Generic name: isotretinoin. A prescription-only drug derived from vitamin A, and which is taken orally. It essentially stops the oil production in sebaceous glands (the oil-producing structures of the skin) and literally shrinks these glands to the size of a baby's. This prevents sebum (oil) from clogging the hair follicle, mixing with dead skin cells, and rupturing the follicle wall to create an environment where a bacterium (Propionibacterium acnes) can thrive, which can result in pimples or cysts. Normal oil production resumes when treatment is completed, and the sebaceous glands slowly begin to grow larger again, but rarely as large as they were before treatment. "Because of its relatively rapid onset of action and its high efficacy with reducing more than 90% of the most severe [acne] inflammatory lesions, Accutane has a role as an effective treatment in patients with severe acne that is recalcitrant to other therapies".
However, Accutane is controversial for many reasons, principally because of its most insidious side effect: It has been proven to cause severe birth defects in nearly 90% of the babies born to women who were pregnant while taking it. Other commonly reported, although temporary, side effects of Accutane include dry skin and lips, mild nosebleeds (your nose can get really dry for the first few days), hair loss, aches and pains, itching, rash, fragile skin, increased sensitivity to the sun, headaches, and peeling palms and hands. More serious, although much less common, side effects include severe headaches, nausea, vomiting, blurred vision, changes in mood, depression, severe stomach pain, diarrhea, decreased night vision, bowel problems, persistent dryness of eyes, calcium deposits in tendons, an increase in cholesterol levels, and yellowing of the skin.
Sunday, October 28, 2007
Thursday, October 25, 2007
Antioxidants and Free-Radical Damage
Antioxidants and free-radical damage are considered so vital to our understanding of the origins of cancer, aging, illness, and disease that they have become a profound area of research. An "antioxidant" isn't a type of ingredient, but the function a specific ingredient can perform on the skin. Free-radical damage is what antioxidants are supposed to take care of, either by stopping new damage, or by reversing earlier damage caused by free radicals.
Let's begin by saying that free-radical damage is bad for the skin. Theoretically, free-radical damage can cause deterioration of the skin's support structures, decreasing elasticity and resilience. The presence of antioxidants in the diet, and, possibly, the topical application of antioxidants in skin-care products, plays a part in slowing down free-radical damage. Antioxidants are ingredients such as vitamins A, C, and E; superoxide dismutase; flavonoids; beta carotene; glutathione; selenium; and zinc.
Despite the proliferation of skin-care products containing antioxidants, according to Dr. Jeffrey Blumberg, chief of antioxidants research at Tufts University, "there is no conclusive scientific evidence that antioxidants really prevent wrinkles, nor is there any information about how much antioxidant(s) or exactly which one(s) has to be present in a product to have an effect."
Even if antioxidants did work to prevent free-radical damage on the skin, the results would hardly be immediate. Free-radical damage in the human body can continue for years before any deterioration can be detected and you can't slap on an antioxidant and expect to immediately notice your wrinkles disappearing.
Despite this lack of hard evidence, fashion magazines and cosmetics companies have heralded the elimination of free-radical damage as the fountain of youth. The excitement around antioxidants is understandable. According to many skin experts, all aspects of aging, including wrinkling, are caused by free-radical damage. Vitamin and cosmetics companies want you to believe their antioxidant products can eliminate it. It isn't known is whether or not you can really stop free-radical damage from taking place on the skin.
Free-Radical Damage
Free-radical damage occurs on an atomic level. Molecules are made of atoms, and a single atom is made up of protons, neutrons, and electrons. Electrons are always found in pairs. However, when oxygen molecules are involved in a chemical reaction, they can lose one of their electrons. This oxygen molecule that now only has one electron is called a free radical. With only one electron the oxygen molecule must quickly find another electron, and it does this by taking the electron from another molecule. When that molecule in turn loses one of its electrons, it too must seek out another, in a continuing reaction. Molecules attempting to repair themselves in this way trigger a cascading event called "free-radical damage."
