Psoriasis Information March 13, 2013

Lately I have come across a few articles about the skin disease psoriasis so I thought I would share the information here.  I’ve addressed the issue of psoriasis before in this blog (see my post August is Psoriasis Awareness Month), but I wanted to go into greater detail here about this disease.

Just what is psoriasis and how many people does it affect?  In the article The Biology Behind Eczema and Psoriasis in Skin Inc. Dr. Claudia Aguirre explains:

Psoriasis has been confused with eczema, lupus, boils, vitiligo and leprosy. Because of the confusing connection with leprosy in ancient times, psoriasis sufferers were even made to wear special suits and carry a rattle or bell, like lepers, announcing their presence. Only in the 19th century was a distinction made between psoriasis and leprosy, alleviating some of the psychosocial impact of this highly visible and distressing skin disease.9 As with eczema, it presents as itchy, red skin and involves altered immunity. However, its complexities reach far beyond the surface of the skin. People with psoriasis have an increased risk of cardiovascular disease, metabolic syndrome, obesity and other immune-related inflammatory diseases—even cancer. The mysteries behind this complicated and debilitating skin disease are only beginning to be unraveled. Psoriasis is a chronic, inflammatory multisystem disease affecting 1–3% of the world’s population.3 Whereas the rashes on eczematous skin can have irregular edges and texture, psoriatic lesions tend to be more uniform and distinct. Red or pink areas of thickened, raised and dry skin typically present on the elbows, knees and scalp. This presentation tends to be more common in areas of trauma, abrasions or repeated rubbing and use, although any area may be affected. Unlike eczema, psoriasis comes in five different forms: plaque, guttate, pustular, inverse and erythrodermic.

Plaque psoriasis affects about 80% of those who suffer from psoriasis, making it the most common type. …

It may initially appear as small red bumps that can then enlarge and form scales. The hallmarks of this type are raised, thickened patches of red skin covered in silvery scales. The other types are less common and present inflamed skin with red bumps; pustules; cracked, dry skin; and even burned-looking skin. Clients will most likely be under a physician’s care, who will diagnose the type of psoriasis present.

As of today, psoriasis has no cure. A single cause of the disease has yet to be uncovered, but it is known that developing the disease involves the immune system, genetics and environmental factors. In psoriasis, aberrant immune activity causes inflammatory signals to go haywire in the epidermis, causing a buildup of cells on the surface of the skin. While normal skin takes 28–30 days to mature, psoriatic skin takes only 3–4 days to mature and, instead of shedding off, the cells pile up on the surface of the skin, forming plaques and lesions. The underlying reason may be due to the hyperactivity of T-cells, which end up on the skin and trigger inflammation and keratinocyte overproduction. Although it is not known why this happens, it is known that the end result is a cycle of skin cells growing too fast, dead cell-debris accumulation and resulting inflammation.

Many psoriasis sufferers receive medication from their doctors but there is encouraging research that the use of OTC AHA (alpha hydroxy acids) can help improve psoriasis symptoms.  In the post How Alpha Hydroxy Acids Could Help Treat Psoriasis Rebecca Harmon writing on Future Derm explains:

In common plaque psoriasis, the overgrowth of skin cells that collect at elbows, knees, hands, scalp, face and other areas can cause embarrassment and in some cases can be painful as clothing catches and pulls on the dry skin patches.

During a particularly hard-to-manage outbreak in my late 20’s, I was desperate to avoid the greasy and expensive steroid cream ($50 for a small tube) and smelling like the back end of a large coal truck wasn’t working for me either.  My particular case was cosmetically disturbing but not medically-complicated so I decided to stop buying the $50 prescription cream and turned to the beauty industry which was just beginning to offer face cream with AHA’s.

I quickly became a fan as I discovered that the flaky psoriasis patches on my face disappeared with a skin care regimen that included a daily application of the AHA face cream. Those were my stay-at-home-with-babies days, and I was as far removed from research or academic writing as one could be, but I didn’t need the denial of a null hypothesis to tell me that this was working.  I used it twice daily on my face and then started rubbing it in to my elbows and knees.  I still laugh remembering the cosmetic rep who finally asked how much face cream I was using (I ordered a lot of this stuff!).

And, yet, the research is in my favor. One study of 12 patients found that a creams with 15% glycolic acid, as well as .05% betamethasone, respectively, were helpful in reducing erythema, transepidermal water loss (TEWL), and lowering Laser Doppler values (Dry Skin and Moisturizer). And alpha hydroxy acids mixed with betamethasone were found to be even more effective in treating psoriasis in a double-blind, split-face, single site clinical study (JEAVD).

