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By: Heather Woolery-Lloyd, MD
Discover the unique skin care challenges of various ethnic skin types and about some treatment options.
The FDA has approved a new drug to treat a rare and slow-growing type of skin cancer.
The agency approved Zolinza capsules for the treatment of cutaneous T-cell lymphoma (CTCL), a type of lymphoma that affects the skin.
The drug is approved for treatment when the disease gets worse, persists, or comes back during or after treatment with other medicines.
Researchers say about three in a million people are diagnosed with the skin cancer each year, mostly middle-aged men.
Zolinza was approved as part of FDA's Orphan Drug program, which offers companies financial incentives to develop medicines for diseases that affect fewer than 200,000 Americans a year.
Benefits and Risks
The safety and effectiveness of Zolinza were evaluated in two clinical trials involving 107 people with CTCL, who received the drug after their disease came back or other treatments had failed.
Of patients receiving the drug, 30% saw improvement, with the benefit lasting an average of 168 days.
The most common serious side effects of Zolinza were blood clots in the lungs (pulmonary embolism), dehydration, deep vein thrombosis (blood clots in deep veins) and anemia.
Other side effects included diarrhea, nausea, anorexia, vomiting, constipation, fatigue, chills, and taste disorders.
The drug has not been studied in pregnant women, but animal studies suggest Zolinza may harm the fetus if used during pregnancy.
Zolinza is manufactured by Pantheon Inc. for Merck & Co. Inc.
By Jennifer Warner, WebMD Medical News, October 11, 2006
Women's skin ages faster than men's, suggests a study that used an experimental laser device to measure skin damage.
Researchers in Germany used the device to determine collagen and elastin levels beneath the skin's surface. Collagen and elastin are the proteins responsible for the elasticity, tone, and texture of skin, and levels typically decline with age.
There is no good way to assess skin, as measured by collagen and elastin composition, short of removing skin and analyzing it in a lab.
The laser procedure shows promise for making the process a whole lot simpler. That could one day help consumers better evaluate the effectiveness of the antiaging skin products they buy, researcher Martin Johannes Koehler, of Germany's Schiller University, tells WebMD.
"Some cosmetics are thought to change the content of collagen to the skin, but until now to measure that you had to cut out a piece of skin," he says.
Multiphoton Laser Imaging
The search for a noninvasive test to measure damage to the skin from sun exposure and aging is the Holy Grail of the cosmetics industry.
But proving that a skin cream that promises to turn back the clock really is worth $100 an ounce is only one potential application for the experimental laser technique, Koehler says.
It may also prove useful for evaluating skin diseases like that seen in, which is a serious autoimmune disease, as well as a skin complication that can occur in transplant recipients, known as graft vs. host disease.
Koehler and colleagues used the technique, called multiphoton laser imaging, on the inner forearms of seven women and 11 men between the ages of 21 and 84.
The researchers used the information gathered from the imaging to develop an aging index of the dermis, an inner layer of the skin. Skin aging was more evident in women than in men of similar age. It was most marked in older women who had been through.
The researchers wrote that menopause-related declines in the sex hormones estrogen and progesterone might explain this acceleration in skin aging.
More Study Needed
But they added that more research is needed to confirm the finding that men and women's skin ages at different rates. The researchers also note that studies comparing their aging index measurements need to be compared to established measures such as skin surface hydration and wrinkle number and depth.
The study is published in the Oct. 1 issue of the journal Optics Letters.
Cosmetic dermatologist Eliot Battle, MD, tells WebMD that the laser procedure is one of several promising experimental techniques that could help clinicians more easily diagnose and treat skin diseases.
"Diagnostic tools like this have been used in every area of medicine, but they are only beginning to be used in dermatology," he says. "This [technique] is an attempt to use the latest and greatest in laser imaging, but much more research is needed. This is just the very beginning of what could be an exciting journey."
SOURCES: Koehler, M.J. Optical Letters, Oct. 1, 2006; vol 31: pp 2879-2881. Martin Johannes Koehler, department of dermatology and allergology, Friedrich Schiller University, Jena, Germany. Eliot Battle Jr., MD, cosmetic dermatologist and laser surgeon, Cultura Cosmetics Medical Spa, Washington, D.C.
By Salynn Boyles, WebMD, October 4, 2006
Black tea eases stress by lowering blood levels of the stress hormone cortisol, says a British study in the journal Psychopharmacology.
The six-week study of 75 people found that those who drank black tea were able to de-stress more quickly than those who drank a caffeinated tea substitute, BBC News reported.
The participants were assigned challenging tasks while their cortisol, blood pressure, blood platelet, and self-rated levels of stress were measured by the researchers. During these tasks, both groups of study participants experienced large increases in blood pressure, heart rate, and self-rated levels of stress.
However, 50 minutes after the stressful tasks, cortisol levels dropped by an average of 47 percent among those who drank black tea and 27 percent among those who drank the tea substitute.
The study also found that the tea drinkers had lower blood platelet activation, which is associated with blood clotting and heart-attack risk, BBC News reported.
It's unclear which ingredients in black tea help reduce stress, the University College London researchers said.
HealthDay News, October 6, 2006
An antibiotic-resistant acne germ can spread among family members, Swedish researchers find.
The germ is Propionibacterium acnes. Skin colonized by P. acnes tends to erupt into the blotches and pustules of acne. Since the 1960s, doctors have fought P. acnes with antibiotics. The bug fought back. It's now common to find P. acnes strains resistant to several common antibiotics.
Doctors hoped that the only people carrying the drug-resistant acne bugs would be patients on long-term antibiotic therapy. That isn't the case, find Carl Eric Nord, MD, PhD, and colleagues at Karolinska Institute in Stockholm, Sweden.
Nord and colleagues took skin samples from 10 acne patients, all on antibiotic therapy, and from two close family contacts of each patient. Twelve healthy, acne-free volunteers -- who were not taking antibiotics and did not have family members with acne -- served as a comparison group.
Nord and colleagues found that nearly half of the family members carried drug-resistant acne bacteria on their skin. Genetic analysis showed that these family members carried the same strain of P. acnes as the acne patient among them.
The good news is that the family members fought off the drug-resistant germs -- but only after the acne patient in their family stopped using antibiotics.
On the other hand, you apparently can't avoid drug-resistant acne germs by avoiding people with acne. A third of the healthy comparison group also carried drug-resistant P. acnes on their skin.
Nord reported the findings at last week's 46th Interscience Conference on Antimicrobial Agents and Chemotherapy, held Sept. 27-30 in San Francisco.
SOURCES: 46th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, Sept. 27-30, 2006.
By Daniel DeNoon, WebMD, October 2, 2006
"Easy on the mind" rather than "easy on the eyes" may be a better way to describe something that’s beautiful, according to a new study.
Researchers found objects and animals that conform to a prototype rather than deviate from it are easier for the brain to process and, therefore, are perceived as more pleasing to the eye.
"What you like is a function of what your mind has been trained on," says researcher Piotr Winkielman of the University of California, San Diego, in a news release. "A stimulus becomes attractive if it falls into the average of what you've seen and is therefore simple for your brain to process. In our experiments, we show that we can make an arbitrary pattern likeable just by preparing the mind to recognize it quickly."
Researchers say the findings build a phenomenon known as "beauty-in-averageness effect," which was discovered in the late 1800s. The theory holds that prototypical images are rated as more beautiful or appealing than variations of the same thing.
To test the theory, researchers had groups of students undergo different experiments. In one experiment, a group of students were presented prototypes of random groupings of dots. Then distortions of the dots in these prototypes were created and presented to the students.
In a second experiment, a group of students rated the attractiveness of random dot patterns and those that conformed to common geometric patterns, like a diamond or square.
The results, published in Psychological Science, showed that the participants categorized patterns quicker and rated them as more attractive when they were closer to their respective prototypes.
A third experiment had students looking at dots also, but this time also examined cheek muscle for smiling action and brow muscle for frowning action.
Researchers also found that the less time it took participants to classify a pattern, the more attractive they found it.
"This parsimonious explanation," says Winkielman, "accounts for cultural differences in beauty -- and historical differences in beauty as well -- because beauty basically depends on what you've been exposed to and what is therefore easy on your mind."
SOURCES: Winkielman, P. Psychological Science, September 2006; vol 17: pp 799-806. News release, University of California, San Diego.
By Jennifer Warner, WebMD, September 29, 2006
Melanoma surgery may get more aggressive to help plan treatment and ultimately improve survival.