What causes a molecule to let go of one of its electrons, generating free-radical damage? The answer is oxygen or any compound that contains an oxygen molecule, such as carbon monoxide, hydrogen peroxide, and superoxide) plus sunlight, and pollution.
You may be asking: With all that free-radical damage taking place, and all this oxygen around us (the air we breathe contains about 20% oxygen), how is it that we are still walking around? Why are we still living? The answer to that is antioxidants.
Antioxidants
Antioxidants prevent unstable oxygen molecules (made unstable by loss of one electron) from interacting with other molecules (taking one of their electrons) and consequently causing them to become unstable, a process that starts the free-radical chain reaction. Fortunately, a vast assortment of antioxidants can be found in both the human body and in the plant world.
So what does that have to do with wrinkles? No one is exactly sure, but theoretically wrinkles appear when the free-radical damage originates from natural environmental factors and fails to be cancelled out by some amount of antioxidant protection. If we don't get enough antioxidant protection, either from our own body's production, from dietary sources, or from antioxidants, including those we put on our skin, free-radical damage continues unrestrained, causing cells to break down and impairing or destroying their ability to function normally.
There's just one problem, the fact that free-radical damage is constant and extensive. Major investigation is now underway in this fascinating area of human aging and sun damage, factors that influence wrinkling. However, the research is still in its infancy, and suggesting anything else is sheer fantasy.
Almost every company makes moisturizers that contain antioxidants, so they aren't hard to find. You won't see any difference in your skin, but if free-radical damage can be slowed, then antioxidants should help. Many scientists think that if there is a fountain of youth, antioxidants could be in it.
Please checkout Emerge Vitamin C Plus
Let's begin by saying that free-radical damage is bad for the skin. Theoretically, free-radical damage can cause deterioration of the skin's support structures, decreasing elasticity and resilience. The presence of antioxidants in the diet, and, possibly, the topical application of antioxidants in skin-care products, plays a part in slowing down free-radical damage. Antioxidants are ingredients such as vitamins A, C, and E; superoxide dismutase; flavonoids; beta carotene; glutathione; selenium; and zinc.
Despite the proliferation of skin-care products containing antioxidants, according to Dr. Jeffrey Blumberg, chief of antioxidants research at Tufts University, "there is no conclusive scientific evidence that antioxidants really prevent wrinkles, nor is there any information about how much antioxidant(s) or exactly which one(s) has to be present in a product to have an effect."
Even if antioxidants did work to prevent free-radical damage on the skin, the results would hardly be immediate. Free-radical damage in the human body can continue for years before any deterioration can be detected and you can't slap on an antioxidant and expect to immediately notice your wrinkles disappearing.
Despite this lack of hard evidence, fashion magazines and cosmetics companies have heralded the elimination of free-radical damage as the fountain of youth. The excitement around antioxidants is understandable. According to many skin experts, all aspects of aging, including wrinkling, are caused by free-radical damage. Vitamin and cosmetics companies want you to believe their antioxidant products can eliminate it. It isn't known is whether or not you can really stop free-radical damage from taking place on the skin.
Free-Radical Damage
Free-radical damage occurs on an atomic level. Molecules are made of atoms, and a single atom is made up of protons, neutrons, and electrons. Electrons are always found in pairs. However, when oxygen molecules are involved in a chemical reaction, they can lose one of their electrons. This oxygen molecule that now only has one electron is called a free radical. With only one electron the oxygen molecule must quickly find another electron, and it does this by taking the electron from another molecule. When that molecule in turn loses one of its electrons, it too must seek out another, in a continuing reaction. Molecules attempting to repair themselves in this way trigger a cascading event called "free-radical damage."
What causes a molecule to let go of one of its electrons, generating free-radical damage? The answer is oxygen or any compound that contains an oxygen molecule, such as carbon monoxide, hydrogen peroxide, and superoxide) plus sunlight, and pollution.
You may be asking: With all that free-radical damage taking place, and all this oxygen around us (the air we breathe contains about 20% oxygen), how is it that we are still walking around? Why are we still living? The answer to that is antioxidants.