I have experienced mild outbreaks of psoriasis since that period but have continued to treat them with AHA-based lotions with consistent results.

And Rebecca isn’t the only extolling AHAs as a psoriasis cure from personal experience.  In the post We Answer Cara Delevingne’s Skin SOS: Psoriasis Alexandra Owens writes in Allure that:

A few years ago, I accidently discovered that Bliss Ingrown Eliminating Pads relieved my symptoms even better than prescription creams I’d tried. I asked New York dermatologist Doris Day why they work so well. “The alpha and beta hydroxy acids [in the pads] would help thin out the plaques of psoriasis, and the oat extracts, witch hazel, and lavender oil would soothe and hydrate the skin—but I would still apply a moisturizer after using them,” she says. “The nice thing about the ingredients being in a pad is that it’s easy to apply to the affected areas.” Another nice thing: You don’t need to see a doctor to get your hands on them.

When it comes to treating clients with psoriasis at the spa keep things simple and gentle and place an emphasis on encouraging relaxation.  Once again I’ll turn to the Skin Inc. article mentioned above:

Both eczema and psoriasis clients have impaired barrier function and increased inflammation, so your goal will be to protect and repair. Remember to always check first with your client’s physician for contraindications to medications and therapies, because some ingredients may counteract each other. For example, salicylic acid may seem a likely choice for exfoliating psoriatic skin, but could, in fact, inactivate a common topical treatment for psoriasis.

Once a full consultation with the client and possibly her physician is completed, proceed with a treatment using minimal products and procedures. A good way to compensate for minimal skin treatment time is to add on stress-relieving techniques, because there is a psychological component to eczema and psoriasis. Complementary therapies, such as aromatherapy, acupressure, reflexology, massage and inhalation techniques can be coupled with skin treatments to lower stress hormones and control inflammation.

Gentle cleansing and exfoliation is crucial to allow the penetration of rich, emollient moisturizers used on dry, sensitive skin. Avoid harsh exfoliants and detergents, and look for ingredients, such as lactic acid. Use anti-inflammatory ingredients, such as red hogweed, ginger, oats and chamomile, coupled with barrier-repairing oils, including evening primrose, borage, argan and sea buckthorn. Finishing a treatment with a physical sunscreen, such as zinc oxide or titanium dioxide will ensure that harmful UV rays do not cause further damage.

Bottom Line:  Though there is currently no cure for psoriasis there are ways to keep symptoms under control.  Since stress makes psoriasis worse finding ways to reduce stress is an integral part of psoriasis treatment and estheticians can certainly be a positive part of that process.

Further Reading:

• A Look at What Psoriasis Is And How To Treat It – Future Derm
• Psoriasis Patients Flock to Social Media for Support – Skin Inc.
• CDC Puts Psoriasis on Its Public Health Agenda - Skin Inc.

Image from worldinfo.info

How Our Skin Gets Its Color and Tone July 30, 2012

 

With the myriad of beautiful skin colors and tones the world over have you ever wondered how our skin gets its color and tone?  The process by which the skin’s melanin behaves is both interesting and complex.

The Skin Inc. article The Anatomy of Global Skin Tones helps to explain how skin color is produced:

The discerning factor in many ethnic groups is skin color. The color of the skin is produced in the deepest layer of the epidermis—the basal layer—which houses not only the keratinocytes responsible for the progression of cells to produce the epidermis, but also the melanocytes responsible for the production of melanin. Melanin plays a key role in protecting the skin from the penetration of UV rays. The darker the skin, the less UV penetration and the lower the incidence of skin cancer. The number of pigment-producing cells, called melanocytes, is equal, no matter what the skin color. The difference is the structure and function of these cells.

To produce melanin, there has to be two components: an enzyme—tyrosinase, and an amino acid—tyrosine. When these two components go through a conversion process called dopa, melanin is produced. In skin of color, there is increased tyrosinase activity, producing a more concentrated melanin content. The pigment granule’s size is the basis for skin color differences; the darker the skin, the larger the granule.

There are two distinct components of melanin. One is constitutive melanin, or pigmentation, and the other is facultative pigmentation. Constitutive pigmentation is the pigment that resides within the keratinocytes and is produced from the body’s own metabolism. Facultative pigmentation is introduced through external stimuli.

The melanocyte is a dendritic cell. The dendrites are tentaclelike projections that enable pigment cells to be deposited into the keratinocyte. These projections are longer in darker skin, enabling pigment granule dispersion into the upper layers of the epidermis.

