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Smoking may increase wrinkles on parts of the body other than the face -- even on areas usually covered with clothes.
Cigarette smoking has long been linked to increased facial wrinkles. A new study shows that that may also be true of the rest of the body.
Yolanda Helfrich, MD, and colleagues studied 82 people at the University of Michigan at Ann Arbor's dermatology clinic.
Participants were 22-91 years old (average age: 56). Most were white; 41 had a history of smoking.
Helfrich's team interviewed participants about smoking, sun exposure, sunscreen use, tanning, and other lifestyle factors.
A medical photographer took pictures of each participant's upper inner arm.
The photos were reviewed by three judges (two dermatology residents and one medical student) who didn't know which participants were smokers.
The judges used a nine-point scale developed by Helfrich's team. A rating of 0 indicated no fine wrinkling; severe fine wrinkling yielded the maximum score of 8.
Smoking and Wrinkles
Nearly two-thirds of the participants had low wrinkle scores ranging from 0-2 points. Smokers generally had the highest scores, indicating deeper wrinkles.
The wrinkle risk was particularly strong for people who had smoked heavily for many years.
"We examined nonfacial skin that was protected from the sun, and found that the total number of packs of cigarettes smoked per day and the total years a person has smoked were linked with the amount of skin damage a person experienced," Helfrich says in a University of Michigan news release.
The study doesn't prove that smoking caused or worsened wrinkles. But the results held when the researchers took other factors, including participants' age, into account.
The study appears in the Archives of Dermatology.
By Miranda Hitti, WebMd, March 19, 2007
Duct tape has many uses, but the claim that it's a cheap, effective treatment for warts is challenged by a new U.S. study in the March issue of the journal Archives of Dermatology.
A small study in 2002 suggested that duct tape helped treat warts on children and young adults. The theory is that the tape irritates the skin and prompts the immune system to attack the virus that causes warts, the Associated Press reported.
But this new study found that warts disappeared in 21 percent of 39 patients who used duct tape for seven days, compared to 22 percent of 41 patients who used moleskin, a cotton-type bandage used to protect the skin.
This new study used transparent duct tape, while the 2002 study used the better-known gray duct tape. Grey duct tape contains rubber while transparent duct tape does not, the AP reported.
"Whether or not the standard type of duct type is effective is up in the air," said study co-author Dr. Rachel Wenner of the University of Minnesota. "Theoretically, the rubber adhesive could somehow stimulate the immune system or irritate the skin in a different manner."
HealthDay News, March 20, 2007
Nearly 11.5 million cosmetic surgical and nonsurgical procedures were performed in the United States in 2006, according to statistics released today by the American Society for Aesthetic Plastic Surgery (ASAPS). Compared to 2005, cosmetic surgical and nonsurgical increased 1%. The Aesthetic Society, which has been collecting multispecialty procedural statistics since 1997, says the overall number of cosmetic procedures has increased 446% since the collection of the statistics first began. The most frequently performed procedure was injectable fillers and the most popular surgical procedure was liposuction.
The top nonsurgical cosmetic procedures include injectable fillers, hyaluronic acid, laser hair removal, microdermabrasion and laser skin resurfacing.
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
Knees hurt? Massage may cut the pain and improve function if you have knee osteoarthritis, a new study shows.
Massage therapy "seems to be a viable option" as an addition to other treatments for osteoarthritis of the knee, write the researchers.
Osteoarthritis, the most common type of arthritis, is mainly seen in older adults. In osteoarthritis, joints are damaged as cartilage, the joints' shock absorbers, wears down.
Osteoarthritis often affects the knees, making it hard to walk. The disease can become disabling.
Massage might improve joint flexibility and circulation, note the researchers, including Adam Perlman, MD, MPH, and David Katz, MD, MPH.
Perlman works at the Institute for Complementary and Alternative Medicine at the University of Medicine and Dentistry of New Jersey. Katz is on staff at Yale University's medical school.
"Massage is free of any known side effects and, according to our results, clearly shows therapeutic promise," Katz says in a Yale news release.
The massage study focused on Swedish massage, the most widely available type in the U.S.
Swedish massage uses long strokes, kneading, and tapping techniques to target the muscles closest to the skin.
The study included 68 knee osteoarthritis patients who were at least 35 years old (average age: 66-70).
Most were white women. All lived in northern New Jersey and had X-rays confirming a knee osteoarthritis diagnosis.
First, patients rated their knee pain, stiffness, and function. Then, they were split into two similar groups.
For a month, patients in one group got two weekly Swedish massages, followed by a month of weekly Swedish massages. Each massage lasted an hour.
For comparison, patients in the other group waited two months before getting the same massage treatment.
After eight weeks of massage, patients reported less knee pain and stiffness and better knee function.
"Massage therapy seems to be efficacious in the treatment of OA [osteoarthritis] of the knee," write the researchers.
They call for further studies on other types of massage and the cost-effectiveness of massage treatment.