Antioxidants
Antioxidants prevent unstable oxygen molecules (made unstable by loss of one electron) from interacting with other molecules (taking one of their electrons) and consequently causing them to become unstable, a process that starts the free-radical chain reaction. Fortunately, a vast assortment of antioxidants can be found in both the human body and in the plant world.
So what does that have to do with wrinkles? No one is exactly sure, but theoretically wrinkles appear when the free-radical damage originates from natural environmental factors and fails to be cancelled out by some amount of antioxidant protection. If we don't get enough antioxidant protection, either from our own body's production, from dietary sources, or from antioxidants, including those we put on our skin, free-radical damage continues unrestrained, causing cells to break down and impairing or destroying their ability to function normally.
There's just one problem, the fact that free-radical damage is constant and extensive. Major investigation is now underway in this fascinating area of human aging and sun damage, factors that influence wrinkling. However, the research is still in its infancy, and suggesting anything else is sheer fantasy.
Almost every company makes moisturizers that contain antioxidants, so they aren't hard to find. You won't see any difference in your skin, but if free-radical damage can be slowed, then antioxidants should help. Many scientists think that if there is a fountain of youth, antioxidants could be in it.
Please checkout Emerge Vitamin C Plus
Sunday, October 14, 2007
Natural Ingredients
If there is one cosmetics industry buzz word that gets almost immediate consumer attention, it's "natural." Whatever preconceived or media-induced fiction someone might believe about natural ingredients being better for the skin has no factual basis or scientific legitimacy. Not only is the definition of "natural" hazy, but the term isn't even regulated, so each cosmetics company can use it to mean whatever they want it to mean. "If a company wants to call their products natural, it can, and it doesn't matter what they contain. [The] FDA has tried to establish official definitions for the use of certain terms such as 'natural' but its regulations were overturned in court. So companies can use them on cosmetic labels to mean anything or nothing at all."
In the world of skin care and makeup, the claims about all-natural products are either exaggerated because the products are laden with lots of unnatural ingredients, or the natural ingredients they do contain are problematic for the skin. Just because an ingredient grows out of the ground or is found in nature doesn't make it automatically good for skin, and the reverse is also true, just because it is synthetic doesn’t make it bad. Yet there are many beneficial natural ingredients for skin, which makes the whole issue more confusing because consumers are often at a loss (or simply don’t have the time) to determine which natural ingredients are helpful and which are harmful (and more products than I care to count contain a frustrating combination of both).
Fruits, vegetables, or any pure food ingredients are not necessarily the best for skin. When it comes to skin care, more often than not, it is some small element of the plant that has benefit for skin. Extracting this component from the plant almost always requires a process that is synthetically derived. Further, these extracts are far more stable than the whole food. Think about it this way: a plant in its pure form isn't stable in the least, especially in skin-care products. Just think of how long a head of lettuce lasts in your refrigerator. It would be far worse sitting on the counter in your bathroom! Regrettably, natural or plant-based preservatives have extremely poor antimicrobial or antifungal properties. Complications for skin due to a product being contaminated are a serious consideration when it comes to how a product is preserved.
Many companies claiming to be all-natural are anything but. They achieve the appearance of being all natural by listing a natural ingredient description in parentheses next to the more technical-sounding ingredient on their label. Although this appears to be helpful information, it still leads consumers in the wrong direction. For example, ammonium lauryl sulfate, a standard detergent cleansing agent, is listed on an Aveda ingredient label as being derived from coconut oil. While that makes the ingredient sound natural, what the label doesn't explain is what the coconut oil has to go through to become ammonium lauryl sulfate. Ammonium lauryl sulfate is the salt of a sulfuric acid compound, neutralized with an ingredient like triethanolamine. None of that makes this ingredient bad for skin, and I wouldn't tell anyone to avoid ammonium lauryl sulfate, but that is the more accurate description of that ingredient and it just isn't "natural." Along with this deception, products from companies that want you to believe they are all natural often, if not always, contain a vast array of synthetic ingredients.
It is important to point out that many natural ingredients can cause allergies, irritation, and skin sensitivities. Just think of how many people have a hay fever response to a wide variety of plants, and observe how many of these plants show up in cosmetics. Citrus often shows up in skin-care products, but most of us have gotten lemon or lime juice on a slight cut while cooking and know it burns like crazy because it's irritating to skin. Camphor (which is distilled from certain trees), peppermint, menthol, and eucalyptus can all cause an irritant or sensitizing response. All of the following natural ingredients can cause skin irritation, allergic reactions, skin sensitivity, and/or sun sensitivity:
The label might say natural, but you could be buying a purely irritating product that might cause an allergic reaction. Simply saying a product is "natural" doesn't tell you anything about the efficacy of the ingredients in a product. Remember, poison ivy is natural too, and I can't imagine a fan of all-natural products applying that to their skin instead of a benign synthetic ingredient.
The notion that natural ingredients are better than synthetic ingredients is even more distressing, because it just isn't true. While vegetable or plant oils may sound better for the skin, varying forms of silicones (i.e., siloxanes, dimethicones, cyclomethicones) are just as beneficial and offer impressive benefits for the skin. But it's hard to glamorize and advertise a "synthetic," unnatural-sounding ingredient. Silicones show up in over 80% of all skin-care, makeup, and hair-care products you buy. Yet you rarely hear about them because the cosmetics companies think consumers won't find them as sexy or alluring as plants, or oxygen therapy, or cellular repair, or a thousand other marketing angles that have nothing to do with what really works for your skin.
I'm not saying there aren't a large range of natural ingredients that are exceptional for the skin, because there are—lots and lots of them—but the idea that they are the "best" (or only) option for skin is just not reality. If you want to use products that contain helpful, non-irritating natural ingredients, what should you look for? The following natural ingredients (though keep in mind the natural form and, at times, the function of these ingredients may be altered after they're treated and prepared for use in a cosmetic product) each have beneficial properties for skin, mostly by making dry skin look and feel better or functioning as antioxidants:
In the world of skin care and makeup, the claims about all-natural products are either exaggerated because the products are laden with lots of unnatural ingredients, or the natural ingredients they do contain are problematic for the skin. Just because an ingredient grows out of the ground or is found in nature doesn't make it automatically good for skin, and the reverse is also true, just because it is synthetic doesn’t make it bad. Yet there are many beneficial natural ingredients for skin, which makes the whole issue more confusing because consumers are often at a loss (or simply don’t have the time) to determine which natural ingredients are helpful and which are harmful (and more products than I care to count contain a frustrating combination of both).
Fruits, vegetables, or any pure food ingredients are not necessarily the best for skin. When it comes to skin care, more often than not, it is some small element of the plant that has benefit for skin. Extracting this component from the plant almost always requires a process that is synthetically derived. Further, these extracts are far more stable than the whole food. Think about it this way: a plant in its pure form isn't stable in the least, especially in skin-care products. Just think of how long a head of lettuce lasts in your refrigerator. It would be far worse sitting on the counter in your bathroom! Regrettably, natural or plant-based preservatives have extremely poor antimicrobial or antifungal properties. Complications for skin due to a product being contaminated are a serious consideration when it comes to how a product is preserved.
Many companies claiming to be all-natural are anything but. They achieve the appearance of being all natural by listing a natural ingredient description in parentheses next to the more technical-sounding ingredient on their label. Although this appears to be helpful information, it still leads consumers in the wrong direction. For example, ammonium lauryl sulfate, a standard detergent cleansing agent, is listed on an Aveda ingredient label as being derived from coconut oil. While that makes the ingredient sound natural, what the label doesn't explain is what the coconut oil has to go through to become ammonium lauryl sulfate. Ammonium lauryl sulfate is the salt of a sulfuric acid compound, neutralized with an ingredient like triethanolamine. None of that makes this ingredient bad for skin, and I wouldn't tell anyone to avoid ammonium lauryl sulfate, but that is the more accurate description of that ingredient and it just isn't "natural." Along with this deception, products from companies that want you to believe they are all natural often, if not always, contain a vast array of synthetic ingredients.
It is important to point out that many natural ingredients can cause allergies, irritation, and skin sensitivities. Just think of how many people have a hay fever response to a wide variety of plants, and observe how many of these plants show up in cosmetics. Citrus often shows up in skin-care products, but most of us have gotten lemon or lime juice on a slight cut while cooking and know it burns like crazy because it's irritating to skin. Camphor (which is distilled from certain trees), peppermint, menthol, and eucalyptus can all cause an irritant or sensitizing response. All of the following natural ingredients can cause skin irritation, allergic reactions, skin sensitivity, and/or sun sensitivity:
- Almond extract
- Allspice
- Angelica
- Arnica
- Balm mint oil
- Balsam, basil
- Bergamot
- Cinnamon
- Citrus
- Clove
- Clover blossom
- Cornstarch
- Coriander oil
- Cottonseed oil
- Fennel
- Fir needle
- Geranium oil
- Grapefruit
- Horsetail
- Lavender oil
- Lemon
- Lemon balm
- Lemongrass
- Lime
- Marjoram
- Oak bark
- Papaya
- Peppermint
- Rose
- Sage
- Thyme
- Witch hazel
- Wintergreen
The label might say natural, but you could be buying a purely irritating product that might cause an allergic reaction. Simply saying a product is "natural" doesn't tell you anything about the efficacy of the ingredients in a product. Remember, poison ivy is natural too, and I can't imagine a fan of all-natural products applying that to their skin instead of a benign synthetic ingredient.
The notion that natural ingredients are better than synthetic ingredients is even more distressing, because it just isn't true. While vegetable or plant oils may sound better for the skin, varying forms of silicones (i.e., siloxanes, dimethicones, cyclomethicones) are just as beneficial and offer impressive benefits for the skin. But it's hard to glamorize and advertise a "synthetic," unnatural-sounding ingredient. Silicones show up in over 80% of all skin-care, makeup, and hair-care products you buy. Yet you rarely hear about them because the cosmetics companies think consumers won't find them as sexy or alluring as plants, or oxygen therapy, or cellular repair, or a thousand other marketing angles that have nothing to do with what really works for your skin.
I'm not saying there aren't a large range of natural ingredients that are exceptional for the skin, because there are—lots and lots of them—but the idea that they are the "best" (or only) option for skin is just not reality. If you want to use products that contain helpful, non-irritating natural ingredients, what should you look for? The following natural ingredients (though keep in mind the natural form and, at times, the function of these ingredients may be altered after they're treated and prepared for use in a cosmetic product) each have beneficial properties for skin, mostly by making dry skin look and feel better or functioning as antioxidants:
- Alfalfa
- Algae
- Aloe
- Andiroba oil
- Apricot kernel oil
- Artichoke extract
- Avocado oil
- Babassu oil
- Bearberry extract
- Beeswax
- Black currant oil
- Black elderberry
- Black tea
- Bladderwrack
- Borage seed extract
- Borage seed oil
- Burdock root
- Candelilla wax
- Canola oil
- Carnauba wax
- Carrot extract and oil
- Castor oil (all forms)
- Ceramides
- Chamomile extracts
- Cocoa butter
- Coconut oil
- Cornflower extract
- Corn oil
- Cranberry seed oil
- Curcumin (tumeric)
- Elderberry
- Evening primrose oil
- Flax extract and oil
- Ginkgo biloba
- Grape seed extract
- Grape seed oil
- Green tea
- Hazelnut oil
- Hemp seed oil
- Honey
- Horse chestnut extract
- Hydrocotyl extract
- Irish moss
- Japan wax
- Jojoba oil
- Kaolin
- Kelp
- Kudzu root
- Kukui nut oil
- Lanolin (all forms)
- Licorice extract and root
- Linseed oil
- Lotus seed extract
- Macadamia nut oil
- Magnesium
- Mallow
- Matricaria
- Nettle
- Oat extracts
- Olive oil
- Oryzanol
- Ozokerite
- Palm oil
- Peanut oil
- Pecan oil
- Pine cone extract
- Propolis
- Pycnogenol
- Rapeseed oil
- Raspberry seed oil
- Rice bran oil
- Rose hip oil
- Safflower oil
- Sea whip extract
- Seaweed
- Sesame oil
- Shea butter
- Slippery elm bark
- Soybean extract
- Soybean oil
- Sunflower oil