A study and editorial in The New England Journal of Medicine support checking the "sentinel" lymph node near melanoma for signs of.
Melanoma is the most serious type of, with more than 53,600 new cases per year diagnosed in the U.S., according to the National Cancer Institute.
The body's lymph system makes, stores, and carries white blood cells that fight infections and other diseases. Lymph nodes are part of the lymph system; they're clustered around the body.
Cancer can spread to lymph nodes. It usually first shows up in one or two "sentinel" nodes that are closest to the cancer site.
In sentinel lymph node biopsy, doctors surgically check the sentinel lymph node or nodes for signs of cancer.
If the biopsy shows cancer in the sentinel node or nodes, that means cancer has spread beyond its original location and would be more likely to be in the other lymph nodes in the area. Sentinel node biopsies are also used with other types of cancer, including.
Sentinel Node Study
The new study comes from researchers including Donald Morton, MD, of the John Wayne Cancer Institute at Saint John's Health Center in Santa Monica, Calif.
Morton's team studied 1,269 people who had surgery to remove isolated skin melanomas of medium thickness.
The researchers randomly assigned 60% of the patients to get sentinel node biopsy. Patients with cancerous sentinel nodes had all the other lymph nodes near the sentinel nodes removed.
The remaining 40% of the patients got careful checkups every few months, without sentinel node biopsy. They kept all of their lymph nodes unless doctors suspected cancer's spread, which happened months or even years later.
Why not just automatically remove all lymph nodes closest to a melanoma? Doing so could have complications and offers no advantage if those nodes are cancer-free.
The researchers followed the patients for five years.
During that time, the overall survival rate between the two groups was similar (around 87%).
But there was an important exception for patients with cancerous lymph nodes.
Of the patients who got sentinel node biopsies that showed cancerous sentinel nodes and had their nearby lymph nodes immediately removed, 72% were alive five years later.
But the five-year survival rate was much lower -- 52% -- for patients with cancerous lymph nodes that were spotted later because they didn't get sentinel lymph node biopsy.
In patients with skin melanomas of medium thickness, sentinel node biopsy "should be preferred to observation," write Morton and colleagues.
That conclusion is "convincing" and "justified," based on the study's results, write editorialists Charles Balch, MD, and Natale Cascinelli, MD.
Balch works in Baltimore, Md., at the Johns Hopkins Medical Institutions. Cascinelli works at the National Tumor Institute in Milan, Italy.
SOURCES: Morton, D. The New England Journal of Medicine, Sept. 28, 2006; vol 355: pp 1307-1317. Balch, C. The New England Journal of Medicine, Sept. 28, 2006; vol 355: pp 1370-1371. National Cancer Institute: "What You Need to Know About Melanoma."
By Mirandi Hitti, WebMD, September 27, 2006
By Judi Bailey
Learn more about identifying this disorder and helping clients who demonstrate its symptoms.
Fair-skinned people who yearn for a suntan -- even though they know it's hopeless and unhealthy -- may one day have cause for celebration.
Harvard scientists have discovered new information about how the skin tans or -- in the case of fair-skinned people -- stubbornly refuses to tan due to a genetic defect. Using a skin treatment, they have turned pale skin dark, while also protecting it from ultraviolet-induced.
"Darkening a person's skin may mimic the protective benefit seen in people who otherwise make a large amount of pigment," says researcher David E. Fisher, MD, PhD, director of the Melanoma Program at Dana Farber Cancer Institute in Boston. And that could translate into a reduction in the toll of the potentially deadly skin cancer melanoma, expected to be diagnosed this year in 62,000 people in the U.S. and to result in 8,000 deaths, according to American Cancer Society projections.
The study appears in the Sept. 21 edition of the journal Nature. Fisher cautions that the study was done only in animals. Using a topical cream instead of the sun's rays, Fisher's team was able to switch on the tanning mechanism in the skin cells of fair-skinned mice, turning them into olive-skinned animals. "This has not been demonstrated in people and there is a lot that needs to be proven before it's ready for even a first attempt in clinical subjects," Fisher says.
Even so, the study was called intriguing by Meenhard Herlyn, DVM, PhD, a tumor biologist at The Wistar Institute, a research center on the campus of the University of Pennsylvania. "What he clearly has shown is ... you can induce a pigmentation, tanning, and the purpose is that people who are very susceptible to skin cancer, including melanoma, can be protected."