Another unique difference in darker skin is that pigment granules—also known as melanosomes—are dispersed singularly over the nucleus of the keratinocyte. In Caucasian skin, the granules are considerably smaller and are released in clusters. Racially blended and lighter global skin colors disperse a combination of both single—and clusters of—pigment granules. The activity of a melanosome transfer generally takes place within the lower and upper spinosum layer. In some cases, the transferral is disseminated as pigment droppings into the dermis as a result of injury or trauma to the skin.

And what about how your skin reflects light?  This turns out to be an interesting scientific issue as well.  Another Skin Inc. article offers an explanation:

Reflection and refraction of light play a large role in the perception of overall skin tone. About 5% of the light that hits facial skin is reflected off the skin’s surface, while the other 95% penetrates it.^5–9 It is this light reflection process that gives human skin its optical depth. The white light passing through skin’s transparent surface reflects off of collagen, which essentially acts as a mirror beneath the surface. As the light reflects back to the surface, it absorbs color from pigments such as melanin and blood within skin’s many layers. Colored light is then diffused softly by the surface, generating a luminous glow.

With aging, collagen becomes more like an antique mirror, and light passes through it, compromising the skin’s ability to reflect and refract light. Additionally, uneven distributions of melanin, or age spots, and hemoglobin, or dilated or broken blood vessels, in the skin can further impede or scatter light, contributing to a dull, less luminous complexion.

(From Talking Tone: Melanin Under the Microscope)

These explanations about how our skin gets its color and tone are also a great reminder about how complex our skin and its processes are.  Never underestimate it!

Image from braintraining101.com

Foods That Prevent Skin Cancer? July 26, 2012

My newest skin obsession is finding out how the foods we eat impact our skin both positively and negatively.  Recently I came across the following information about foods that may help prevent skin cancer.

According to Prevention magazine (August, 2012, page 26):

Supplements – including vitamins, minerals, and antioxidants from berries, green tea, red wine, and dark chocolate – may help protect against skin cancer, a recent spate of studies show.  ”Regularly drinking green tea or adding antioxidants in the form of vitamin E or beta-carotene may be helpful, although topical use shows greater promise,” says Andrew Weil, MD, director of the Arizona Center for Integrative Medicine.  ”Compounds found in grapes (resveratrol); berries (ellagic acid); cruciferous vegetables such as broccoli, cauliflower, cabbage, kale, bok choy, and brussel sprouts; garlic; onions; and the spice turmeric also show promise for general cancer prevention.”  But the effects are modest, Dr. Weil says.  Preliminary studies also suggest that Heliocare, an oral supplement made from South American fern plants, may boost the body’s defense against sun damage slightly, but it’s very expensive.  So don’t forget the sunblock!

And drinking caffeinated coffee may help prevent certain types of skin cancer as well:

Drinking more cups of caffeinated coffee could lower a person’s risk of developing the most common form of skin cancer, basal cell carcinoma, according to a recent study published in Cancer Research, a journal of the American Association for Cancer Research.

“Our data indicate that the more caffeinated coffee you consume, the lower your risk of developing basal cell carcinoma,” said Jiali Han, associate professor at Brigham and Women’s Hospital, Harvard Medical School in Boston and Harvard School of Public Health.

Han and his colleagues conducted a prospective analysis of data from the Nurses’ Health Study, a large and long-running study to aid in the investigation of factors influencing women’s health, and the Health Professionals Follow-up Study, an analogous study for men.

Of the 112,897 participants included in the analyses, 22,786 developed basal cell carcinoma during the more than 20 years of follow up in the two studies. The results revealed a decrease in the risk for basal cell carcinoma as coffee consumption increased. Similar results were seen with other caffeinated products such as tea, cola and chocolate. Caffeinated coffee also reduced risk for other serious conditions such as type 2 diabetes and Parkinson’s disease.

However, consumption of decaffeinated coffee was not associated with a decreased risk of basal cell carcinoma, the study found. Also, neither coffee consumption nor caffeine intake were associated with the two other forms of skin cancer, squamous cell carcinoma and melanoma, the most deadly form of skin cancer.

Still, Han said more studies in different populations are needed before the group can make a “definite” determination on the impact of caffeine on these serious health conditions.

(Skin Inc.Study Says Caffeinated Coffee Decreases Skin Cancer Risk)

At least now I know my morning coffee is protecting my skin instead of hurting it, and I’ll continue to drink my green tea in order to help my skin.

April is Rosacea Awareness Month April 23, 2012

April is Rosacea Awareness Month so I thought it would be a good time to remind my readers about this skin disease.

