. “The most important part of an ‘anti-aging’ regimen is to avoid sun exposure, and the best way to do that is with constant use of physical blocks.”

4. Skin-lightening cream (hydroquinone) can reduce the appearance of sun damage. Hydroquinone is the active ingredient in most skin-lightening creams. It acts to down-regulate melanin production in melanocytes, but can be reversed fairly easily by UV exposure (i.e. sunlight up-regulates melanin production). So even if you’re already pale-skinned, hydroquinone products can even out skin tones and sun spots – but only if you simultaneously commit to aggressive avoidance of UV exposure.

I hope you’ve found these skin tips enlightening (pun intended). I’ll have to think of some other good questions to ask my dermatologist in 6 months from now, during my next cancer screening. Because as an empowered patient, I intend to learn as much as I can in my 15 minutes with the doctor, and then share it with as many people as possible. :-)

Dermatologists Relocate To The Sunniest Parts Of The U.S.

Dermatologists spend their days telling patients to avoid the sun and their careers striving to practice in it. They’re leaving the Midwest and mountain states to practice in the southern and western U.S.

To evaluate the migration patterns of dermatologists from residency to clinical practice, researchers reviewed data from the American Academy of Dermatology’s membership database. They looked at 7,067 dermatology residents who completed training before 2005 and were actively practicing in 2009. Results appeared at the September issue of the Archives of Dermatology.

Most graduates from Middle Atlantic and Pacific census divisions relocated Read more »

*This blog post was originally published at ACP Internist*

Why Are Humans So Drawn To Sunlight Despite Its Negative Consequences?

Sunny-beachIt doesn’t make sense: If sunlight causes cancer, why are human beings so drawn to it, flocking to sunny beaches for vacation time and hoping for sunshine after a rainy spell?

One answer, says David Fisher, chief of dermatology at Harvard-affiliated Massachusetts General Hospital in Boston, may be that humans are literally addicted to sunshine so our skin can make vitamin D. New evidence suggests that we get the same kick out of being in the sun that we get from any addictive substance or behavior. It stimulates the so-called “pleasure center” in the brain and releases a rush of feel-good chemicals like endorphins.

So there may be more than a desire to look good in a tan behind the urge to soak up the sun’s rays. This craving may be a survival mechanism that evolved over thousands of years because humans need vitamin D to survive. Skin makes this crucial vitamin when it is exposed to sunlight. There isn’t much vitamin D in food (except in some of today’s fortified foods) so the human brain rewards us with a rush of pleasure when we seek out the sun and get vitamin D.

Seeking sunshine can be downright dangerous. As Fisher points out, Read more »

*This blog post was originally published at Harvard Health Blog*

Hard Water: Is It Hard On Your Skin?

Hard water is tap water that’s high in minerals such as calcium and magnesium. Hard water isn’t harmful, except the minerals prevent your soap from sudsing. Some people think that hard water is more likely to cause a rash than soft water.

Take a recent patient of mine: He moved his family to San Diego from the East Coast (good move this winter, no?) After they moved here, they noticed their skin became dry and itchy. He blamed San Diego’s notoriously hard water and installed a water softener in the main water line. It was costly, but did it improve their skin?

A recent study from the UK looked at this question: Does hard water worsen eczema? The answer was no, it doesn’t. Water hardness did not seem to have any impact on eczema, the most common skin rash.

What’s more important than the hardness of the water is the type of soap you use. True soap tends to strip the skin of its natural oils, leaving it exposed and irritated. Non-soap cleansers, of which Dove is the prototype, leave more oils on your skin, keeping it hydrated and protected.

My patient and his family didn’t get any better after installing a water softener (although he said they could drink our tap water without gagging now.) I advised him to change to a moisturizing soap and to apply moisturizer daily.

San Diego is drier than most of the country, and the low humidity can be a shock to skin accustomed to humid air. Many people who move here find they have to moisturize more often than they did back home.  When they complain, I suggest they could alternatively move back to the East Coast this winter — no takers so far.

*This blog post was originally published at The Dermatology Blog*

Fungus: An Unwanted Yoga Partner

Yoga is good for your mind and body, including your skin. Yoga mats, on the other hand, might not be. Using someone else’s yoga mat for an hour could lead to an infection.

Fungal infections are common and appear as athlete’s foot, toenail fungus, and ringworm. Unfortunately, the fungus can survive on surfaces like mats long after the infected person has left. Although most people blame the gym locker room when they develop athlete’s foot, you can catch the fungus from a variety of places anytime you walk barefoot.

Fortunately, even if the fungus comes into contact with your skin, it doesn’t always lead to infection. Dry, cracked skin, or soft, wet skin disrupt your primary defense against the fungus — the densely packed barrier of skin cells, oils and proteins on your healthy skin’s surface. Here are five ways to prevent taking a fungus home with you from your next yoga class:

1. Bring your own mat. At least you know what you have.

2. Use an alcohol sanitizer on your hands and feet after your class. Sanitizers with at least 60 percent alcohol are excellent at drying up the fungus and killing it long before it has a chance to infect you. Read more »

*This blog post was originally published at The Dermatology Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »