Poorly Executed Cosmetic Procedures Can Leave Lasting Damage

A visit to a skin treatment clinic in a Florida suburban mall in late 2004 changed 52-year-old Jordan Miles' life forever.

She had responded to an ad from the clinic that promised help for her teenage son's acne. He didn't get the treatment, but Miles made an appointment for herself for laser treatments to remove sunspots on her arms, back and chest.

Two women ended up performing the procedure -- neither, Miles later found out, had the necessary training.

"They started with the laser on my chest, and when they got to my back, they decided the sunspots were worse, and so they upped the laser, further intensifying the procedure," Miles recalled.

The outpatient procedure left Miles, a mental health counselor, in such excruciating pain that she vomited on her way home. Getting no helpful response from the clinic, she consulted a dermatologist, who confirmed that she was covered in red, stripe-like second- and third-degree burns that would leave lasting scars.

The redness subsided, but each burn drained the pigment from her skin, leaving Miles open to further skin problems should she ever expose the affected areas to the sun.

"I now have what looks like zebra stripes everywhere," Miles said. "I'm restricted from a lot of activities and types of clothing. It's terrible."

Miles' experience is hardly unique. In the past few years, reports of fraudulent or shoddy cosmetic and plastic surgery procedures have grabbed headlines:

• In 2003, New York City financial analyst Maria Cruz died after a fatal reaction to lidocaine, delivered by Dean Faiello, a 46-year-old from Newark, N.J., who had been posing as a cosmetic surgeon. Faiello fled to Costa Rica but was apprehended by U.S. authorities in 2006 and is now in prison.
• In 2004, four people in Florida became paralyzed after Bach McComb, an osteopath with a suspended license, administered lab-strength botulism toxin -- not the much weaker Botox -- to himself, his girlfriend and two others. McComb was later sent to prison for three years.
• In 2005, a 46-year-old California woman died of multiple organ failure after receiving a buttock injection of what had been billed as a "French polymer" but was actually cooking oil. The beautician who delivered the shot, 39-year-old Martha Mata Vasquez, was sentenced to 15 years in prison in January.

It's tough to tell how often these types of dangerous procedures are being performed in the United States, experts said.

"I think that, especially in big cities, it's more common than you think, because I see lots of patients with problems who have been treated in hotel rooms, for example," said Dr. Rhoda Narins, past president of the American Society for Dermatologic Surgery (ASDS) and a clinical professor of dermatology at New York University Medical Center.

"Sometimes, when I ask patient what it is that they have had, they really have no idea," she said. In many cases, procedures are performed in non-medical settings -- hotel rooms, private homes, beauty clinics and spas, Narins said. "I've seen several patients who had spa treatments and got comfortable there, and then they were offered non-medical-grade silicone. They ended up having horrendous reactions."

Dr. John W. Canady, vice president of the American Society of Plastic Surgeons (ASPS), said that the underground nature of these sub-par procedures makes them especially hard to track.

He and Narins said consumers should watch out for the following "red flags" when seeking out cosmetic injections or surgeries:

• Check for credentials. It's not enough that your "doctor" is wearing a white lab coat and has a certificate on the wall. A number of organizations -- the ASDS, the ASPS, the American Board of Plastic Surgery and state medical boards -- have online resources that people can check to verify credentials and experience.
• Be wary of cheap deals. "If a procedure has an unbelievable price that nobody else is offering, then you really have to slow down and examine why it's so cheap -- why is it so out of line with the rest of the market?" said Canady, who is also professor of plastic surgery at the University of Iowa.
• Look for nearby medical support. Even procedures conducted by the best-qualified staff can go awry, so make sure your practitioner has equipment and qualified personnel on hand to deal with allergic reactions, clotting and other events. Most reputable clinics will have hospital affiliations. "As a patient, you want to know what things are available if things don't go right," Canady said.

Most of all, the experts said, ask questions.

"It's important to be a responsible consumer, to do your homework, to not be afraid to ask the tough questions," Canady said. "If you ask people legitimate questions in a non-offensive way, and they get angry or hostile with you, then you need to go find somebody else."

Narins agreed that an educated, proactive consumer is the best defense against fraud and abuse in her industry.

"People shouldn't take chances with their health. When you inject something into your body, this is not the same as getting a massage," she said. "This is something that can seriously affect you, and for a long time."

That's a lesson Miles said she learned the hard way, but she's hopeful that her story can at least help others. The clinic she received her laser treatment from has since closed down, and Florida state law was recently toughened to mandate that all laser procedures be done under a doctor's supervision.

But Miles said her scars are a daily reminder that patients remain vulnerable.

"Make no assumptions, and don't be afraid to ask questions," she advised. "The mistake I made was that I never asked these women if they were a nurse practitioner, or if they had any experience doing this before, or how many times they had done it before. All of those were major mistakes."

HealthDay News, 2/26/2007, By E.J. Mundell

Spearmint Tea May Help Women With Hirsuitism

Drinking two cups of spearmint tea a day might help treat women with an unsightly condition that causes them to grow excess hair on their face, breasts and stomach, Turkish researchers report.

The tea works by lowering the levels of circulating male hormones in these women, the scientists claim in the current online issue of Phytotherapy Research.

The authors called the findings preliminary.

"There are no recommendations for patients and physicians yet," said Mehmet Numan Tamer, co-author of the study and a professor of endocrinology and metabolism at Suleyman Demirel University in Isparta, Turkey. "This is the first clinical study about the spearmint tea, but further studies are needed to give the practical recommendations to patients."

But other experts feel the findings are far-fetched.

"This is absurd," said Khursheed Navder, an associate professor of nutrition and food science at Hunter College in New York City. "I completely think it is very preliminary, and you need major randomized trials. It's nothing to get thrilled about."

Hirsutism is a condition that can occur in both men and women, but, for obvious reasons, it is more of a cosmetic concern in women. The hair growth is a result of unnaturally high levels of androgens such as testoserone.

According to Tamer, standard therapy includes oral contraceptives to suppress androgens or drugs such as spironolactone, which prevents the body responding to androgens.

Spearmint, which grows naturally near Isparta, has been widely used for indigestion, nausea and vomiting, as well as for the common cold, cough, sinusitis, fever and bronchitis.

"Spearmint has been used as an herb for a long time now," confirmed Navder. "These are all folk remedies."

The Turkish researchers thought that spearmint might be linked with reports of diminished libido in townsmen (presumably because of its effects on androgen levels). In one previous rat study, spearmint reduced testosterone levels.

"Previously, we investigated the effects of [peppermint] and [spearmint] herbal teas on testicular function in an experimental rat model and found that testosterone levels were decreased," Tamer said. "Because we found the anti-androgenic effects of spearmint, we decided to observe the effect of this herbal tea on the androgen levels in hirsute women."

For this study, 21 women with hirsutism drank two cups of herbal spearmint tea for five days at a certain time in their menstrual cycle.

All women showed a decrease in free testosterone (circulating hormone not bound to other molecules) and an increase in several different "female" hormones, including follicle-stimulating hormone and estrogen.

There was no significant decrease in total testosterone levels; it was unclear if there was any change in amount of excess hair growth.

"The next step is to show the effect of spearmint tea on hirsutism scores of the women in a treatment period," Tamer said.

Although the amounts of spearmint used in this study are not generally toxic, the herb can be harmful if taken in larger amounts

New Drug Helps Ease Psoriasis

Many patients with moderate to severe chronic psoriasis showed significant improvement after treatment with Humira (adalimumab), according to a study presented at the recent annual meeting of the American Academy of Dermatology in Washington, D.C.

The REVEAL (Randomized Controlled EValuation of Adalimumab Every Other Week Dosing in Moderate to Severe Psoriasis TriAL) included 1,200 patients. After 16 weeks, 71 percent of the patients who took the drug showed a 75 percent improvement in skin clearance, compared to 6.5 percent of patients who received a placebo.

The study also found that patients who took the drug continuously were much less likely to experience a worsening of their psoriasis symptoms.

Upper respiratory tract infection, headache and nasopharyngitis were the most common side effects reported by patients in the study.

The REVEAL results will be submitted by drug maker Abbott in its applications to have Humira approved for treatment of psoriasis in the United States and Europe.

Psoriasis is an autoimmune disease that causes raised, inflamed, scaly, red skin lesions that can crack and bleed. There is no cure for psoriasis, which affects about 125 million people worldwide. Of those, about 25 percent have moderate to severe psoriasis. The disease can occur at any age but typically appears between the ages of 15 and 35.

HealthDay News, February 13, 2007

Hundreds of Bacteria Species Discovered on Human Skin

Human skin is crawling with bacteria, say U.S. researchers who identified more than 200 species -- 8 percent of which were previously unknown -- on samples collected from the forearms of six people.

The New York Medical School team used genetic analysis to detect the types of bacteria present on the volunteers' skin, BBC News reported.

An initial analysis detected 182 species of bacteria. Another test was conducted eight to 10 months later to see if there had been any changes. That second analysis revealed 65 more kinds of bacteria.

About half the species were already known to be common skin dwellers, but 8 percent had not been previously described in scientific literature. The researchers also found that about 75 percent of the bacteria species were unique to individuals, which suggests the skin is "highly diversified," BBC News reported.

The findings were published online in the journal Proceedings of the National Academy of Sciences.

"Over the years maybe about 50 different organisms have been found in human skin but we knew there were more organisms present" that couldn't be detected, study leader Martin Blaser, professor of microbiology, said in a prepared statement.

"We have now gone up five-fold from what's been known before," he said.

Experts say that bacteria plays an important role in keeping skin healthy, BBC News reported.

HealthDay News, February 6, 2007

Genital Skin Cancer More Deadly for Females

Women are three times more likely than men to die of genital nonmelanoma skin cancer, new U.S. research shows.

Genital nonmelanoma skin cancer can be caused by sexually transmitted human papillomavirus (HPV), which is also associated with cervical cancer.

In this study, researchers found that almost 30,000 people -- 22,000 women and 8,000 men -- died of genital nonmelanoma skin cancers in the United States from 1969 to 2000.

The older a person is, the greater their risk of genital nonmelanoma skin cancer (NMSC). The findings were scheduled for presentation Sunday at the annual meeting of the American Academy of Dermatology, in Washington, D.C.

"As dermatologists, we expect to see skin cancers induced by ultraviolet light, because sunlight is one of the primary risk factors for the disease," researcher Dr. Martin A. Weinstock, professor of dermatology and community health at Brown University in Providence, R.I., said in a prepared statement.

"But some of the most dangerous types of skin cancers are those that are not sun-induced, such as skin cancers that occur on genital skin -- a place that is not exposed to intense sun and is not routinely examined by dermatologists. That's why there needs to be an increased awareness of this issue, so patients and physicians can be better prepared to detect these cancers early before they become fatal," said Weinstock, who is also chief dermatologist at Veterans Affairs Medical Center in Providence.

Because they're not always readily visible and may not cause any noticeable symptoms, genital skin cancers can be difficult to diagnose.

"The number of deaths attributed to genital NMSCs was higher than expected, and we believe HPV was a major cause of these cancers," Weinstock said.

"The availability of the new HPV vaccine offers the potential for a substantial reduction in the development of these skin cancers for future generations," he noted.

In addition, since "HPV is a sexually transmitted disease, both men and women can practice preventive measures that could lead to a decline in mortality rates from genital NMSCs and heed the warning signs of the disease, including new growths or sores that don't heal, to detect it early."

HealthDay News, Monday, February 5, 2007

70 Potential New Psoriasis Treatments Being Investigated

Psoriasis Cure Now, a nonprofit patient advocacy group, today reported that biotech and pharmaceutical companies are investigating a record 70 potential new treatments for psoriasis and psoriatic arthritis. The data, culled from published reports and clinical trial recruitment Web sites, shows continued, strong business interest in the psoriasis market.  A New York Times article last week called into question the profitability of the psoriasis sector, lighting up psoriasis message boards with concerns that the psoriasis drug pipeline could dry up. The full (and free) report of psoriasis treatments under clinical development is available on the Psoriasis Cure Now Web site: www.psoriasis-cure-now.org/hope.php.

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