Here are some basic facts about rosacea:

Rosacea usually first strikes individuals between the ages of 30–60, and may initially resemble a simple sunburn or an inexplicable blush. Suddenly, without warning, a flush comes to their cheeks, nose, chin or forehead. Then, just when they start to feel concerned, the redness disappears.

Unfortunately, it happens again and again, becoming ruddier and lasting longer each time–and eventually visible blood vessels may appear. Without treatment, bumps and pimples often develop, growing more extensive over time, and burning, itching and stinging are common.

In severe cases, especially in men, the nose may become enlarged from the development of excess tissue. This is the condition that gave comedian W.C. Fields his trademark red, bulbous nose. In some people the eyes are also affected, feeling irritated and appearing watery or bloodshot. Severe cases of this condition, known as ocular rosacea, can result in reduced visual acuity.

Among the most famous rosacea sufferers is former President Bill Clinton, whose doctors disclosed that he has this condition in The New York Times. Others reported to have suffered from the disorder include Princess Diana, financier J.P. Morgan and the Dutch painter Rembrandt.

In new NRS surveys, 69% of rosacea patients said they experienced a flare-up related to emotional stress at least once a month, and more than 90% of the respondents said they had suffered some form of physical pain from their condition. A burning sensation was the most commonly reported discomfort, named by 75%, followed by itching, cited by 65%, and stinging, mentioned by 62%. Other types of pain associated with rosacea included swelling (44%), tightness (42%), tenderness (40%), tingling (31%), prickling (23%) and headache (20%).

Perhaps even more ravaging than its physical effects, rosacea often inflicts significant damage to people’s emotional, social and professional lives.

Source:  Only on SkinInc.com: April is Rosacea Awareness Month – Are You Helping Rosacea Clients Cope?

Though there is no cure for rosacea this skin disease can be kept under control by making lifestyle adjustments (avoiding alcohol and steam rooms, applying proper sun protection, and avoiding other individual triggers) and using the right skincare products.  The right skincare products will be soothing, gentle, and anti-inflammatory.  Figuring out what triggers your rosacea to become worse and then avoiding and controlling those triggers makes a huge difference in how your rosacea looks and then affects your life.

Hopefully in the future scientists and doctors will find a cure for this skin disease.

Sources and Further Reading:

• National Rosacea Society
• My post – Rosacea: Causes, Triggers, and Treatment Options

Image from buynaturalskincare.com

The Peptide Puzzle: Hype or a Real Breakthrough? November 28, 2011

If you are someone who is interested in anti-aging advances you’ve probably been hearing about peptides for quite some time.  Since being added to skincare products peptides have been touted as a true anti-aging breakthrough and as an ingredient that will revitalize and rejuvenate the skin.  Yet the question remains – are peptides truly an anti-aging breakthrough or is this just a lot of marketing hype?

What Are Peptides and What Do They Claim To Do?

Simply put – a peptide is a chain of amino acids that form a protein.  Peptides have numerous applications when it comes to our health and wellbeing, but when it comes to skincare peptides are said to repair and regenerate the skin and to help rebuild collagen.  But before you go out and purchase a product with peptides in it (these products are usually very expensive) there are a few things to keep in mind:

Peptides are biologically active compounds that closely resemble proteins—both are chains of amino acids. The difference? Peptide chains include fewer amino acids. Generally, a chain with more than 50 amino acids is a protein while those with fewer is a peptide. However, there are exceptions. Peptides are classified according to their length. Therefore, you’ll often encounter terms such as dipeptides—two amino acids; tripeptides—three; tetrapeptides- four; pentapeptides—five; and so on. Although there are probably thousands of naturally occurring peptides, to date, only several hundred have been characterized.¹

Peptides play an array of important roles in the body, depending on the type. They may reduce inflammation, enhance antioxidant defense mechanisms, regulate bodily functions and even offer analgesic properties. In cosmeceuticals, three types of peptides are used, including:

• Signal peptides that encourage fibroblasts to increase production of collagen while decreasing the breakdown of existing collagen;
• Neurotransmitter peptides that limit muscle contraction and, thus, are said to mimic the effects of botulinum toxin; and
• Carrier peptides that stabilize and deliver trace elements necessary for wound-healing and enzymatic processes.

Given that signs of skin aging, including fine lines and wrinkles, are caused by a breakdown of collagen and elastin—the proteins that give skin strength and elasticity, as well as slow cellular turnover—the abilities of these peptides seem the perfect match for skin care formulations. However, not only are peptides expensive to utilize, in their natural state they also have shortcomings that significantly limit their potential in skin care applications. These shortcomings include the following.

