Recent Releases - AAD News Releases

How You Feel On the Inside Could Be Affecting How You Look On the Outside

2008-11-13T12:00:00-08:00

In the emotional rollercoaster of life, sometimes the “down” periods have long-lasting effects on more than just our mood. In fact, numerous studies link factors that impact our emotional well-being – such as stress, depression and anxiety – to an increase in skin, hair or nail problems. Now, dermatologists are advising patients to recognize these secondary symptoms and to seek treatment early before they cause additional stress.

Speaking today at the American Academy of Dermatology’s academy (Academy), dermatologist and clinical psychologist Richard G. Fried, MD, PhD, FAAD, of Yardley, Pa., discussed the reciprocal relationship between feelings and appearance, and how failing to address these concerns can affect how we look, feel and function.

“When patients are going through a rough period in their lives, negative emotions can wreak havoc on their appearance,” said Dr. Fried. “So, as a result, patients might start to notice that their hair is thinning, their skin is inflamed or their nails are brittle – which can be physical manifestations of their mental state. These unwanted physical changes can have a profoundly negative impact on how they feel. The negative emotions can trigger a vicious cycle of worsening skin, hair and nails leading to worsening of their emotional state and can lead to further worsening of the skin problem. Dermatologists can play a key role in helping patients not only alleviate these physical symptoms, but also help enhance their quality of life during a difficult time.”

Psychodermatology Interventions
Stress can manifest itself on one’s appearance in many ways, primarily by making the skin more sensitive and more reactive. For example, Dr. Fried noted that stress can make rosacea more red, result in acne lesions that are more inflamed and more persistent, cause brittle nails and ridging of the nails, cause hair loss, cause or worsen hives, and cause excessive perspiration. In addition, stress also is a known trigger or can be a worsening factor for fever blisters, psoriasis, seborrheic dermatitis and has even been shown to impair skin barrier function and dehydrate the skin – allowing more irritants, allergens, and infectious agents to penetrate the skin and cause problems. Stressed skin often appears stressed, distressed and older.

“When it comes to treating patients who we suspect may be experiencing skin, hair or nail problems as a result of stress or other emotional factors, it is helpful to ask them whether their skin seems to look or feel worse when they are stressed,” said Dr. Fried. “Beyond the direct physiological effects of stress, patients under stress also tend to neglect or abuse their skin, lacking the energy and motivation to adhere to their skin care regimens. There also might be signs of stress-related behaviors – such as scratching, pulling or rubbing – that can exacerbate problems.”

To successfully treat stress-related dermatologic conditions, Dr. Fried recommends that traditional dermatologic therapies should be used in conjunction with appropriate stress management strategies. For example, Dr. Fried discussed how stress reduction interventions and techniques can reduce the culmination of negative events that can worsen many of these problems.

To illustrate the seriousness of living with skin problems, Dr. Fried points to studies showing that people tend to be more distressed by skin, hair or nail problems since they are so visible and uncomfortable, than by other serious medical conditions, such as heart disease or diabetes.

"When dermatologists treat both the skin and stress, the skin often clears more quickly and completely as the native influences of stress are diminished,” said Dr. Fried. “Consequently, their overall anxiety level can decrease and they may start to feel better about how they look and how they’re feeling emotionally.”

Moving to the microscopic level, Dr. Fried added that stress reduction can decrease the release of pro-inflammatory stress hormones and chemicals. For example, release of neuropeptides (or stress chemicals released from the nerve endings) can be reduced with stress management techniques. This often results in skin that looks and functions better. These interventions can reduce blood vessel over-activity, resulting in less blushing or flushing. Decreasing stress allows the patient to focus more positive energy on good skin care rather than negative behaviors.

“It is fair to say that when people are under stress, they tend to ‘fall off the wagon’ in terms of practicing good skin care,” said Dr. Fried. “They may not use their sunscreen or their skin care products when they’re feeling stressed, because all of their energy and focus is being diverted by their ongoing stress. They also might not be eating or sleeping as well or staying hydrated, which all can contribute to a dull or lack-luster appearance.”

With accurate diagnoses by a dermatologist, effective treatments improve the appearance and function of the skin. This alone can substantially reduce patients’ stress and improve their skin, hair and nail conditions. However, Dr. Fried noted that if stress is clearly interfering with patients’ overall well-being and ability to cope, simultaneous stress management interventions are warranted. In some instances, referral to a mental health professional who has an interest and understanding of skin problems may be warranted.

Cosmetic Interventions
While skin rejuvenation procedures have been shown to significantly improve a person’s outward appearance, studies suggest these types of cosmetic interventions also can have positive effects on how people feel and how they function.
“When people feel more attractive and more confident in their appearance, they tend to perform better in other areas of their lives – in their work, family life, social life, and marriage or personal relationships,” explained Dr. Fried. “Under the right circumstances, cosmetic procedures can be a powerful ally. But it’s important for patients to understand that these procedures are not a panacea. Realistic expectations are the key to effectively delivered promises.”

Currently, Dr. Fried is analyzing data from a 2008 study designed to measure the positive ripple effects of botulinum toxin injections on other aspects of patients’ lives. In this study, 76 middle-aged patients were treated with one botulinum toxin injection and then asked to complete a questionnaire during their follow-up visit to gauge how they felt following the procedure.

“The results of our study clearly showed that patients treated with botulinum toxin experienced substantial benefits,” said Dr. Fried. “In fact, 29 percent reported feeling less anxious, 36 percent said they feel more relaxed, and 49 percent were more optimistic. Even a portion of patients diagnosed with seasonal affective disorder, or SAD, prior to treatment reported they felt less sadness during the winter following botulinum toxin injection.”

A previous study conducted by Dr. Fried evaluated the clinical and psychological effects of the use of alpha hydroxy acids (AHAs) in 32 patients. After 12 weeks, patients demonstrated significant improvements in facial skin tone and fine wrinkling, and reported satisfaction with their physical appearance and the quality of their interpersonal relationships.

“The results of these two studies echo observations of recognized experts from around the world – that cosmetic interventions can improve a patient’s self-image and help them feel better about themselves,” added Dr. Fried. “Feeling stressed, depressed or anxious is exhausting, and patients who report improvements in these negative feelings following a cosmetic procedure can use that redirected energy to pursue new interests that can enhance their lives.”

For proper diagnosis and treatment of any skin, hair or nail conditions, Dr. Fried advised patients to consult their dermatologist to determine the root of the problem and discuss the potential benefits of any treatment.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Stop Skin Cancer On the Spot

2008-11-13T12:00:00-08:00

Based on current estimates, 8,420 people are expected to die from melanoma this year. In an effort to reverse this sobering trend, dermatologists and the scientific community alike are continually developing new diagnostics, refining detection guidelines and providing patients with the tools they need to properly examine their own skin for signs of skin cancer.

Speaking today at the American Academy of Dermatology’s academy (Academy), dermatologist Ellen S. Marmur, MD, FAAD, chief of the division of dermatologic and cosmetic surgery at The Mount Sinai Medical Center in New York, presented the latest advances in diagnosing skin cancer and the Academy’s new detection strategies that emphasize the importance of patient involvement.

“There are some exciting innovations in diagnosing skin cancer that can help us detect skin cancer early, when it is most treatable,” said Dr. Marmur. “Even simple detection tools designed by the Academy that patients can use in their own homes can save thousands of lives.”

New Technologies for Diagnosing Skin Cancer
Dermatologists traditionally diagnose skin cancer by evaluating the skin using a clinical examination and, if necessary, a magnifying device and then biopsying any suspicious lesions. Now, technological advances in computers, lasers and other polarizing light sources are providing dermatologists with tools to enhance the evaluation of suspicious lesions and, in some cases, decreasing the number of biopsies needed for an accurate diagnosis. The idea is to hone in on suspicious lesions earlier and with more specificity.

One of the newest technological developments in the fight against skin cancer is the use of sophisticated imaging to scan and enhance certain features of suspected lesions. Similar to how a computerized tomography (CT) scan highlights areas of the brain for abnormalities, imaging devices can now work on the skin to help detect cancerous tissue.

Another exciting technology dermatologists are using to evaluate suspected skin cancers is a hand-held light device known as dermascopy that can look at the pigment of the skin through specialized filters that magnify and polarize lesions. For example, similar to how filters are used on cameras to create certain backgrounds, filters are used on this device to enhance certain features of lesions – such as brown or red background colors that could indicate a melanoma (the deadliest form of skin cancer).

Dr. Marmur noted that one of the main benefits of dermascopy is the ability to immediately evaluate a potential melanoma based on its magnified characteristics, which could help decrease the number of biopsies needed to make an accurate diagnosis, or can push the physician to biopsy a borderline lesion that appears more suspicious with the assistance of the dermatoscope.

In addition, newer computer systems are being used in conjunction with hand-held photography devices to more accurately diagnose melanomas. For example, the photo device takes a digital picture of the suspicious lesion, which is then magnified on the computer screen for closer examination. The computer system also contains a database of characteristics of approximately 100,000 evolving melanomas, which the lesions are then graded against to see if certain features score high enough on the scale to warrant having a biopsy.

“With the improvement of early detection methods, we are finding an increasing number of smaller skin cancers,” said Dr. Marmur. “We know from experience that detecting skin cancer in its earliest stage means better cure rates and survival rates. Prognosis plummets as the depth of melanoma increases even by the smallest increment of one millimeter.”

New Self-Exam Tools
Since skin cancer is the only cancer you can see on the surface of your skin at its earliest stage, performing regular skin self-examinations is an easy way to detect any suspicious spots that could be cancerous. To enhance a patient’s ability to detect the warning signs of skin cancer, the Academy is refining the ABCDs of melanoma detection by adding an “E.” The letter “E” stands for Evolving – a mole or skin lesion that looks different from the rest or is changing in size, shape or color. This is in addition to other qualities of moles for which individuals should check their skin – Asymmetry (one half unlike the other half), Border (irregular, scalloped or poorly defined), Color (varies from one area to another; shades of tan and brown, black; sometimes white, red or blue), and Diameter (the size of a pencil eraser or larger). If a mole exhibits any of these characteristics, it should be brought to a dermatologist’s attention.

An analysis of 2001-2005 data from the Academy’s National Melanoma/Skin Cancer Screening Program supports the need for people to watch their moles for changes. A study of the data published in the July 2007 issue of the Journal of the American Academy of Dermatology found those who indicated they had a mole that changed recently in size, color or shape were two times more likely to be diagnosed with a suspected melanoma.

“Some melanomas don’t show any other abnormalities except that they are evolving over time,” said Dr. Marmur. “It’s not unusual for people to wait until a melanoma has grown significantly to see a dermatologist, and unfortunately, that sometimes means the cancer has spread to other areas of the body. I am confident lives will be saved by encouraging people to bring their evolving moles to the attention of a dermatologist. And I have been able to save lives purely because a partner or spouse has detected a changing lesion on someone who rushed in for a biopsy and curative surgery.”

Dr. Marmur explained she sees numerous patients who say that they have had a mole forever, but that it recently started bleeding and then ultimately turns out to be a skin cancer. She added that a classic example of an evolving skin cancer is a man who notices a mole that begins bleeding while he is shaving. This can be a basal cell carcinoma, a squamous cell carcinoma or a melanoma. All three are serious and can be cured if caught early.

“Melanoma can be on the skin for a long time before it ‘misbehaves’ and gives patients a clue that it may be a lesion that needs to be addressed,” said Dr. Marmur. “We find that people who check their skin regularly – looking for the warning signs of skin cancer and taking note of any changes – are more likely to spot skin cancer in its earliest stages before it spreads.”

The Academy’s Body Mole Map is a tool individuals can use to track their moles. The map provides information on how to perform a skin exam, images of the ABCDEs of melanoma and space for people to track their moles to determine any changes over time. Free downloads of the Body Mole Map are available at www.melanomamonday.org.

Dr. Marmur also encourages her patients to involve a family member or partner in skin exams, which can help people thoroughly examine their skin in hard-to-reach spots and help them decide if a lesion seems to be evolving over time. In her practice, Dr. Marmur estimates that patients report that they are getting a suspicious mole checked at the urging of another person about five times per week – with men representing the largest group of referrals.

“My favorite example is of a daughter who had been trying to get her mother to come in to get a suspicious mole on her back checked, but the mother was very reluctant because she didn’t like going to the doctor,” said Dr. Marmur. “Before the daughter went off to college, she asked her mom to make her an appointment at my office to get a spot on her face checked that she was concerned about. When they arrived at my office, the daughter told her mother that the appointment was really for her. The mole turned out to be a melanoma, and we were able to save the mother’s life due to her daughter’s plan to get her to my office.”

Dr. Marmur’s patient story supports recent research that shows involving a partner in the self-examination process can improve the early detection of skin cancer. As such, the Academy is encouraging people to “Screen the One You Love.” While candy and flowers are short-term gifts, the gift of a skin examination is a gift of life and health. Popular holidays, such as Valentine’s Day (February 14), Mother’s Day (May 10), Father’s Day (June 21) and Grandparents Day (September 13) are reminders for people to check their loved ones’ skin for suspicious moles using the Academy’s Body Mole Map.

“People sometimes get confused by what to look for on their skin, and that could result in them ignoring any potential red flags that might be starting to crop up,” said Dr. Marmur. “So I always tell people to get to know their skin and if something is bleeding or doesn’t look right, then see a dermatologist. Whether or not you have a partner available to assist you with your skin self-exam, you should make skin self-exams part of your regular health regimen."

For more information about skin cancer, please visit the SkinCancerNet section of www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Editor’s Note: The Academy encourages editors to provide the Academy’s Body Mole Map from www.melanomamonday.org to their readers by either printing the mole map or including a link to the mole map in an upcoming issue. For questions or assistance, please contact the Academy’s Communications Department at (847) 330-0230.

Is There Really Such a Thing as Hope In a Jar?

2008-11-13T12:00:00-08:00

When it comes to cosmeceuticals, consumers are bombarded by marketing claims that often fail to live up to their hype. Banking on promises that a product can “reverse the aging process” or "deliver the results of a facelift" leads consumers to spend billions of dollars each year to try an array of anti-aging skin care products. Their hope is that one day they will find a product that actually lives up to its claims.

Speaking today at the American Academy of Dermatology’s academy (Academy), dermatologist Patricia K. Farris, MD, FAAD, clinical associate professor of dermatology at Tulane University School of Medicine in New Orleans, discussed how to separate fact from fiction when evaluating cosmeceuticals and tips for gauging the validity of product claims.

“When consulting with our patients, dermatologists can suggest skin care products that have strong science behind them and that have been proven to be safe and effective in human studies,” said Dr. Farris. “The biggest problem with cosmeceuticals is not that they don’t work, but that their benefits are greatly exaggerated.”

Cosmeceuticals can be divided into categories based on their active ingredients. Anti-oxidants represent the largest category. They are followed by peptides (small proteins that stimulate the production of collagen and thicken the skin) and growth factors (compounds that act as chemical messengers between cells and play a role in cell division, new cell and blood vessel growth, and the production and distribution of collagen and elastin). More recently, Dr. Farris noted that the new trend is toward combination products. For example, cosmeceuticals with multiple anti-oxidants, retinol plus anti-oxidants, growth
factors plus vitamin C and other unique combinations that are now being mass marketed. Consumers tend to favor combination products, embracing the philosophy that if one ingredient is good, then two must be better.

“The important thing to understand about combination products is that often the individual ingredients have been studied, but the combination of active ingredients has not,” said Dr. Farris. “More rigorous scientific studies are necessary to assure that biologic activity is maintained when ingredients are formulated together, and clinical studies should be done to determine if combination products really offer any added benefit.”

Consumer demand is high for cosmeceuticals containing “natural” or “organic” ingredients. However, Dr. Farris advised that the notion that these ingredients are safer than synthetic ones is a common misconception. In reality, there is no data to support the notion that natural or organic ingredients – derived from the root, stem, leaves, flowers and fruit of plants – are safer or even more effective than their synthetic counterparts.

“The problem with cosmeceuticals labeled 'natural' is that the labels themselves don’t mean anything because these products are not regulated by the Food and Drug Administration (FDA),” said Dr. Farris. “In fact, 'natural' skin care products are less tested and scrutinized than synthetic products and pharmaceuticals.”

Dr. Farris noted that most compounds as they exist in their natural state cannot be formulated into skin care products. They must be chemically altered before they can be incorporated into cosmetics. For instance, compounds including retinol, vitamin C, and soy are among those that require chemical alteration – after which they are referred to as enhanced natural ingredients. Enhanced natural ingredients tend to be more stable, penetrate better and have more long-lasting effects on the skin than unaltered plant extracts, which is the reason why most cosmeceuticals contain chemically-altered ingredients.

“There are a number of cosmeceutical ingredients that are completely synthetic, such as collagen-boosting peptides and synthetic forms of vitamin A,” explained Dr. Farris. “These compounds are among the most potent anti-aging ingredients and have been used extensively by dermatologists. So, it’s important for consumers to understand that synthetic ingredients are not necessarily bad and, in fact, skin care products containing these ingredients are probably among the most effective in the marketplace.”

Dr. Farris explained that the key to evaluating the effectiveness of cosmeceuticals is understanding how they are tested. After an active ingredient has been identified, it is evaluated using polymerase chain reaction (PCR) testing, which is used to characterize biologic activity and determine if the ingredient is an anti-oxidant or anti-inflammatory. PCR testing also can tell if an ingredient increases collagen production or reduces collagen breakdown. Although PCR testing is a valuable part of the testing process, many of the claims made as a result of PCR testing are not substantiated by human studies.

"For dermatologists, the gold standard for confirming a product’s efficacy remains the double-blind, vehicle-controlled study," said Dr. Farris. "In this type of objectively designed study, the product containing the key ingredients is tested against the vehicle, or the product formulation that is similar to the product being tested but without the key active ingredients." Dr. Farris explained that even though a compound may stimulate collagen production in PCR testing, it does not mean that the ingredient will cause any visible improvement in fine lines and wrinkles.

“Since cosmeceuticals are not subject to the FDA’s rigorous approval process, most cosmetic manufacturers do not perform double-blind, vehicle-controlled studies,” said Dr. Farris. “Instead, they rely on what are called open-label user studies where subjects apply test creams for a few weeks and then assess their improvement over baseline. Unfortunately, these types of studies are of no real value in determining product efficacy because they do not assess the vehicle's effect and there are no objective measures. People participating in these studies want to believe that they look better after using the product, but that does not necessarily mean it works."

Dr. Farris offered these tips when purchasing cosmeceuticals:

Ask yourself what the product claims to do and what kinds of studies have been performed.
Trust your instincts. If it sounds too good to be true, then it probably is.
Stick with products and brands that you know to be reputable. Well-known manufacturers have more money behind their active ingredients and product testing.
Beware of Web site claims, as many are biased even if they say they are objective.
For day, use products containing anti-oxidants, as they have sun-protection properties. At night, use products containing retinoids, peptides or growth factors for their repair properties.
Talk to your dermatologist about the best options for your skin care needs. For more information on aging skin, go to the "AgingSkinNet" section of www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at
1-888-462-DERM (3376) or www.aad.org.

Enhanced Cosmetic Procedures Plus New At-Home Treatments Give Patients More Options

2008-11-13T12:00:00-08:00

To satisfy the public's quest for younger-looking skin, the marketplace for cosmetic procedures has expanded dramatically over the years, with little signs of slowing down. From new facial fillers that produce longer-lasting results to at-home treatments that can temporarily remove unwanted hair, the average consumer now has many choices when it comes to improving their appearance. However, this trend also has created an influx of unqualified practitioners lacking the training and expertise of dermatologists who understand the science behind these cosmetic procedures and their effects on the skin. This can put patient safety at risk.

Speaking today at the American Academy of Dermatology’s academy (Academy), dermatologist Ranella J. Hirsch, MD, FAAD, clinical assistant professor of dermatology at Boston University School of Medicine in Boston, discussed how new technology and products entering the growing market of cosmetic procedures are enhancing dermatologists’ ability to fine-tune treatments and the pros and cons of at-home cosmetic procedures.

Dermatologists Select Safest Solutions
Advances in the use of fillers, lasers and botulinum rejuvenation are allowing dermatologists to better refine treatments based on each patient’s specific cosmetic needs. Dr. Hirsch credits the influx of new technologies and products in these areas as the reason behind the expanded treatment options for patients.

“The biggest news in cosmetic procedures is the number of new products in the pipeline that allow us to truly customize and refine treatments for the individual patient,” said Dr. Hirsch. “Dermatologists are now in a position to be able to offer patients very specific solutions to each of their skin concerns.”

For example, the technology behind lasers and other light sources – which is the cornerstone of many skin rejuvenation procedures – is continually evolving. Fractional resurfacing is one of the newer laser technologies that gives dermatologists the option to safely treat patients with more extensive skin damage. Dr. Hirsch noted that the main benefits of fractional resurfacing are increased collagen production that creates more dramatic results to improve the appearance of skin texture and reduce the appearance of wrinkles and acne scars, doing so with considerably less downtime than other older invasive laser technologies.

In addition, laser technologies used to treat vascular lesions – such as port-wine stains and other birthmarks – have greatly improved over the years. This allows more patients to benefit from treatment, especially infants. For example, the pulsed dye laser selectively heats abnormal blood vessels within the port-wine stain without injuring the surrounding skin.

“It is simply best practice for a dermatologist trained in laser technologies to determine if a patient’s birthmark is conducive to treatment and how early and aggressive the intervention should be,” added Dr. Hirsch.

A number of new fillers have been introduced in recent years to replace lost volume in the skin and to shape and sculpt areas that show signs of aging.

Where once natural collagen was the only filler available, now the advent of synthetic collagens, several hyaluronic acids, L-polylactic acid, and calcium hydroxyapatite allow dermatologists to correct signs of aging from sunken cheeks to fine lines around the eyes and lips. “Fillers represent the most visible area of cosmetic procedures where new products have really expanded the menu of choices available for very specific skin problems,” said Dr. Hirsch. “Different kinds of fillers can address specific kinds of facial lines, specific kinds of aging and shaping of the face.”

Botulinum toxin, most widely known for its ability to diminish wrinkles and other facial lines, currently is being studied across many medical specialties for an array of different conditions. For example, one manufacturer is seeking FDA approval of using botulinum toxin to treat migraines. Dr. Hirsch explained that a few new manufacturers have introduced botulinum toxin formulations in recent years. This helps patients by making pricing more competitive and, hence, more affordable.

“The important thing to remember with any of these cosmetic procedures is that you have to be sure that what you’re choosing is the real McCoy – authentic and trustworthy.” cautioned Dr. Hirsch. “Unless you go to a dermatologist specifically trained in cosmetic procedures, you cannot be sure you are receiving the highest quality care – and in the case of botulinum rejuvenation, the safe dosage and manufacturer-specific formulation.”

At-Home Treatments
For some consumers, the “do-it-yourself” cosmetic treatments that can be performed at home represent a viable alternative for those looking for a quick, albeit temporary, remedy. Many of the at-home products such as microdermabrasion kits and chemical peel solutions that can be purchased at drug stores can be safe when they have been thoroughly tested for this type of self-use. To ensure the highest level of safety, the concentration of the active ingredients in these products is much lower than that used by dermatologists.

However, Dr. Hirsch pointed out that there are drawbacks to at-home treatments of which consumers should be aware. While most at-home treatments do not produce results as dramatic or long-lasting as the cosmetic procedures performed in dermatologists’ offices, there are still safety concerns if these are used improperly or if any of the active ingredients cause an unforeseen skin reaction.

“It is important for consumers considering any at-home cosmetic treatments to first discuss these products with their dermatologist,” advised Dr. Hirsch. “For example, a person using a retinoid could be at risk for an adverse skin reaction from a chemical in these at-home products that should not be used simultaneously.”

Perhaps the most sought after new at-home cosmetic procedure that has been introduced recently is in the realm of laser hair removal devices. Unlike the laser hair removal procedures performed in dermatologists’ offices and which offer a long-term solution to unwanted facial and body hair, laser hair removal performed at home is intentionally temporary. Despite giving consumers only a temporary remedy for unwanted hair, Dr. Hirsch added that these types of devices can be expensive – ranging in price from approximately $800 to $1,000. These devices also can pose a safety concern for people who are tan or have darker skin.

The concern for people using an at-home laser hair removal device or for those opting to receive cosmetic treatments outside of a dermatologist’s office, such as at a spa or mall-based establishment, is that many factors could adversely affect the outcome of the procedure and pose unforeseen side effects.

“Knowing who not to treat is extremely important, and that is why consumers should remain highly skeptical of cosmetic procedures offered at local malls or venues where packages of treatments are sold,” said Dr. Hirsch. “In these cases, there is no motivation to turn anyone away, and the consequences could be very serious. To ensure the highest level of safety and efficacy, see your dermatologist for all your skin care needs.”

For more information on aging skin, go to the "AgingSkinNet" section of www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at
1-888-462-DERM (3376) or www.aad.org.

Dermatologists Debunk Myths, Offer Advice For Conditions That Hit Below the Belt

2008-11-13T12:00:00-08:00

While spider veins, varicose veins, cellulite and pedicures gone awry may sound like the makings of a modern-day horror flick, the scary part is these dermatologic conditions and associated problems can strike anyone at anytime. In fact, much of what is perceived as common knowledge or factual information about these problems is little more than fiction.

Speaking today at the American Academy of Dermatology’s (Academy) academy, dermatologist Robert A. Weiss, MD, FAAD, associate professor of dermatology at Johns Hopkins University School of Medicine in Baltimore, addressed common myths about spider veins, varicose veins and cellulite, the latest treatment options, and how to ensure a safe pedicure.

Spider and Varicose Veins
Spider veins, also referred to as roadmap veins, are very tiny superficial blood vessels that increase in size over time and commonly occur on the legs. Dr. Weiss noted that some people are more susceptible to spider veins, including women and those who have a blood relative with the condition. Spider veins also are common in workers who stand regularly in their jobs – such as nurses, cashiers or hair stylists – as standing increases the venous pressure in the legs and can cause the veins to stretch.

Although some spider vein suffers may mistakenly believe tanning their legs can help mask their condition, Dr. Weiss warned that excess sun exposure actually can cause spider veins. Harmful ultraviolet light breaks down collagen – which composes the walls of spider veins – and can cause thinning and spreading of the veins.

“There are many common myths about spider veins, so it is important for patients to consult their dermatologist for the best advice on how to minimize their risk of developing the condition and how to treat it,” said Dr. Weiss.

Dr. Weiss set the record straight on the following myths about spider veins:
Myth: Crossing your legs causes spider veins. Dr. Weiss: “Everyone at some point crosses their legs, and not everyone develops spider veins. This common myth has no truth to it.”

Myth: Gaining a lot of weight causes spider veins. Dr. Weiss: “When people lose weight, they actually may be more prone to spider veins, as weight loss causes the skin to deflate and reveal what is underneath. Fat under the skin actually helps mask spider veins.”

Myth: Vitamin supplements that contain horse chestnut extract prevent spider veins. Dr. Weiss: “There is no truth that any vitamin supplements can prevent spider veins. The fact is that heredity accounts for 80 percent of people who develop spider veins.”

"Even with the advent of lasers, sclerotherapy is still considered the gold standard in treating spider veins," said Dr. Weiss. He explained that sclerotherapy is the most efficient treatment because large areas of the veins can be treated with hair-thin needles. "One sclerotherapy injection can cover a very large area of veins, whereas with a laser you have to cover this same area dot by dot,” said Dr. Weiss. Newer sclerosing solutions that have recently been introduced make the procedure more comfortable for patients and virtually eliminate any stinging or pain during the procedure.

Varicose veins are larger, dilated blood vessels that can be raised above the skin’s surface and have a rope-like appearance. While Dr. Weiss noted that many of the same myths for spider veins apply to varicose veins, the main myth relating to varicose veins is that you only need to treat the veins that are visible on the surface of the leg.

“Most varicose veins stem from a hidden vein trunk beneath the skin’s surface, that must be treated for any procedure to be successful,” said Dr. Weiss. Two of the latest treatments for varicose veins include lasers and radiofrequency. With the laser procedure, tiny laser fibers are delivered to the vein through a needle puncture that is thread up to the main vein trunk responsible for these veins. The laser’s heat shrinks the vein from the inside, and an ultrasound-guided anesthetic is placed around the vein to reduce discomfort and increase safety during the procedure.

With the new radiofrequency procedure, radiofrequency energy converted to heat is used to collapse the vein, which is then reabsorbed by the body. The radiofrequency energy is delivered by a simple needle puncture, and Dr. Weiss noted that 95 percent of treatments are successful.

Cellulite
Cellulite, a hormonally based condition unique to women, is caused by a herniation or rupture of fat through the fibrous tissue and the subsequent pulling back of this tissue that creates dimpled areas – typically on the thighs. A common myth is that liposuction can improve the appearance of cellulite. Dr. Weiss explained that although liposuction removes excess fat, it can make the appearance of cellulite worse by creating more depressions in the skin.

Some new remedies being explored to treat cellulite work by softening the fibrous bands and contracting them at the same time, which effectively tightens up the fibrous bands. One procedure Dr. Weiss is currently studying in clinical trials involves using a large panel of red and infrared Light Emitting Diodes (LEDs) to emit certain wavelengths known to soften and disrupt fat tissue, which causes them to shrink. This procedure is combined with rollers and suctions to soften the fibrous bands that are pulling the skin back in and causing cellulite. In this controlled study, Dr. Weiss is treating 20 patients with the device on one thigh and the other thigh is left untreated. Patients receive two to three treatments a week for a period of three to four weeks.

Dr. Weiss also is studying the effectiveness of another new laser to melt fat and disrupt the fibrous bands of cellulite. The laser fiber is inserted under the skin and then stroked back and forth to break up cellulite.

“While we are still tabulating our results from this study, the initial results I have seen of the treated thighs are very encouraging,” said Dr. Weiss. “We’re also exploring another technology to improve cellulite using mono-polar radiofrequency, in which the tip on the device that delivers the energy is four
times larger than the standard tip used for other skin rejuvenation procedures. All of these new technologies have the potential to improve cellulite more quickly, more effectively and with longer-lasting results.”

Safe Pedicures
Despite their popularity, pedicures can pose serious health risks for nail salon patrons if proper sanitation is overlooked.