- Sweet almond oil
- Tea tree oil
- Vanilla Planifolia
- Walnut oil
- Wheat germ glycerides and oil
- Wheat Protein
- Whey Protein
- White tea
- Willow bark
- Willowherb (fireweed) extract
- Yeast
- Yucca extract
Wednesday, October 10, 2007
Stretch Marks
It isn't a stretch (pun intended) to say no one wants stretch marks on any part of their body. Once these grooved, tread-like marks show up, the quest to find something, anything to get rid of them begins. As you might imagine, I receive an amazing number of emails asking me which products or medical procedures really get rid of stretch marks. I'm sure the volume of these questions is in direct response to the assortment of advertisements promising to smooth out these strange bodily striations. In the world of cosmetics, a consumer's burning desire to have flawless skin always leads to hype and myths about what products can and can’t work. And bogus products for stretch marks abound.
Products that lead women to waste their money and hope for an improvement in the appearance of stretch marks include StriVectin-SD, Mederma, Vita-K Solution, Magia Bella, Maternity Solutions, ScarSof Scar Softening Cream, Phytomer, Decleor, Mustela, and Caudalie. Despite the ads you've seen and the claims you’ve heard about these products, none of them have substantiated evidence they can make a positive impact on the formation or prevention of stretch marks, but of course, that never stops the cosmetics industry from trying to convince you otherwise.
Medically speaking, stretch marks are called striae distensae. While we know a lot about stretch marks, there is still a great deal not yet fully understood about their cause and restoration .
Stretch marks occur when skin is abnormally distended or stretched for a period of time, such as from pregnancy or weight gain, causing the skin's support structure (in the form of collagen and elastin) to break down or rupture. In fact, the visibly curled ends of stretch marks are actually bands of elastin broken beneath the skin. Essentially, stretch marks are a scar that has formed from the inside out, rather than scarring that occurs when skin is externally wounded. There appears to be a genetic tendency toward them, but the exact link is not clear. It is speculated that the way each person's skin heals is a good indicator of the depth and severity of stretch marks they may eventually see. A person whose skin heals well with minimal scarring can expect less obvious stretch marks, while skin that heals poorly (or slowly) or tends to develop raised or thickened scars can generally expect stretch marks that are more pronounced.
It may surprise you to know that in the United States it is estimated that 90% of pregnant women, 70% of adolescent females and 40% of adolescent males have stretch marks. There does not seem to be an ethnic tendency toward stretch marks, as all races can be affected. Individuals with fair to light skin typically have pink-tinged stretch marks while the same marks on darker skin tones tend to take on a deeper pigmentation than the skin surrounding them. Discoloration from these marks does fade over time, but regrettably, the striated appearance rarely returns to its original smooth appearance.
Is there anything you can do to improve or eliminate the appearance of stretch marks? First of all, you need to know that, despite numerous cosmetic products (StriVectin-SD being the most heavily advertised) making claims of being able to fade, prevent, or eliminate stretch marks, that just isn't possible. There are no cosmetic ingredients that can change the structure of skin in a way that would raise the indentations back to where the skin level used to be. However, there is research showing tretinoin (the active ingredient in Retin-A, Renova, or in generic form) can have a positive effect. Because tretinoin can stimulate elastin synthesis, remodel collagen in the dermis, and improve skin’s texture and color, it can be a strong (though not curative) ally for improving the appearance of stretch marks. A 0.05% or 0.1% concentration of tretinoin is recommended, and the best results are seen when this drug is used at the first signs of stretch marks.