By Kathleen Doheny, WebMD, September 20, 2006
The Cosmetic, Toiletry, and Fragrance Association (CTFA) announced today that it has filed comprehensive comments with the Food and Drug Administration (FDA) on the science and regulation of nanoparticles in personal care products. CTFA comments, which can be found at www.ctfa.org, specifically address issues raised in a petition filed with the FDA earlier this year on the use of nanotechnology in personal care products, in particular, sunscreen products.
“Nanoparticles in sunscreens are very small particles that have been reviewed and approved by FDA. They have been used safely and effectively by consumers for decades to protect from harmful UV rays and to prevent skin cancer,” said John Bailey, executive vice president for science at CTFA and former FDA official. “These ingredients have properties that provide a greater degree of protection from the sun, are transparent when applied and aesthetically pleasing, and therefore encourage greater consumer acceptance.”
The nanoparticles in sunscreens, titanium dioxide and zinc oxide, are established, efficacious sunscreen filters that have been on the market for decades. In 1996, FDA concluded that smaller, micronized particles of titanium dioxide are not new substances and that there is no evidence demonstrating that these micronized particles are unsafe. Nano-sized titanium dioxide and zinc oxide, unlike the larger particle size ingredient, form a transparent rather than a thick, white coating, which leads to greater consumer acceptance and use of sunscreen products, and therefore greater protection from skin cancer and other damaging effects of the sun. The same improvement in formulation esthetics also applies to the use of these materials in cosmetics.
“Nanoparticle ingredients in personal care products sit on top of the skin, are used in small amounts, and are not absorbed into the body. The general scientific consensus is that there is no risk to human health. But we don’t rest on this knowledge alone,” Bailey said. “We take the science of safety very seriously, and that is why we review the latest and most comprehensive scientific research, including nanotech research, before bringing a product to market.”
According to widely accepted independent research studies, the size of these nanoparticles does not make them inherently different in terms of toxicity or impact on human health than larger particles. It is also important to note that humans have long been exposed to some types of nanoparticles in the atmosphere such as smoke from candles, fireplaces and other sources.
In the case of the sunscreen ingredients zinc oxide and titanium dioxide, the overwhelming weight of the scientific evidence states that these substances are safe and non-toxic, including when used in cosmetics and sunscreens.
Authoritative bodies that have thoroughly reviewed titanium dioxide and zinc oxide include:
- The FDA:
Concluded that these substances are safe for use in cosmetics. Titanium dioxide has been approved for use as a color additive in food, drugs, cosmetics, and contact lenses. Zinc oxide is approved for use as a food ingredient, a color additive in drugs and cosmetics, and as a protectant for injured skin.
Concluded that these substances are safe for use in OTC drug products, including sunscreens, skin protectants, and other products.
- The Scientific Committee for Cosmetic Products in the European Union:
Considered more than 100 titanium dioxide safety studies and concluded that these substances are safe for use in cosmetics.
- Germany BfR, Federal Agency for Risk Assessment:
In 2006, reviewed these two substances and found that the nanoparticles did not penetrate the skin, and that the biological properties of the nanoparticles were not necessarily different from those of larger particles.
- The Australian government Department of Health and Aging:
In 2006, published a comprehensive review of the science on zinc oxide and titanium dioxide and found no evidence that sunscreens containing these materials in nanoparticle form pose any risk.
“The FDA has broad authority to ensure that personal care products and ingredients utilizing nanotechnology are safe for consumers and has consistently exercised that authority,” CTFA’s Bailey added. “Sunscreens, some of which utilize sun-protecting nanoparticles, are required to go through an extensive pre-market review process to prove they are safe and effective.”
The FDA comprehensively regulates the safety of consumer health products. Under the Federal, Food, Drug, and Cosmetic Act (FFDCA), FDA has erected a complex and comprehensive regulatory system to safeguard the public health. This regulatory system has worked to ensure that, among other things, the food eaten by US consumers, the medical technology used by physicians and patients, and the personal care products used by countless citizens are among the safest in the world.
Based in Washington, D.C., CTFA is the trade association representing the cosmetic, toiletry, and fragrance industry in the United States and globally. Founded in 1894, CTFA has a membership of approximately 600 companies including manufacturers, distributors, and suppliers of the vast majority of finished personal care products marketed in the United States.