• Peptides have a large molecular size and are hydropholic (water-liking), so they are unable to penetrate the lipopholic (fat-liking) stratum corneum layer of the epidermis.² Despite this, peptides are generally unstable in water-based formulations. The presence of water breaks down the peptide bond, rendering it inactive.³
• Should peptides be absorbed, the abundant presence of enzymes found in the skin can also break down peptide bonds.⁴

Fortunately, peptides are easily modified to improve their characteristics relative to use in skin care formulations. Chemists have found creative ways to overcome their limitations, such as attaching a fatty acid component to improve absorption into the skin, specific activity and economic feasibility.

Source:Peptides: Ready for Primetime?  by Ahmed Abdullah, MD in SkinInc.

Do Peptides Really Work in Skincare Products?

Here are some more consumer tips to keep in mind before purchasing a product with peptides in it:

Although chemists have found ways to optimize peptides for use in topical skin care formulations, they still face hurdles before they can generate the results anticipated by the consumers who buy them. Assuming the peptide has been modified to improve its stability in skin care formulations, through chemistry, the use of appropriate product packaging and its ability to penetrate the skin, it’s still essential that the product feature an effective delivery system to reach the target area where collagen synthesis, wound-healing and other activities may occur. Only when the peptide is absorbed by the skin and delivered to the targeted area in a stable form will it stand the potential of generating results.¹

Formulators are certainly rising to this challenge. Sophisticated new delivery systems are regularly being developed, and the onus is on skin care professionals to stay on top of these new developments to ensure the products they are recommending stand a strong chance of truly providing their marketed benefits.

Another challenge: To be effective, peptides must be utilized in appropriate concentrations. Unfortunately, ingredient concentrations within a formulation are rarely disclosed on the label. Given the generally high cost of peptides, some manufacturers use them in concentrations below those utilized in scientific research or recommended by the peptide manufacturer. This is a marketing trick that allows the company to tout the use of a certain peptide and charge a lower price for the product. However, the formulation is nearly certain to be ineffective. Because of this, it is important to request and obtain backup research for product claims from manufacturers.

Speaking of research, although some third-party studies do exist that demonstrate positive outcomes from the use of peptides in skin care, there remains the issue of consumer expectations. For example, acetyl hexapeptide-8 is incapable of delivering results similar to that of botulinum toxin injections. Yet, this mantra is still promoted by many consumers and even individuals within the industry when referring to this compound. Because of this, consumer expectations are often out of line with the true capabilities of some peptide products. To be clear, if peptides were indeed able to produce results that matched much of the hype, they would be classified as drugs and require U.S. Food and Drug Administration (FDA) approval for use. To that point, it’s often necessary to downplay much of the hype surrounding the use of these ingredients until a stronger base of unbiased research exists.

Source:Peptides: Ready for Primetime?  by Ahmed Abdullah, MD in SkinInc.

There are even more issues with peptides to keep in mind.  Here is what Dr. Ellen Marmur in her book Simple Skin Beauty has to say about peptides (pages 288-289):

 Much like growth factors, peptides are a bioengineered version of a natural element in the body.  (Some natural moisturizers contain plant peptides, derived from wheat or rice.  Along the same lines as kinetin, which has a plant growth factor, these may work as well as biotech versions.  Considering that we don’t know what will penetrate the skin anyway, why not?)  The idea of adding peptides to the skin is theoretically like sending in a surge of troops to carry out repair and regeneration.  In vitro tests have found that pentapeptide-4 does prompt fibroblasts to product more collagen in cell cultures.  (As usual, there is a serious lack of truly objective data since the companies that manufacture the peptide ingredients have funded most of the studies.)  And remember, a cell culture is a dish of cells and is far cry from your skin.

My bottom line:  Can peptides penetrate to the dermis to stimulate collagen production?  Without scientific studies that biopsy the skin, it’s difficult to assess whether they can and if they really work.  The inspiration behind these ingredients makes sense, and time will tell if some may be effective antiagers.  Because peptides happen to be effective humectants, a product containing them will successfully hold moisture in the skin.

They’re worth a try, especially since you’re assured of getting an excellent humectant and most include antioxidant components too.

On the other hand, Dr. Leslie Baumann lists peptides as one of the “most misleading skin care claims of 2009“:

The theory is that topically applying peptides can trick our skin cells into producing even more collagen. In reality, peptides don’t penetrate the skin — if they did, other peptides such as insulin would already be supplied by creams rather than injections. Products like StriVectin may make the skin feel smooth but they have not been shown to have long-term clinically-significant benefits.