“Every instrument used for a pedicure needs to be sterilized properly to prevent the spread of fungal infections and even potentially serious antibiotic-resistant staph infections, such as Methicillin-resistant Staphylococcus aureus, or MRSA,” said Dr. Weiss.

In order to ensure a safe pedicure, Dr. Weiss advised consumers to ask nail technicians how their instruments are cleaned and to avoid any salons that don’t appear to be clean. Another option he recommended for people who regularly get pedicures is to consider buying their own instruments to use at the salon to minimize their risk of contracting an infection. Foot baths that are not properly cleaned after each use also can harbor bacteria and fungus, which can cause infections, so consumers should ask if they have been thoroughly disinfected before they use them.

Another potential hazard of pedicures is smoothing the surface of the nail too aggressively with nail files and buffers at the base of the nail, which can damage the cuticle.

“It’s a common myth that pushing your cuticles back helps keep nails healthy and helps them grow,” said Dr. Weiss. “Actually, the cuticle is the nail’s protective barrier, and pushing back on the cuticle can damage it – increasing your risk of infection.”

Utilizing current technology, dermatologists can assist people with many of their skin and nail concerns below the belt. Dr. Weiss added that the best way to avoid being misled by myths concerning skin, hair or nails is to discuss your questions with a dermatologist.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

John J. Voorhees, MD, FRCP, FAAD, Named Recipent of Prestigious Dermatology Award

2008-09-24T12:00:00-08:00

The American Academy of Dermatology (Academy) today announced the selection of dermatologist John J. Voorhees, MD, FRCP, FAAD, to receive the 2009 Eugene J. Van Scott Award for Innovative Therapy of the Skin. In conjunction with this award, Dr. Voorhees also will present the Phillip Frost Leadership Lecture at the plenary session of the Academy's 2009 Annual Meeting, March 6-10, in San Francisco.

Dr. Voorhees is chair of the department of dermatology at the University of Michigan Medical School in Ann Arbor, Mich., and also is the Duncan and Ella Poth Distinguished Professor at the university.

Dr. Voorhees' award recognizes his key contributions in the treatment of psoriasis and aging skin. His research on psoriasis has studied the immunologic mechanisms of this skin disease, leading to greater use of immunosuppressive therapies for its treatment. His research has explored the molecular mechanisms of aging and photoaging skin and the biochemical manner in which topical retinoids and other agents improve both photoaged skin and the wrinkling associated with natural skin aging. These studies have the potential to result in new therapies to prevent photoaging and reverse the appearance of chronological skin aging.

During the Phillip Frost Leadership Lecture, Dr. Voorhees will discuss his findings about aging skin. Also at the Annual Meeting, Dr. Voorhees will receive the $15,000 Eugene J. Van Scott Award along with an additional $10,000 for the Phillip Frost Leadership Lecture. This award and lecture were made possible by a donation from Phillip Frost, MD, FAAD, Emeritus Clinical Professor of Dermatology at the University of Miami School of Medicine in Miami and former Chairman of the Dermatology Department at Mt. Sinai Medical Center in Miami Beach. Dr. Frost named the award after his mentor, Eugene J. Van Scott, MD, FAAD, with whom he worked at the National Institutes of Health early in his career.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Grammy Award Winner LeAnn Rimes Urges Psoriasis Sufferers to "Stop Hiding" and "Start Living"

2008-09-03T12:00:00-08:00

Many of the nearly seven million Americans living with psoriasis may be faced with physical, emotional or social challenges as they struggle with public stigmas and misperceptions of this painful, chronic immune disorder that affects the skin. Today marks the launch of a nationwide awareness campaign, “Stop Hiding from Psoriasis,” led by Grammy Award-winning artist and psoriasis sufferer, LeAnn Rimes, who is working with the American Academy of Dermatology (Academy) and National Psoriasis Foundation to raise awareness of psoriasis and encourage sufferers to talk to their dermatologist about the impact of the disease.

LeAnn knows first-hand the physical and emotional pain of psoriasis. “Having battled severe psoriasis my whole life, I have gone to great lengths to hide my condition, especially as a performer. Over the years, I’ve had to deal with the emotional and physical toll psoriasis has had on my self-esteem and confidence, but today I no longer let psoriasis define who I am or how I feel about myself. I hope by joining this effort and sharing my story, others will be empowered to stop hiding from their psoriasis and better manage their disease and not let it limit them or their aspirations.”

Why is there a need for a psoriasis campaign?
Psoriasis has long been a misunderstood disease. A Psoriasis Foundation survey found that at least half of the patients surveyed feel their psoriasis leads others to stare or think the condition is contagious. In fact, this is the reality of psoriasis:

Psoriasis is a non-contagious, sometimes painful, chronic immune disorder, resulting in unexpected flare-ups of itchy, red patches of skin called “plaques” that may crack and bleed.
Recent research suggests that severe psoriasis may occur with other medical conditions such as cardiovascular disease, obesity and diabetes.
Up to 30 percent of people with psoriasis may develop psoriatic arthritis, a chronic condition that typically combines skin lesions with a progressive form of arthritis affecting the joints.

Another recent survey of the general public found that awareness about psoriasis and its impact is very low. Almost half of American adults surveyed admitted that they are uncomfortable around those with psoriasis, particularly in close settings like restaurant service or shaking hands in a meeting, suggesting that the misperception of psoriasis as a contagious disease is very strong.

In particular, the survey found that:

Most people (86%) say they’ve heard of psoriasis, but nearly half (48%) say they are not very or not at all familiar with the disease
More than half (57%) of adults become uncomfortable when they are being waited on in a restaurant by a server who has psoriasis, and half may be uncomfortable accepting a date with a person who has psoriasis
If diagnosed with psoriasis, 82% feel they would be uncomfortable wearing clothes that would expose their skin, and 80% felt they would be uncomfortable being intimate with others.

“Based on these findings, our task is to not only educate psoriasis sufferers and the public about the significant physical impact of the disease, but perhaps more importantly, to clarify some of the misconceptions that drive the painful emotional burden for patients,” said dermatologist Mark Lebwohl, MD, Chairman, National Psoriasis Foundation Medical Board.

How will this campaign help elevate awareness of psoriasis?
To address the needs of the psoriasis community, the Academy and the Foundation, funded with
support from the global health care company Abbott, joined forces to create the campaign, “Stop
Hiding from Psoriasis.” This educational effort is meant not only to encourage people suffering from psoriasis to see a dermatologist to better manage their disease, but also to educate the general public about psoriasis and dispel common misperceptions attached to the disease.

“Currently, there is no cure for psoriasis. Because psoriasis can be debilitating physically, mentally, and emotionally, it’s extremely important for sufferers to establish a relationship with a dermatologist and initiate an ongoing discussion about their overall health – including how their psoriasis may impact their health both physically and emotionally,” said dermatologist David M. Pariser, M.D., President-Elect, American Academy of Dermatology. “Together, psoriasis patients and their dermatologists can determine an appropriate plan to manage their disease. There’s no reason for people to hide and suffer alone.”

Learning More About Psoriasis
Psoriasis affects nearly seven million people in the U.S. The chronic, non-contagious immune disorder speeds the growth cycle of skin cells and results in thick, scaly areas of skin. While psoriasis can occur in people of all ages, it typically appears in patients between the ages of 15 and 35, and currently has no cure. The most common form, called plaque psoriasis, appears as red, raised areas of skin covered with flaky white scales that may itch or burn.

Psoriasis most commonly appears on the scalp, knees, elbows and torso, though it can develop anywhere on the skin. It may even occur on the fingernails and toenails. In addition to its physical symptoms, psoriasis also may affect one’s life, potentially leading to poor self image. Some patients experience social isolation, and depression -- from dealing with the misperception that psoriasis is contagious to worrying about how to hide symptoms. Social interactions – from initiating a friendship to starting a relationship – may become more challenging when living with psoriasis.

For more information about psoriasis, visit StopHiding.org, a new Web site with information about psoriasis and additional background on the effort to raise awareness by encouraging psoriasis sufferers to “stop hiding” and “start living.”

About the American Academy of Dermatology
The American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, andmost representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

About the National Psoriasis Foundation
The National Psoriasis Foundation is the world’s largest non-profit organization dedicated to serving people with psoriasis and psoriatic arthritis. Through education and advocacy, the Foundation promotes awareness and understanding, ensures access to treatment and supports research that will lead to effective management and a cure. For more information, please call the Psoriasis Foundation, headquartered in Portland, Oregon, at 800.723.9166, or visit www.psoriasis.org.

About the Campaign Surveys
The National Psoriasis Foundation conducts survey panels twice each year to understand the experiences and opinions of people with psoriasis. These surveys help the Foundation gain awareness and document the impact of this disease. Each survey sample consists of more than 400 psoriasis and psoriatic arthritis patients. Approximately two-in-three respondents reported having moderate-to-severe psoriasis.

As part of the Stop Hiding campaign, Abbott also conducted a detailed survey of American consumers to assess awareness, knowledge and attitudes about psoriasis. The online survey, conducted in June 2008, was directed to 1,000 adults aged 18 to 65, in a sample representative of the U.S. population based on U.S. Census Bureau indicators.

Acne and Rosacea Got You Seeing Red? Patients with Skin of Color Advised to Seek Proper Diagnosis, Treatment to Prevent Common Side Effects

2008-07-30T12:00:00-08:00

By its very nature, skin of color is considered sensitive skin by dermatologists who regularly treat darker-skinned patients for a wide range of skin problems. Acne and rosacea can be especially problematic skin conditions for people with skin of color, as any skin irritation in these patients can cause pigmentation problems that can result in the lightening or darkening of the skin.

At the American Academy of Dermatology's Summer Academy Meeting 2008 in Chicago, dermatologist Valerie D. Callender, MD, FAAD, clinical assistant professor of dermatology at Howard University College of Medicine in Washington, D.C., discussed the importance of early intervention in treating acne and rosacea in patients with skin of color.

"As we become a more diverse population with lots of different skin types and tones, we also are seeing an increase in skin concerns that, while not new, are affecting more and more people with darker skin," said Dr. Callender. "Even skin conditions like acne and rosacea can create pigmentation problems in these patients, which can be very hard to treat. However, these problems can be improved by seeing a dermatologist who is trained to properly diagnose these conditions and to carefully consider a patient's potential risk of skin irritation."

Dr. Callender explained that people with skin of color have diverse ethnic backgrounds, which is why there is such a wide range of skin types. Those with pigmented skin include African-Americans, Asians, Hispanics/Latinos, Middle Easterners, and Native Indians.

Acne: Early and Aggressive Management is Key
While acne is considered the most common skin condition in the United States, there is no cure for this bothersome condition and problems can remain long after the pimples and pustules have cleared — particularly in darker-skinned patients. Post-inflammatory hyperpigmentation (commonly referred to as dark spots or blemishes) is a concern for these acne patients, as the irritation the skin experiences from acne lesions can leave their mark in the form of long-lasting skin discoloration.

Topical retinoids, which Dr. Callender considers the mainstay of treatment in acne patients of color, have been shown effective in clearing acne lesions while also reducing the occurrence of post-inflammatory hyperpigmentation. Tretinoin, tazarotene and adapalene are three commonly prescribed topical retinoids that Dr. Callender recommends for her patients. She explained that combining one of these topical retinoids with other effective acne medications — such as a benzoyl peroxide and oral antibiotic combinations — can enhance results.

"One combination topical retinoid containing tretinoin and clindamycin works great for darker-skinned acne patients because clindamycin reduces the inflammation of acne lesions," said Dr. Callender. “Your dermatologist can determine the best treatment regimen based on your skin type and severity of acne."

In addition, chemical peels and microdermabrasion can be used for acne and resulting pigmentation problems. For example, Dr. Callender noted that chemical peels containing salicylic acid penetrate into the follicle where acne starts and unclogs the follicle — leading to an improvement in acne. Dr. Callender cautioned that these procedures should only be performed by a dermatologist or another qualified physician since these procedures could actually harm the skin if performed improperly.

Fractional laser resurfacing also has been found to be safe for treating acne scars in patients of color. However, Dr. Callender recommended that microdermabrasion and chemical peels should be tried before fractional laser resurfacing for treating superficial acne scars.

Rosacea: Proper Diagnosis is Important First Step
Rosacea, the chronic skin disease characterized by redness, flushing and prominent blood vessels of the face, is thought to be more common in people of European descent, particularly those of Celtic origin. However, Dr. Callender pointed out that rosacea can occur in people of all skin types.

"Traditionally, rosacea has been overlooked and underreported in patients of color," said Dr. Callender. "In fact, while there are 14 million Americans affected by rosacea, the incidence of the condition in skin of color has not been reported. To address this lack of epidemiological data, a multi-center study looking at the incidence of rosacea in this population is being initiated. We think the data will show that rosacea is clearly an equal-opportunity condition that should not be overlooked in skin of color."

One problem associated with rosacea in patients of color is post-inflammatory hypopigmentation, or lightening of the skin, that can occur simultaneously with redness. In some cases, these patients also may experience post-inflammatory hyperpigmentation, or darkening of the skin. Dr. Callender also noted that rosacea is often misdiagnosed in patients of color, as clinicians may mistake the signs and symptoms of the condition for lupus — a systemic, autoimmune condition that commonly occurs as a "butterfly rash" involving the face.

"Dermatologists can recognize the nuances that distinguish rosacea from lupus in skin of color, which is why it is very important for patients to see a dermatologist for the proper diagnosis and treatment," explained Dr. Callender. "Some medications prescribed for lupus, such as prednisone, can make rosacea worse, so a misdiagnosis can really delay the road to recovery."

Rosacea triggers, such as sunlight, heat or high temperatures, certain beverages, stress, and spicy foods, are the same for patients of all skin types. Since the skin is so sensitive in rosacea patients, Dr. Callender advised patients — including those with skin of color — to practice proper sun protection year-round, including applying broad-spectrum (UVA and UVB) sunscreen with a Sun Protection Factor (SPF) of 30 or higher.

"Sun protection is very important for everyone, and patients of color with acne or rosacea need to properly protect themselves from the sun because these conditions make their skin so sensitive," said Dr. Callender. "I recommend that my patients look for sunscreens that contain micronized zinc oxide and titanium dioxide, as they are physical filters and less irritating to the skin."

For more information on acne and rosacea, visit www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of conditions of the skin, hair and nails.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 14,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Consumer Alert: Black Henna Tattoos Can Cause Serious Skin Reactions

2008-07-30T12:00:00-08:00

Dermatologists are warning consumers that the harmless-looking, henna tattoos that are being sold everywhere from summer carnivals and open-air malls to cruise ships and vacation hot spots could contain a harmful chemical known as para-phenylenediamine, or PPD, used to create longer-lasting black henna tattoos. Notably, PPD has been associated with a rash of major skin problems.

At the American Academy of Dermatology's Summer Academy Meeting 2008 in Chicago, dermatologist Sharon E. Jacob, MD, FAAD, assistant clinical professor of pediatrics and medicine (dermatology) at the University of California, San Diego, discussed the dangers of black henna tattoos and how dermatologists are treating an increasing number of patients, including very young children, with skin problems from allergic reactions to PPD.

Natural henna used for temporary tattoos is made from leaves of the lawsonia inermis plant, which provides a vegetable coloring that comes in shades of brown, green or red. Temporary coloring (dyeing) of the skin with natural henna is considered harmless and only lasts for a few days. To increase the intensity of the tattoo beyond which can be attained with natural henna color and to prolong the longevity of the temporary tattoo from days to weeks, some henna tattoo artists are adding PPD (commonly also used for black hair dye) into the henna mix. This turns the tattoo black.

The U.S. Food and Drug Administration (FDA) prohibits the direct application of PPD to the skin because of its known health risks. However, since the tattoo industry is not regulated, people are still getting black henna tattoos and exposing themselves to serious medical problems. "Perhaps the most alarming issue we are seeing with black henna tattoos is the increase in the number of children — even children as young as four — who are getting them and experiencing skin reactions," said Dr. Jacob. "Kids make up a significant portion of the population that receives temporary tattoos, because parents mistakenly think they are safe since they are not permanent and are available at so many popular venues catering to families. In fact, nothing could be further from the truth."

Dr. Jacob noted that to date, there have been hundreds of case reports of allergic contact dermatitis from black henna tattoos, with reactions ranging from mild eczema to blistering and even permanent scarring. The first sign of a reaction is typically redness and itching, followed by bumps, swelling and then blisters. Topical steroids can be used to stop the reaction, but Dr. Jacob explained that whether or not any scarring occurs depends on the depth and severity of the inflammation.

In addition, some people may become sensitized to PPD from just one exposure — meaning that the immune system becomes prepared to remember the chemical to which it has been exposed or a chemical with a similar structure. When this happens, a person can develop a lifelong sensitivity to PPD and an allergy can cause a cross reaction to other compounds, including certain medications. For example, use of some heart, hypertension and diabetes medications, and even some anesthetics used in topical hemorrhoid preparations or oral gels, can lead to allergic reactions in people previously sensitized to PPD.

"Each exposure to PPD re-challenges the immune system, so each time you get a black henna tattoo or use a hair dye that contains PPD, there is an increased risk of having a reaction," said Dr. Jacob. "Many people are sensitized to PPD, but don't have a reaction to it. However, each time you are exposed to black henna, you increase your risk of developing a lifelong allergy to it."

Dr. Jacob advised if one does choose to obtain a henna tattoo, only do so if you can be certain that only vegetable henna is used, not PPD-adulterated henna. "Unless the artist can tell you exactly what's in the tattoo, don't get one," said Dr. Jacob.

The American Academy of Dermatology Association (AADA) endorses a ban on the practice of applying PPD-adulterated henna tattoos, and some state dermatology societies have started posting warnings on their Web sites about black henna tattoos.

For any skin reactions that develop from a temporary tattoo, Dr. Jacob recommended that people see their dermatologist for proper diagnosis and treatment. If a serious reaction occurs, such as severe blistering or swelling, she said seek immediate medical attention.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Dermatologists Warn Ceramic Flat Irons Could Damage Hair And Lead To Hair Breakage

2008-07-30T12:00:00-08:00

While hairstyles come and go, pin-straight hair favored by A-list celebrities and emulated by scores of loyal fans from coast to coast appears to have real staying power. That's why the use of flat irons, which are used to straighten hair, has increased in popularity in recent years. Now, dermatologists warn that some flat irons can damage hair and cause hair breakage which could put a crimp in this coveted hairstyle.

At the American Academy of Dermatology's Summer Academy Meeting 2008 in Chicago, dermatologist Paradi Mirmirani, MD, FAAD, assistant clinical professor of dermatology, University of California, San Francisco, presented evidence that when ceramic flat irons are used improperly or too frequently, hair breakage can occur.

"The newer flat irons that have a ceramic coating instead of a metal one are marketed as providing more rapid and uniform heat transmission. While this allows for quicker straightening of the hair with less damage, it is really a classic case of buyer beware," said Dr. Mirmirani. "We're seeing that when these ceramic flat irons are used at the highest heat settings and on a daily basis to achieve straight hair, they can really take a toll on the structure of the hair and cause very noticeable problems that can be hard to repair."

Temporary hair straightening using a flat iron is achieved by applying heated tongs to the length of the hair. This heat breaks and then reforms the hydrogen bonds in the inner core of the hair fiber. Dr. Mirmirani noted that while the goal of straightening is to alter the inner substance of the hair, the unwanted consequence may be damage to the outer protective cuticle, causing weathering, damage and eventual hair breakage.

Hair weathering or damage is usually characterized by dry ends or flyaway hair. However, if breakage occurs, it can happen anywhere along the length of the hair and cause a shaggy or skimpy appearance to the hair. When this occurs, flat iron users may use the device even more frequently to try to tame the broken or uneven appearance of their hair — which can lead to more damage.

Today, many ceramic flat irons on the market have variable heat settings with maximum temperatures of up to 410 degrees Fahrenheit (210 degrees Celsius). Prior studies have shown that temperatures of 347 to 419 degrees Fahrenheit (175 to 215 degrees Celsius) for as little as five minutes are enough to damage most hair. However, Dr. Mirmirani warns this threshold may be even lower if the heat is applied to damp hair or hair that has been chemically treated with color or permanents, as she is seeing patients who fit this scenario more frequently. If women are not willing to give up their flat irons in the quest for straight hair, Dr. Mirmirani advised them to take precautions.

"Proper use of flat irons is extremely important, especially given how quickly hair can be damaged with high heat settings," said Dr. Mirmirani. "Flat irons should only be applied to dry hair, and specialized styling products that act as heat protectors may be applied to the hair prior to pressing to help prevent burning and allow for smoother hair that remains straight longer. If there is a temperature setting on the device, it should be set no higher than 347 degrees Fahrenheit, or 175 degrees Celsius, or on the low/medium setting."

Although how frequently a flat iron should be used depends on an individual's hair type, Dr. Mirmirani recommended that these devices should probably not be used more than two to three times per week. For those who won't leave home without the ultra straight look, Dr. Mirmirani acknowledged that forgoing the daily flat iron routine will take willpower — but the end result will be healthier, stronger hair that is not as prone to breakage and will look better in the long run.

Dr. Mirmirani added that for many women and young girls, flat irons are not the only source of hair damage. Improper hair care is a common cause of hair loss, and excessive or improper use of devices, such as flat irons, is only one piece of the puzzle," she said. "In fact, many of the styling products that women routinely use — including hair dyes, perms and relaxers — can all cause hair breakage. Pairing these products with the regular use of a flat iron to straighten hair could exacerbate hair breakage and cause lasting damage if left untreated."

Treatment of damaged or broken hair includes avoiding any heat or chemicals, cutting the damaged hair, and minimizing friction to the hair. Because it does not affect normal hair growth, most hair loss from breakage is temporary. Once hair is sufficiently damaged, it may take up to two years to be fully repaired. For successful diagnosis and treatment of hair damage, including hair loss, see your dermatologist.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Saving Face Without Surgery? New Minimally Invasive Technologies Can Rejuvenate Skin with Minimal Downtime, Less Risks

2008-07-30T12:00:00-08:00

The popular belief that good skin is something you're born with isn't entirely true. In fact, experts believe that genetics account for only 20 percent of natural aging, with 80 percent thought to be from accumulated sun exposure. But for those who would rather steer clear of going under the knife to shave a few years off their appearance, a new arsenal of aesthetic procedures that work without visibly wounding the skin are quickly gaining popularity.

At the American Academy of Dermatology's Summer Academy Meeting 2008 in Chicago, dermatologist Arielle N.B. Kauvar, MD, FAAD, clinical associate professor of dermatology at New York University School of Medicine in New York, discussed the latest non-surgical options in skin rejuvenation for treating photodamage and pigmentation problems, wrinkles and textural changes, and loose skin.

Photodamage and Pigmentation Problems
Aging skin is associated with a range of cosmetic concerns — from pigmentation problems and splotchy skin to redness due to enlarged vessels or capillaries. The development of dry, dull skin also is common, adding to an overall lackluster appearance. Other effects include a loss of collagen, which results in the thinning of the skin and loss of structural integrity or weakening of the skin.

"As we age, the majority of these skin problems are a direct result of long-term sun exposure," said Dr. Kauvar. "Also, the loss and movement of the underlying fat layer of the skin over time causes us to lose volume in our skin — creating that 'sunken in' look. Fortunately, we now have a number of minimally invasive procedures that can be used either alone or in combination to combat the telltale signs of aging."

Several different types of minimally invasive lasers and light sources can be used to treat pigmentation problems. In general, these technologies work by selectively targeting the affected areas of the skin with varying wavelengths and pulse durations without injuring the top layer of skin. For example, Dr. Kauvar noted that the KTP, Nd:YAG and Alexandrite lasers work well on areas of the skin affected by noticeable changes in pigmentation, such as sun spots or splotchy skin. Intense Pulsed Light sources, or IPLs, target both vascular and pigmentation changes on the skin, and the pulsed-dye and pulsed-KTP lasers also are used for vascular conditions.

In addition, peeling techniques — such as microdermabrasion or light chemical peels — are minimally invasive options for removing the accumulated layer of dead skin cells that cause a dull appearance. Dr. Kauvar added that these peeling procedures can improve the overall radiance of the skin and also remove some of the abnormal pigmentation from sun damage.

Wrinkles and Textural Changes
Many of the changes in the skin's texture can be directly attributed to the natural aging cycle and sun damage. Although wrinkles are perhaps the most obvious changes that occur, enlarged pores and even acne scars often worsen as we get older — resulting from the loss of collagen. Plump and smooth-to-the-touch skin, commonly referred to as baby skin, also is replaced by crepe-like skin, which feels dramatically different to the touch.

To treat large pores, Dr. Kauvar recommended the use of non-ablative lasers to heat the layer of tissue in the superficial dermis, resulting in the production of new, thicker and smoother skin. Often referred to as a "lunchtime procedure," non-ablative lasers have minimal side effects that only last for a few hours — primarily redness and puffiness that can be covered by make-up following the procedure.

While non-ablative lasers are designed for patients with superficial skin damage who are not expecting dramatic results, fractional non-ablative lasers can deliver better results for patients with more extensive signs of aging.

Fractional non-ablative lasers heat pixilated columns of skin to depths three-to-four times deeper than traditional non-ablative heating, creating increased collagen production that provides improved results in skin texture, fine wrinkles and acne scars. The primary side effect of fractional non-ablative lasers is redness that lasts slightly longer than their non-ablative counterparts — in most cases overnight as compared to a few hours.

For patients with even deeper wrinkles and scars, fractional ablative lasers are considered comparable to the traditional ablative lasers, such as the CO2 laser that is considered the gold standard in laser skin resurfacing. With fractional ablative lasers, microscopic plugs of tissue are removed and heated at the same time. Since only 10 percent to 40 percent of the surface area of the skin is treated, Dr. Kauvar noted that the procedure requires much less downtime and the risks are lower than with other ablative lasers. "Fractional ablative lasers are a dramatic advance over traditional laser resurfacing," she said.

Even with laser resurfacing, wrinkles that are a result of constant muscle movement (frown lines and crow's feet, for example) can be hard to treat. Dr. Kauvar added that the popular injectible botulinum toxin, which works by relaxing the muscles that cause wrinkles, works well for these hard-to-treat wrinkles when used in combination with skin resurfacing. For deeper folds and creases, such as vertical lip lines or smile lines, Dr. Kauvar suggests hyaluronic acid fillers.

Skin Looseness/Loss of Volume
With the further loss of collagen, the skin loses elasticity and becomes lax. These deeper folds result in jowl formation or what is commonly referred to as "chicken neck." Fortunately, there are a variety of options to tighten loose skin.

Monopolar and bipolar radiofrequency, pulse infrared light and infrared lasers all work by deeply heating the skin's tissue, which causes collagen contraction and new collagen production without visibly wounding the skin. These procedures typically require four to six treatment sessions, with side effects limited to redness and swelling that last several hours.

When the skin loses volume from the loss and movement of the subcutaneous fat layer, the result is a drawn appearance with more angular features. To replace volume, a number of proven fillers can be used to plump up the skin. For example, hyaluronic acid fillers last four to 12 months, while polylactic acid and hydroxyapatite are semi-permanent fillers that last from 12 to 18 months. In each case, these filler materials stimulate collagen production, as the material injected into the skin is replaced by the body's own collagen.

"Fillers are an excellent option for softening angular lines, filling the hollows under the eyes and early jowl formation, and correcting deep smile lines," said Dr. Kauvar. "A patient with more advanced aging could benefit from a combination of procedures, such as lasers and fillers, to improve the overall appearance of their skin."

Dr. Kauvar added that a permanent filler, polymethylmethacrylate (PMMA), is now available in the U.S. This filler consists of tiny acrylic plastic beads suspended in collagen that, once placed into the skin, cannot be reversed.

Unlike the hyaluronic acid fillers that can be dissolved at any time with an enzyme that reverses the effects, PMMA cannot be removed. Dr. Kauvar cautioned patients to thoroughly discuss their expectations with their dermatologist before considering this irreversible procedure.

"For the average person with mild-to-moderate skin problems, minimally invasive skin rejuvenation offers a range of options to slow down or reverse the aging process," said Dr. Kauvar. "Your dermatologist can help you decide what procedures are right for you."

For more information on aging skin, visit www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of conditions of the skin, hair and nails.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Stubborn Nail Problems Can Improve From Proper Diagnosis, Treatment by Dermatologists

2008-07-30T12:00:00-08:00

For many of us, the health of our nails is something we often take for granted. That is until something goes wrong and changes the appearance or texture of the nails. Dermatologists, who are the physician experts in the care of skin, hair and nails, find that brittle nails, nail fungus and problems from nail cosmetics are among the most common sources of nail disorders. Help can be found by seeking proper diagnosis and starting a proven treatment regimen, which can include medications and behavioral changes.

At the American Academy of Dermatology's Summer Academy Meeting 2008 in Chicago, dermatologist C. Ralph Daniel, MD, FAAD, clinical professor of dermatology at the University of Mississippi in Jackson, Miss., and clinical associate professor of dermatology at the University of Alabama in Birmingham, Ala., discussed these common nail complaints and how to recognize when a problem requires medical intervention.

Brittle Nails
Brittle nails are a common nail problem frequently seen by dermatologists in their practices. While it is rare for an internal illness or a drug to cause brittle nails, the primary cause is typically environmental. Dr. Daniel explained that there are two types of brittle nails — hard and brittle nails, and soft and brittle nails.

Hard and brittle nails are caused by too little moisture, with older people more prone to this condition. This type of brittle nails can make nails feel dry, and chipping or flaking commonly occurs anywhere on the nail plate. Dry skin also is common in people with brittle nails, and the condition occurs more frequently in the winter from dry heat used to warm the indoors and in very dry climates with little humidity, such as Arizona.

At the other end of the spectrum, soft and brittle nails are thought to be caused by too much moisture and can affect people of any age. However, soft and brittle nails are more common in young people, particularly those who wash their hands frequently — including medical professionals and chefs. While soft and brittle nails don't feel dry, they tend to layer more at the end of the nail plate when they chip.

"When we treat brittle nails, we always ask patients if their toenails are affected as well — and most will say no," said Dr. Daniel. "This indicates that if the condition was caused by a lack of something in the body, such as a vitamin or mineral, it also would cause brittleness in the toenails. For that reason, dermatologists believe brittle nails are the result of contact with the environment, particularly work environments due to contact with water, or low or high humidity."

Typically, hard and brittle nails are treated by adding moisture to the nails; whereas patients with soft and brittle nails need to reduce the amount of moisture that comes in contact with their hands. For example, Dr. Daniel recommends that people with soft and brittle nails who engage in wet work should wear light cotton gloves under vinyl gloves to keep moisture away from the nails. Latex gloves are not preferred, because latex is more irritating and causes the hands to sweat. In general, he said it is a good idea for patients with either type of brittle nails to wear gloves and avoid irritants.

Nail Fungus
Fungal infections, known as onychomycosis, comprise approximately half of all visits to the dermatologist for nail-related problems. Since the infection occurs under the nail plate or in the nail bed, it can be difficult to treat. Fungal infections — which can be white, green, yellow or black in color — often cause the end of the nail to separate from the nail bed, and they may build up under the nail plate and discolor the nail bed. Because the feet are usually confined in a warm, moist environment, toenails are more susceptible to fungal infections.

"We know that the foot acts as a reservoir for fungus that can spread elsewhere on body, so it is important for dermatologists to treat the source of an infection and check the toenails and bottom of the foot when a fungus is present," said Dr. Daniel. "Patients who have had trauma to a nail also are more susceptible to nail fungus, as the trauma can serve as a pre-disposing event."

Dr. Daniel added that psoriasis patients are prone to developing nail fungus. In fact, one study found that the occurrence of nail fungus was 56 percent greater in patients with psoriasis than in non-psoriatic patients. Men with psoriasis also were two-and-a-half times more likely to have nail fungus than women with psoriasis. Dermatologists find that while medications traditionally used to treat nail fungus work for psoriatic patients affected by this infection, these medications will not improve the underlying psoriasis.

Nail fungus can be difficult to treat, but most cases improve with the use of available prescription topical medications. Experimental treatments for nail fungus include photodynamic therapy (PDT) and new topical treatments, and studies are currently being done with nanoparticles.

Side Effects of Nail Cosmetics
Nail cosmetics, used to enhance the appearance of nails, also can be a source of potential problems. Though not common, allergic reactions and infections from nail cosmetics used at home or at nail salons pose serious health risks.

For example, Dr. Daniel reported that most of the problems associated with nail salons are from the use of acrylic glues to hold artificial nails in place, which can cause pain, redness, itching or scaling. Although the U.S. Food and Drug Administration (FDA) banned the use of methyl acrylics, there are still instances of these types of nails being used at some salons despite their known health risks.

In addition, some of the ingredients in nail polishes and polish removers can cause allergic reactions. Free formaldehyde, which means it is not bound to another substance, also is banned by the FDA as a nail hardener because it can cause itching, redness or even blisters. Dr. Daniel also advised that consumers use nail polish remover with acetates rather than acetones, which are more drying and irritating.

To decrease the chance of contracting an infection at nail salons, Dr. Daniel recommended these tips:

Don't use the instruments at nail salons — bring your own instruments with you
If you don't own your own instruments, buy a pack of disposable instruments at the nail salon that are only intended for one-time use.
If you must use the reusable instruments at a nail salon, make sure they are sterilized properly in an autoclave. If not, find another salon.

"To ensure that your nails are strong and healthy, it is important to take care of them properly and not subject them to harsh environmental conditions or unnecessary hazards in an attempt to improve their appearance," said Dr. Daniel. "Oftentimes, changes in our nails can signal a serious underlying health problem. In a sense, dermatologists act as detectives who can diagnose a variety of health problems from clues they observe in the nails. So, see your dermatologist if you notice any abnormalities or have any concerns about the health of your nails."

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

New Research on Genetic Changes in Melanomas and Teens' Use of Indoor Tanning Could Lead to Better Prevention and Treatment Strategies

2008-07-30T12:00:00-08:00

Melanoma, the most serious form of skin cancer, accounts for more than 75 percent of all skin cancer deaths. Despite repeated health warnings based on proven science that overexposure to ultraviolet (UV) light is the most preventable cause of all skin cancers, including melanoma, many Americans are not properly protecting themselves from this known carcinogen. Now, new understanding of the emerging field of genetic epidemiology of melanoma and the factors that influence teens' use of indoor tanning could shed more light on ways to protect future generations from skin cancer.

At the American Academy of Dermatology's Summer Academy Meeting 2008 in Chicago, dermatologist Martin A. Weinstock, MD, PhD, FAAD, professor of dermatology and community health at Brown University in Providence, R.I., and chief dermatologist at Veterans Affairs Medical Center in Providence, led the presentation of key findings from research that could pave the way for future skin cancer prevention and treatment strategies.

Link Between UV Exposure and Melanoma: The Gene Factor
When it comes to melanoma, there are multiple types of melanoma that can occur throughout the body and their relationship to UV exposure is different from one type of melanoma to another. Dr. Weinstock explained that over the past few years, the fields of genomics and genetic epidemiology have been advancing tremendously. The role of genetics in the study of melanoma is an attempt to understand the connection between genetic changes in melanoma associated with different types of melanoma.

"Everyone is born with genes that are inherited from their parents," said Dr. Weinstock. "Sometimes the genes in certain skin cells become mutated, deleted or amplified over time due to UV radiation and other factors, and these genetic changes in skin cells that take place could result in melanoma."

Different types of melanoma also are characterized by different genetic changes. For example, Dr. Weinstock explained that a melanoma that occurs on the face of an older person with extensive sun exposure will have a different genetic make-up than a melanoma found on the back or trunk area of a younger person with more limited exposure to UV light. From this greater understanding of the genetic characteristics of different types of melanomas, Dr. Weinstock suggested that further research could show which preventative behaviors at different ages could help decrease the incidence of age-related melanomas.

A greater understanding of the relationship between UV exposure and melanoma could lead to more implications for treatment and preventive measures. For example, Dr. Weinstock noted that the oncology community is hopeful that a specific chemotherapy could be developed in the future that would target each type of melanoma based on where they occur on the body and their genetic characteristics.

"The better we understand the different types of melanoma, the more we can direct our therapies and prevention efforts," said Dr. Weinstock. "Since these new therapies won't be available anytime soon, it's still important for people to protect their skin from UV radiation from the sun and tanning beds."

Influences on Teens' Use of Indoor Tanning
Despite its link to both melanoma and squamous cell carcinoma, indoor tanning is big business. In fact, published reports indicate that the indoor tanning industry has an estimated revenue of $5 billion, a fivefold increase from 1992. The prevalence of indoor tanning among older U.S. teen girls is as high as 40 percent.

A multi-component project to identify the factors that influence the likelihood of indoor tanning known as CITY 100 (Correlates of Indoor Tanning in Youth) examined the environmental, policy and individual level variables that may be related to teens' use of indoor tanning in 100 of the most populous U.S. cities. The primary component used to gather data consisted of a phone survey of 6,125 teen/parent pairs, with the teen sample ranging in age from 14 to 17. It was noted that 52 percent of the teen sample was female, 69 percent was classified as non-Hispanic white, and approximately 10.4 percent had used indoor tanning in the past year.

Other facets of the study included analyzing the presence and stringency of state indoor tanning legislation; evaluating local enforcement of state laws; assessing the density (per population) of tanning facilities in each city (i.e., availability); and assessing the practices of tanning facilities related to youth access, including parental consent, banning teens based on age, and the frequency teens were allowed to tan their first week.

The study found that only 28 states had any type of indoor tanning law, with 21 of these states having a youth access law. Even the majority of states with tanning laws that were reviewed did not perform annual inspections, and 70 percent of the facilities said they would allow a fair-skinned, 15-year-old girl who had never used an indoor tanning facility to tan every day the first week of tanning.

"Access to indoor tanning was found to be a significant contributing factor in teens use of these facilities," said Dr. Weinstock. "The study found that having a higher density of facilities in one's city and having at least one facility within two miles of one's home were each significantly related to indoor tanning. In fact, the lead investigator pointed out that the mean number of tanning facilities per city exceeded the number of Starbucks locations, and 89 percent of the teens in the sample lived within three miles of a tanning facility."

Dr. Weinstock also noted that the individual influences that were significantly associated with a higher likelihood of tanning included being female, older, or non-Hispanic white; having parents or friends who tan indoors; believing that tans are attractive; being exposed to ads; and having higher household incomes or weekly allowances.

"Teens appear to be a primary target of the indoor tanning industry, which resembles the tobacco industry in distorting science with the likely result of confusing the public about the facts," said Dr. Weinstock. "We hope these findings will demonstrate the need for tighter regulations and enforcement of this unhealthy practice."

In the interest of protecting public health, the American Academy of Dermatology Association (AADA) opposes indoor tanning and supports a ban on the production and sale of indoor tanning equipment for non-medical purposes. In the meantime, the AADA advocates for youth access laws until the Food and Drug Administration (FDA) takes action.

For more information about skin cancer, please visit the SkinCancerNet section on www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Jean I. Bolognia, MD, FAAD, Delivers American Academy of Dermatology's Everett C. Fox, MD, Memorial Lectureship

2008-07-30T12:00:00-08:00

Jean L. Bolognia, MD, FAAD, a Connecticut-based dermatologist, delivered the Everett C. Fox, MD, Lectureship at the American Academy of Dermatology's (Academy) Summer Academy Meeting 2008.

The Everett C. Fox, MD, Lectureship was created through a bequest from the estate of Everett C. Fox, MD, who served as vice president of the American Academy of Dermatology in 1946.

During Dr. Bolognia's lecture "The Moles in my Life," she reviewed the idea of signature nevi as well as specific types of nevi and their relationship to melanoma. Dr. Bolognia shared this information based on more than 20 years of experience seeing patients with melanocytic nevi.

Dr. Bolognia is a vice chair and professor in the department of dermatology at Yale University School of Medicine, New Haven, Conn. She also is director of the Pigmented Lesion Clinic. After receiving her medical degree from Yale University, she completed an internship in internal medicine and a residency in dermatology at Yale-New Haven Hospital.

An active member in the dermatology community, Dr. Bolognia is a past member of the Academy's board of directors and has served on many councils, committees and task forces. She is an author of numerous articles, editorials and book chapters.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

American Academy of Dermatology Association Announces Appointments

2008-07-15T12:00:00-08:00

The American Academy of Dermatology Association (AADA) recently named Kelly Haenlein as director of federal regulatory policy and John Hedstrom as director of congressional and state policy. Sandra Peters, formerly senior manager for workforce, policy and insurance, also was promoted to director of the AADA’s Practice Policy and Management department. The AADA is the Washington, DC-based sister organization of the American Academy of Dermatology.