By Miranda Hitti, WebMD Medical News, December 11, 2006
When it comes to treating the aging face, patients have their pick of numerous laser therapies for successful skin rejuvenation. But finding an effective treatment for the delicate skin of the neck can often be a real pain in the neck. Now, a retrospective review presented in a recent issue of Lasers in Surgery and Medicine, the journal of the American Society for Laser Medicine and Surgery, finds that a skilled practitioner can successfully resurface an aging and photodamaged neck using the Carbon Dioxide (CO2) laser if a series of treatment parameters are strictly followed.
In her article entitled “Safe and Effective Carbon Dioxide Laser Skin Resurfacing of the Neck,” laser expert Suzanne D. Kilmer, MD, of the Laser & Skin Surgery Center of Northern California, Sacramento, CA, outlines three key components essential to effective laser resurfacing of the neck with the CO2 laser that she and her colleagues have used to safely treat more than 1,000 patients over the past 10 years.
“We have found that for the CO2 laser to work safely and effectively on the neck, 1) the skin has to be sufficiently hydrated with a pre-operative topical anesthesia; 2) the laser has to be administered at a low density with only a single pass; and 3) the treated epidermis must not be wiped following the procedure,” explains Dr. Kilmer. “These three ingredients, in a sense, make up the ‘recipe’ for how to safely use the CO2 laser for neck resurfacing. And like all recipes, every step must be followed and all the ingredients must be added properly for the end result to turn out right.”
In order to adequately hydrate the skin prior to the laser procedure, Dr. Kilmer recommends that patients wash their entire face and neck with hot water and then immediately apply a thick layer—like frosting on a cake—of the topical anesthesia EMLA. The area is then sealed using a plastic wrap, and this process is repeated 45 minutes before the procedure. Dr. Kilmer notes that proper hydration is critical, as it “plumps up” the skin and creates a protective buffer against the laser that also aids in absorbing the laser’s energy.
During a typical laser skin resurfacing of the face with the CO2 laser, the epidermis is completely removed. For neck resurfacing, the laser energy is lowered so the epidermis is not removed and stays intact. This low density coupled with a single pass of the laser creates less trauma and less wounding on the neck. Dr. Kilmer points out that while the face would normally be wiped to remove the epidermal debris following the procedure, it is important not to wipe the treated epidermis from the neck because it serves as a natural dressing that protects the skin and aids in the healing process.
“Most of our patients that undergo CO2 laser skin resurfacing on their face also get their neck done at the same time,” says Dr. Kilmer. “Performing both procedures helps to blend the results, eliminating the noticeable line of demarcation that usually occurs when the neck is left untreated.”
While non-ablative laser treatment for skin rejuvenation has gained in popularity during the past few years, Dr. Kilmer notes that the CO2 laser produces longer-lasting results than its non-invasive counterparts and only a single treatment session is needed instead of a series of treatment sessions.
“As with any procedure, patients need to be informed of the potential risks, how much downtime is involved, and the importance of post-operative care before undergoing CO2 laser resurfacing,” adds Dr. Kilmer. “But for any single resurfacing treatment, the CO2 laser delivers the most overall improvement—hands down.”
Patients with a personal or immediate family history of vitiligo are not considered candidates for this procedure, as laser resurfacing can trigger depigmentation of the treated area consistent with this condition.
Findings from a new study confirm that tea extracts applied to the skin promote the repair of damage from radiotherapy, and shed light on the mechanisms involved in the injury...
Finally, there may be something duct tape can't fix: the lowly wart.
Despite claims in an earlier study, covering warts with duct tape may not make them vanish faster after all, say Dutch researchers, including Maastricht University's Marloes de Haen, MD.
The Dutch researchers had heard of a study in which duct tape showed promise as a home remedy for warts -- the skin infections caused by the human papillomavirus.
So de Haen's team conducted their own study, now published in the Archives of Pediatrics & Adolescent Medicine.
The study included 103 Dutch kids aged 4-12 who had at least one wart.
For six weeks, half the children wore duct tape over one of their warts, while the rest wore corn pads over one of theirs.
Once a week, the children uncovered the wart, soaked it in warm water for five minutes, then rubbed the wart gently with a pumice stone.
During the study, the warts covered by duct tape were only slightly more likely to heal than those covered by corn pads.
"After six weeks, the wart had disappeared in 16% of the children in the duct tape group, compared with 6% in the placebo [corn pad] group," the researchers write.
That margin was so slim that it may have been due to chance, de Haen's team says.
Most of the kids in the duct tape group -- 81% -- said the tape didn't stick well to their skin. And 15% reported skin irritations, including rashesrashes.
"Further research with longer follow-up would only be useful with a tape that is better sticking," write the researchers.
By Miranda Hitti, WebMD Medical News, November 8, 2006
Good news for sleepless new parents—research shows that massage helps newborn babies sleep more and cry less.
Massage also lowers stress levels in infants and helps the bonding process with the parent, it was claimed.
The study found that infants under six months who received massage also had lower levels of the stress hormone cortisol compared to babies who had not.