The Beauty Brains has even more damning things to say about peptides (though keep in mind that The Beauty Brains post I am quoting from is from 2008)

Peptides have no function in skin care products.  They do not increase collagen or prevent DNA damage.  They are story ingredients that make people feel better about the products they are using.  There’s nothing bad about them in your skin product.  They just don’t provide much benefit.

Should You Buy a Skincare Product with Peptides In It? 

So who do you believe when it comes to the benefits of peptides in skincare products?  I’m on the fence about this one – I do think that peptides in skincare products could be great, just make sure you get the right product.  Remember these products are pricey.  There are two good sources for specific product information – one is FutureDerm and another is Paula Begoun’s Beautypedia.  I would check both of these sources before making any purchases.

Further Reading:  Here are some more resources for peptide information – both for and against their use in skincare products

• Peptides:  Cosmetic Ingredient Dictionary Paula Begoun
• The Next Generation of Peptides by Lydia Sarfati in Skin Inc.
• Cosmeceutical Critique: Peptides by Dr. Patricia Farris  – The Skin Type Solutions Library under ingredients

August is Psoriasis Awareness Month August 11, 2011

August is Psoriasis Awareness Month so I wanted to use this post to highlight some resources for those suffering from this skin disease.

 

What Is Psoriasis?

According to Dr. Ellen Marmur in her book Simple Skin Beauty (pages 230-231) psoriasis is a condition that is:

 … characterized by thick, red plaque with a white, silvery (micaceous) scale on top.  It’s itchy and painful and can create big fissures on the skin.  It tends to be on extensor surfaces, such as the elbows, knees, and scalp.  There are several types of psoriasis, and some can be quite severe, affecting the joints and causing something called “psoriatic arthritis”.  It can also be mild, manifesting itself as one patch of plaque on the body, such as dry, cracked elbows that don’t soften no matter how much moisturizer you put on.

Psoriasis is a genetic, chronic inflammatory disease where for some reason lymphocytes (immune cells) are attaching the skin, causing cell turnover to accelerate.  Therefore, the dead skin cells aren’t shedding as fast as the maturing cells are rising to the surface.  This pile-up creates a silvery scale on the surface.

Psoriasis Treatments

If you do suffer from psoriasis there are some things you can do at home to help prevent your condition from getting worse.   Once again, according to Dr. Marmur:

Don’t scratch or try to scrub off the scaly skin.  Instead, moisturize with a thick, occlusive cream or ointment twice a day.  Sweat will irritate the skin, as will fragranced products or perfume.  Psoriasis sufferers have to be careful about everything they put on their skin – even sunscreen can sting.  Even one patch of plaque should lead you to see a dermatologist, especially since it’s likely that you will develop others in the future.  It’s important to get a good treatment program to prevent a more extensive outbreak.

So what other treatment options are out?  According to Dr. Amy Taub, as quoted in the article August is Psoriasis Awareness Month; Is Your Spa Ready? online at Skin Inc. :

• Laser. A 308nm laser provides targeted phototherapy treatment for psoriasis offering safe, effective and lasting results. This laser uses a focused beam of ultraviolet light on the affected skin area avoiding exposure to healthy skin.
• Topical agents. In mild psoriasis, where less than 10% of the body surface is affected, topical creams, ointments, gels and lotions are often applied first. These usually consist of steroids, vitamin D derivatives, retinoids (vitamin A derivatives) and tar-based topical treatments. The most common is a steroid because of its anti-inflammatory properties and because it also decreases the redness and scaling relatively quickly.
• Oral or injectables. When psoriasis is more severe or light treatments or topicals have failed, oral or injectable solutions may be considered. They work by decreasing the metabolism in overactive cells thereby decreasing the rapidity with which psoriatic skin is made helping to normalize it. In addition, sufferers now have biologic medications available, also known as “designer” drugs, which attack specific molecular targets in the immune system.

Dr. Taub tells SkinInc.com exclusively about possible psoriasis treatments that are currently in the works.

Awaiting U.S. Food and Drug Administration (FDA) approval, new biologic agents are being investigated at a very rapid pace. New receptor molecules have been identified as targets (called IL-23 receptors) that may be even more specific than the agents that are known about today. The older biologics have undergone many years of study, and the dermatologic community is finally feeling more confident about the long-term safety of these agents as a result of this data. In fact, there may even be some negative consequences of not treating psoriasis. More data is pointing to the fact that having unchecked psoriasis could lead to an increased risk of cardiovascular disease, leading many dermatologists to push more toward treatment as being more conservative.