“Kelly and John each have an extensive government relations background that will serve them well in their new positions as they further the efforts of the AADA,” said executive director and CEO Ronald A. Henrichs, CAE. “We also are pleased to recognize Sandra for her contributions through this well-deserved promotion.”

Ms. Haenlein will represent the AADA in its federal regulatory lobbying efforts, specifically working with the Food and Drug Administration (FDA) and the Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS). Immediately prior to coming to the AADA, Haenlein spent more than two years at the American College of Cardiology (ACC), where she was senior specialist for member strategy. Previously, Haenlein was a research analyst at Westat, where she conducted interviews for the Agency for Healthcare Research and Quality’s (AHRQ’s) Consumer Assessment of Healthcare Providers and Systems patient satisfaction survey product. Haenlein holds a bachelor of science degree in policy, analysis, and management from Cornell University in Ithaca, N.Y., and a master’s degree in health administration from Cornell’s Sloan Program.

Mr. Hedstrom will lead the AADA’s lobbying and advocacy efforts on dermatologic issues with federal and state legislators, state regulators, the White House, and gubernatorial offices. Mr. Hedstrom was most recently assistant director of government relations at the Society of Thoracic Surgeons. Prior to that, he was a congressional lobbyist for the American College of Obstetricians and Gynecologists. He began his career as an associate at the law firm of Porter Wright Morris & Arthur. Hedstrom received his bachelor of arts degree from Washington & Lee University, Lexington, Va., and his law degree from Marquette University Law School, Milwaukee, Wis.

Ms. Peters, who has been with the AADA since 1998, will lead the organization’s coding, reimbursement and practice management functions. Before taking over as department director, she managed and executed five medical director summit meetings and managed the AADA’s 2002 and 2005 Dermatology Practice Profile Surveys. Prior to coming to the AADA, Peters worked for Mercer Consulting, where she put together directly contracted preferred provider organizations for self-funded employers. She also negotiated physician and hospital contracts for a Midwestern PPO. Peters received her master’s in health administration from the University of South Carolina. She is a past chair of the Specialty Society Insurance Coalition and a past board member of the American Association of Preferred Provider Organizations.

The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. The American Academy of Dermatology Association is a sister organization to the Academy and the resource for government affairs, health policy and practice information for dermatologists, and plays a major role in formulating socioeconomic policies that can enhance the quality of dermatologic care. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

EDITOR’S NOTE: Photos of Kelly Haenlein, John Hedstrom, and Sandra Peters are available by contacting the Academy’s Communications Department at (847) 330-0230.

Eileen M. Murray, CAE, CFRE, Named Deputy Executive Director of the American Academy of Dermatology

2008-07-08T12:00:00-08:00

The American Academy of Dermatology (Academy) recently welcomed Eileen M. Murray, CAE, CFRE, as deputy executive director. In her new role, Ms. Murray will oversee the Academy’s Communications, Creative & Publishing, Development, Education, Meetings & Conventions, Member Services and Web Services departments.

“Eileen has a wealth of association management experience and knowledge which will help advance the immediate and long-term strategy of the Academy and its membership," said Executive Director and CEO Ronald A. Henrichs, CAE. “Her extensive association background and insight will be an asset to the Academy.”

Immediately prior to coming to the Academy, Ms. Murray served as vice president and executive director of the American Health Information Management Association (AHIMA) Foundation of Research and Education (FORE). Her background includes experience in program development, strategic planning, marketing, community relations, fundraising, membership management and public relations.

Prior to joining AHIMA, Ms. Murray was chief development officer at the American Society of Plastic and Reconstructive Surgeons. Other leadership positions include serving as the executive director of the Hyde Park Art Center and the director of the Center for Partnership Programs at the American Bar Association.

Ms. Murray holds a master’s degree in management, with a concentration in public and nonprofit management, from Northwestern University’s Kellogg Graduate School of Business, Evanston, Ill.

The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. The American Academy of Dermatology Association is a sister organization to the Academy and the resource for government affairs, health policy and practice information for dermatologists, and plays a major role in formulating socioeconomic policies that can enhance the quality of dermatologic care. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

EDITOR’S NOTE: A photo of Eileen Murray, CAE, CFRE, is available by contacting the Academy’s Communications Department at (847) 330-0230.

American Academy of Dermatology, Major League Baseball and Major League Baseball Players Association Play Sun Smart™ to Strike Out Skin Cancer

2008-06-20T12:00:00-08:00

Major League Baseball (MLB) and the Major League Baseball Players Association (MLBPA) are teaming up with the American Academy of Dermatology (Academy) this summer through the Play Sun Smart™ program to educate players and fans about skin cancer. The many hours spent in the midday sun playing baseball or cheering for their favorite team puts both players and fans at risk for skin cancer, a potentially life-threatening condition that affects 1 in 5 Americans.

Baseball Commissioner Allan H. (Bud) Selig learned the importance of skin cancer detection and prevention in 2004 when he was diagnosed and successfully treated for melanoma.

"Long before early detection of my own Level IV Melanoma saved me, Major League Baseball was committed to educating and warning our teams and our fans about the dangers of sun exposure and skin cancer," said Baseball Commissioner Allan H. (Bud) Selig. "We've been playing sun smart for ten years now and while there is still a lot of education to be done, I am proud that Baseball is a leader in the fight against skin cancer. I encourage the public to get a skin cancer screening from a dermatologist because it could save your life. When it comes to the sun, we want all of our field personnel, front office staff and fans to play smart and defeat skin cancer."

This year marks the 10th year of the Play Sun Smart™ program, a public service partnership between the Academy, MLB and the MLBPA to raise awareness of the importance of skin cancer detection and prevention. MLB has dedicated June 21, the first day of summer, as Play Sun Smart™ skin cancer awareness day.

In celebration of the 10th year of the program, MLB is expanding its commitment to help strike out skin cancer by releasing a new public service announcement (PSA) which will be played at ballparks across the country featuring past and present spokesmen, urging the public to Play Sun Smart™. In addition to the PSA, MLB will be distributing sun safety tip cards at guest services in all ball parks and sun safety messages will be made by the game day announcers. A full page Play Sun Smart™ ad also will run in USA Today prior to June 21, MLB's Skin Cancer Awareness Day.

More than 1 million new cases of skin cancer are diagnosed each year and one American dies of melanoma almost every hour (every 62 minutes). Of these cases, more than 116,500 are melanoma, a cancer that claims more than 8,000 lives annually. Since the Play Sun Smart™ program's inception in 1999, more than 19,000 skin cancer screenings of players, trainers, coaches and staff of the MLB family have been conducted.

"The baseball community continues to set a good example of sun-safe behavior," said dermatologist Brian B. Adams, MD, MPH, Chair of the Academ'’s Sports Committee. "We encourage everyone, including baseball players and fans, to regularly conduct skin self-examinations to look for signs of skin cancer which can be successfully treated if caught early."

Skin self-examinations consist of regularly looking over the entire body, including the back, scalp, soles, between the toes and on the palms. If there are any changes in the size, color, shape or texture of a mole, the development of a new mole or any other unusual changes in the skin, see a dermatologist immediately.

Just like the pros, the public can be screened for skin cancer by visiting the Academy's Web sites at www.PlaySunSmart.org or www.aad.org to find a free screening in their area. Through this public service, dermatologists have volunteered to conduct more than 1.8 million skin cancer screenings and have detected 180,170 suspicious lesions, including 20,933 suspected melanomas, since 1985.

Sun exposure is the most preventable risk factor for skin cancer. You can have fun in the sun and Be Sun Smart^SM. Here’s how to do it:

Generously apply water-resistant sunscreen with a Sun Protection Factor (SPF) of at least 15 that provides broad-spectrum protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays to all exposed skin. Re-apply every two hours, even on cloudy days, and after swimming or sweating. Look for the AAD SEAL OF RECOGNITION™ on products that meet these criteria.
Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible.
Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 4 p.m. If your shadow is shorter than you are, seek shade.
Protect children from sun exposure by playing in the shade, using protective clothing, and applying sunscreen.
Use extra caution near water, snow and sand as they reflect the damaging rays of the sun which can increase your chance of sunburn.
Get vitamin D safely through a healthy diet that may include vitamin supplements. Don’t seek the sun.
Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
Check your birthday suit on your birthday. If you notice anything changing, growing, or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.

The American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Robert D. Greenberg, MD, FAAD, Elected Assistant Secretary-Treasurer of The American Academy Of Dermatology

2008-05-28T12:00:00-08:00

Robert D. Greenberg, MD, FAAD, a Vernon, Conn., dermatologist has been elected by the board of directors as assistant secretary-treasurer of the American Academy of Dermatology (Academy), the world's largest dermatologic society, representing more than 16,000 physicians specializing in the diagnosis and medical, surgical and cosmetic treatment of conditions of the skin, hair, and nails. In addition, Dr. Greenberg will hold this same position for the American Academy of Dermatology Association. He will become secretary-treasurer at the conclusion of the 2010 Annual Meeting, succeeding Mary E. Maloney, MD, FAAD, whose term began in 2007.

Dr. Greenberg is in private practice with a faculty appointment at the University of Connecticut School of Medicine, Farmington, Conn. He is a graduate of the University of Michigan, Ann Arbor. He completed an internship at Washington University, St. Louis, and a residency in dermatology at the University of Virginia, Charlottesville.

Dr. Greenberg is a previous member of the Academy's Board of Directors. He is currently the chair of the Academy's Ethics Committee. Dr. Greenberg is a past chair of the Academy's Organizational Structure Committee, the Health Care Delivery Committee and the Advisory Board. Dr. Greenberg also has served as secretary/treasurer and president of the Connecticut Dermatology and Dermatologic Surgery Society.

The American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. A sister organization to the Academy, the American Academy of Dermatology Association is the resource for government affairs, health policy and practice information for dermatologists, and plays a major role in formulating socioeconomic policies that can enhance the quality of dermatologic care. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Editor's note: A photo of Dr. Robert D. Greenberg can be obtained by contacting the Academy's Communications Department at (847) 330-0230.