A team of researchers from Warwick Medical School and the Institute of Education at the University of Warwick looked at nine massage studies covering 598 babies under six months old.
Babies were massaged by parents who had been trained by health professionals and the infants who received massage were found to have beneficial effects.
One of the studies found that massage could affect the release of the sleep hormone melatonin, helping babies' sleeping patterns.
Another showed that babies in an orphanage who usually had little tactile stimulation grew faster, were less ill and had less clinical visits when they were given massage, made eye contact with and spoken to.
The researchers also found that massage built better relationships between babies and mothers who had postnatal depression.
Angela Underdown, who led the research, said: "Given the apparent effect of infant massage on stress hormones, it is not surprising to find some evidence of an effect on sleep and crying.
"It gives parents and babies intimate time. We haven't said that it should be on offer to everyone, but massage does no harm, and it improves a number of factors. It seems to have some effect on sleep and relaxation.
"We looked at babies under six months because that's when parents and babies are forming their attachments and babies are forming their sleep patterns."
Life Style Extra, November 8, 2006
A new combination treatment offers hope to people who have the blistering, potentially fatal skin disease known as pemphigus vulgaris.
By combining the cancer-fighting drug rituximab with intravenous immune globulin, Harvard doctors have discovered a therapy that can effectively treat people with cases of pemphigus vulgaris that haven't responded to other treatments.
"We got a home run with this combination," said study co-author Dr. Marshall Posner, medical director of the head and neck oncology program at the Dana-Farber Cancer Institute and Harvard Medical School.
"These patients were extremely ill and on multiple medications," he said. "This therapy resulted in complete eradication of the disease for nine patients." The remaining two patients in the study required additional doses of the treatment before they, too, went into remission. All of those involved in the study had sustained remissions, some as long as 37 months, by the end of the study.
Results of the study are published in the Oct. 26 issue of the New England Journal of Medicine.
Pemphigus vulgaris is a rare autoimmune disease that causes the skin cells to stop adhering to one another. Blisters and lesions form, usually beginning in the mouth and then spreading to the skin.
"Before the discovery of corticosteroids, it was fatal within five years. People lost the surface of their skin, and died horrible deaths," explained Dr. John Stanley, chairman of the department of dermatology at the University of Pennsylvania School of Medicine. "This is an instructive disease about the power of the immune system. While it's usually used for good, it can actually destroy you."
Stanley co-authored a review article in the same issue of the journal about pemphigus and other dermatological diseases.
Currently, the first line of treatment for this devastating skin condition is prednisone, a corticosteroid. While it's often an effective treatment, it has numerous side effects that can be serious, so people generally can't stay on high doses for a long time. Other medications used are immune-suppressing agents that also carry the risk of serious side effects, such as infection.
Posner said most deaths from pemphigus occur as a result of immune-system suppression. But without suppressing the immune system, people with pemphigus would continue to develop blisters and erosions in their skin, giving bacteria an easy entry into the body.
Another treatment option is intravenous immune globulin. This option is usually reserved for those who don't respond to the other treatment options. Stanley said scientists aren't sure how this therapy works, but it may be that it replaces the immune-system antibodies that are attacking the skin cells with healthy antibodies.
For most people, these treatments options have proved lifesaving, and people with the disease often do well, said Stanley.
However, there are people who don't respond to any of the currently available treatments. And, the 11 people treated in the new Harvard study fell into that category. None of the available treatments had worked for them, and the disease was covering more than 30 percent of their body's surface area.
Each study volunteer received two cycles of rituximab weekly for three weeks. During the fourth week, they received a dose of intravenous immune globulin. Then, they received monthly infusions of both rituximab and IV immune globulin for four months.
During the initial treatment, nine of the 11 study participants went into remission for an average of 32 months. The remaining two required additional treatments about six months after treatment, but subsequently went back into remission.
While previous research on rituximab has sometimes found serious side effects, such as allergic reaction, Posner said there were virtually no side effects seen in this trial.
He said he thinks this drug combination would likely be helpful in less severe cases of pemphigus vulgaris, and he added that it could potentially be useful for treating other autoimmune diseases, such as rheumatoid arthritis, systemic lupus and type 1 diabetes.
"This therapy offers hope for this disease, and it could lead the way to treatment for other diseases that have a big impact on people's lives -- it needs to be investigated in other diseases so we can see how it works in other situations," Posner said.
Stanley said he doubted that rituximab would become a first-line treatment for pemphigus vulgaris anytime soon because the medication is quite costly and insurance companies would likely balk at paying for an expensive drug that isn't FDA approved specifically for treating pemphigus. The problem, he added, is that because pemphigus is so rare, it would be difficult to conduct a large enough trial to get such approval.
But, Posner suggested that while the rituximab/immune globulin combination treatment is more expensive initially, a cost analysis comparing all of the costs, including hospitalizations, might find the combination treatment is the cheaper alternative in the long run.
By Serena Gordon, HealthDay Reporter, October 26, 2006