If you think that you may have psoriasis see a dermatologist immediately in order to start a treatment plan before your condition worsens.  Please see below for lots of online resources for even more information about psoriasis.

 

Other online resources for information about psoriasis and treatment options:

• National Psoriasis Foundation
• Psoriasis – Paula Begoun
• Tim Gunn’s Fashion Therapy for Psoriasis  -  The New York Times
• Psoriasis Health Center - WebMD

Teens and Tanning Beds April 28, 2011

Hopefully you don’t know a teen who uses a tanning bed, but the scary thing is that too many teens do use tanning beds since they are completely unaware of the dangers involved with their use.  Once a teen starts tanning it is really hard to get them to stop (it has even been proven that tanning is addictive which is very scary).  The US lags behind other nations in banning the use of tanning beds by teens; for instance the UK has banned the use of tanning beds by anyone under the age of 18.

According to The Skin Cancer Foundation:

Despite a link between indoor tanning bed use and an increased risk of melanoma, the deadliest form of skin cancer, 2.3 million teenagers visit tanning salons every year. In the spring, many tanning salon patrons are college students getting ready for spring formals, and high school students gearing up for prom season. So it’s no surprise that melanoma is now the most common form of cancer in young adults 25-29 years old, and the second most common form of cancer in adolescents and young adults ages 15-29.

“The damage caused by the ultraviolet (UV) radiation from tanning beds and the sun is cumulative and often irreversible, and the earlier people start to tan, the higher their risk of developing skin cancer in their lifetimes,” said Perry Robins, MD, President, The Skin Cancer Foundation. “In fact, melanoma risk increases by 75 percent when indoor tanning begins before age 35.”

If the threat of skin cancer isn’t enough to scare young people away from tanning salons, they should know that 90 percent of visible skin changes commonly attributed to aging are caused by exposure to UV radiation. Tanning accelerates the signs of aging, including wrinkles, leathering and fine lines, which can be seen as early as in one’s twenties.

Despite the fact that The American Academy of Pediatrics supports a ban on the use of tanning beds by minors it is still legal for teens to use tanning beds.  The Skin Cancer Foundation points out:

In the US, tanning is regulated by the states, some of which allow children as young as 14 to tan. The US Food and Drug Administration (FDA) classifies UV-emitting tanning machines as Class I Medical Devices, meaning that it considers them to “present minimal potential for harm to the user.” Last year, the General and Plastic Surgery Devices Panel of the FDA’s Medical Devices Advisory Committee unanimously recommended that the FDA upgrade its classification of tanning devices to better reflect the serious health risks tanning machines pose. The majority of the panel was also in favor of an age restriction to limit minors’ access to UV tanning devices.

So until the FDA and/or the federal government ban the use of tanning beds by minors what can you do to prevent teens from using tanning beds?  First and foremost, I think education is key.  If scaring a teen with the risk of cancer isn’t enough to get them to stop using a tanning bed appeal to their vanity by explaining that they are aging their skin tremendously by using a tanning bed.  If you want to do even more write to the FDA and/or your senator or congressperson asking them to support a ban on tanning bed use by minors.  Recommend to a teen who really likes how their skin looks tan to get a spray tan or fake a tan with a home applied tanning lotion.  There are a tremendous number of products on the market in all price ranges so there is really no excuse not to try one if you like the way your skin looks tan.

If any of the above tactics don’t stop the teens you know from tanning have them hear a personal story about the dangers of tanning beds.  I found this story on the FDA website:

Brittany Lietz Cicala of Chesapeake Beach, Md., began tanning indoors at age 17. She stopped at age 20 when she was diagnosed with melanoma, the deadliest form of skin cancer. The former Miss Maryland says she used tanning beds at least four times a week, and sometimes every day.

“Growing up, until I started using tanning beds, my parents were very strict about me wearing sunscreen,” says Cicala. Although she also tanned in the summer sun during her 3 years of tanning bed use, Cicala estimates that 90 percent of her UV exposure was in tanning beds during this period.

In the 4 years since she was diagnosed with melanoma, Cicala’s surgeries have left her with about 25 scars. Cicala gets a head-to-toe skin exam every 3 months, which usually results in removal of a suspicious growth.

 

Sources and Further Reading:

•  An ABC World News segment about the dangers of indoor tanning including the personal story of a young woman battling melanoma.
• Lots of information about the dangers of indoor tanning can be found on this page of The Skin Cancer Foundation website.
• Indoor Tanning: The Risks of Ultraviolet Rays from the FDA.
• Teens and Melanoma - Skin Inc.
• Indoor Tanning Encouraged by Parents, Peers- Skin Inc.

   

 

 

More Beauty Facts February 15, 2011

 

A few more interesting and curious beauty facts:

•  ”Health and beauty care items” accounted for 20% of all items stolen from supermarkets in 2008, according to a survey from the Food Marketing Institute, with Oil of Olay skin creams topping the list of swiped items. (Skin Inc.)
• According to The NPD Group Inc., in 2005 the average age a woman began using beauty products was 17; today it is 13.7. Experian Market Research shows that 43% of 6- to 9-year-olds are already using lipstick or lip gloss, 38% use hairstyling products and 12% use other cosmetics (J. Bennett: Newsweek article “Generation Diva”). (Skin Inc.)
• According to Datamonitor, 28% of consumers currently deliberately avoid certain cosmetics or toiletries because of fears about certain ingredients, and 39% are somewhat or extremely concerned about parabens or petrochemicals used in beauty product formulations. U.S. Food and Drug Administration statistics confirm that cosmetics are one of the safest categories of products used by Americans: With more than 11 billion personal care products sold each year, only 150 adverse experiences (mostly skin rashes or allergies) have been reported. (Skin Inc.)

Botox Explained January 27, 2011

 

Since Botox’s approval by the FDA for cosmetic use it almost seems like its uses, potential side effects, and safety are taken for granted.  But do you really know how Botox works, how to store it, and how it is injected?

Skin Inc. just published a very comprehensive article that really explains everything you need to know about Botox.  Entitled Chemodenervation From Physiology of the Skin, Third Edition the article succinctly goes into detail about the history of the use of Botox, how it is injected, how injecting Botox affects facial wrinkles and also other body conditions like excessive sweating, and the potential side effects from Botox injections.

If you have ever had any questions about Botox be sure to check this article out.  Reading it will only take a few moments and leave you much better informed in the long run.

Winter Sun Care December 15, 2010

Just because it is cold doesn’t mean you should put away your sunscreen.  Just the opposite, especially if you are going to participate in outdoor winter sports.  According to an online article in Skin Inc:

… researchers found that while UV levels can be just as high atop a snowy mountain as on a sandy beach in mid-summer, skiers and snowboarders don’t always protect their skin accordingly.  “It’s a little counterintuitive,” lead researcher Peter A. Andersen, of the School of Communication at San Diego State University in California, told Reuters Health. “But there’s an inordinate amount UV at that elevation, reflecting off the snow and coming at you from all directions. Skiers are bathed in radiation.”  … 

Andersen and his colleagues visited 32 high-altitude ski resorts in western North America, where they took a total of 4,000 UV readings—some pointed directly at the sun, others at the sky away from the sun or at the snowy slope of the mountain. On the same days, they interviewed guests on chairlifts and observed their sun-protective clothing and equipment.Not surprisingly, UV radiation peaked at midday, and was more intense during spring than winter, with clear skies and at higher altitudes and lower latitudes. Higher temperatures also played a small role. Of course, avoidance of these peak conditions does not mean absolute UV protection, the researchers say. Although UV can drop by as much as half with cloud cover, for example, there is still plenty of skin-damaging radiation that sneaks through.

“Depending on the conditions, the UV index at a ski resort can potentially be as powerful as Waikiki on a bright, sunny day,” he said, referring to the Hawaiian beach. He pointed out that his team had multiple readings of 10, or “very high,” based on the U.S. Environmental Protection Agency’s UV index. But people’s behavior didn’t always match the UV intensity, report the researchers in the Archives of Dermatology.

 

So what can you do to protect yourself from the sun while participating in outdoor winter sports?    Apply a sunscreen with spf 30 or higher every two hours while outdoors or reapply after sweating.  Cover up with gloves, hats with brims, and sunglasses while outdoors.  Any exposed skin should have sunscreen on it so be sure to apply sunscreen to your neck and ears.  And don’t forget your lips!  They need sunscreen as well – always. 

And remember these tips are for everyone even if you don’t spend a lot of time outdoors during the winter.  You still need your sunscreen if all you are doing is driving back and forth from work in your car.   Sun protection is  year round committment – never put your sunscreen away!

 

Sources and Further Reading

 

• UV Radiation as Prominent in the Snow as on the Beach - Skin Inc. – December, 2010
• Your Winter Face - The Skin Cancer Foundation
• My posts -  Winter Skincare Tips and Dos and Don’ts and Winter Skincare