Other than topically applying tretinoin there are other medical cosmetic corrective procedures that can have very good results. These methods include chemical peels and non-ablative laser treatments. Studies have been conducted using Intense Pulsed Light (IPL) and Pulsed Dye Laser (PDL) treatments emitting 585 nanometers (nm) of light. Results after five sessions were labeled as a clinical improvement, with microscopic analysis showing improvement in the length, depth, and coloration of stretch marks. This type of laser carries a low risk of side effects and complications when operated at appropriate treatment parameters and time intervals.
Beyond non-ablative lasers, you can also consider a series of chemical peels. Trichloroacetic acid (TCA) peels may be of some help for improving the appearance of stretch marks when used at the proper concentration (typically 20% TCA) and applied by a dermatologist or cosmetic surgeon skilled in the use of this type of peel. A benefit of TCA peels (and the reason it can help improve the appearance of stretch marks) is their skin-tightening effect. Because TCA peels penetrate further than AHA or BHA peels, they are believed to have a greater ability to stimulate collagen and elastin for the depth of damage seen in stretch marks. As you may recall, deep damaged strands of these skin-supporting substances are chiefly responsible for the emergence of stretch marks.
One more myth to bust: you may have heard that specific moisturizing ingredients such as cocoa butter, vitamin E, or other various plant oils can prevent or reduce the appearance of stretch marks. As soothing and moisturizing as these ingredients are, they have no impact on how stretch marks are formed. Stretch marks are not caused because skin is dry or needs a special supplement. Rather stretch marks develop far below the skin's surface due to extreme strain, stress, and trauma that eventually breaks down the skin's support structure. No moisturizer in the world can prevent that kind of injury and damage to the skin from taking place.
Products that lead women to waste their money and hope for an improvement in the appearance of stretch marks include StriVectin-SD, Mederma, Vita-K Solution, Magia Bella, Maternity Solutions, ScarSof Scar Softening Cream, Phytomer, Decleor, Mustela, and Caudalie. Despite the ads you've seen and the claims you’ve heard about these products, none of them have substantiated evidence they can make a positive impact on the formation or prevention of stretch marks, but of course, that never stops the cosmetics industry from trying to convince you otherwise.
Medically speaking, stretch marks are called striae distensae. While we know a lot about stretch marks, there is still a great deal not yet fully understood about their cause and restoration .
Stretch marks occur when skin is abnormally distended or stretched for a period of time, such as from pregnancy or weight gain, causing the skin's support structure (in the form of collagen and elastin) to break down or rupture. In fact, the visibly curled ends of stretch marks are actually bands of elastin broken beneath the skin. Essentially, stretch marks are a scar that has formed from the inside out, rather than scarring that occurs when skin is externally wounded. There appears to be a genetic tendency toward them, but the exact link is not clear. It is speculated that the way each person's skin heals is a good indicator of the depth and severity of stretch marks they may eventually see. A person whose skin heals well with minimal scarring can expect less obvious stretch marks, while skin that heals poorly (or slowly) or tends to develop raised or thickened scars can generally expect stretch marks that are more pronounced.
It may surprise you to know that in the United States it is estimated that 90% of pregnant women, 70% of adolescent females and 40% of adolescent males have stretch marks. There does not seem to be an ethnic tendency toward stretch marks, as all races can be affected. Individuals with fair to light skin typically have pink-tinged stretch marks while the same marks on darker skin tones tend to take on a deeper pigmentation than the skin surrounding them. Discoloration from these marks does fade over time, but regrettably, the striated appearance rarely returns to its original smooth appearance.
Is there anything you can do to improve or eliminate the appearance of stretch marks? First of all, you need to know that, despite numerous cosmetic products (StriVectin-SD being the most heavily advertised) making claims of being able to fade, prevent, or eliminate stretch marks, that just isn't possible. There are no cosmetic ingredients that can change the structure of skin in a way that would raise the indentations back to where the skin level used to be. However, there is research showing tretinoin (the active ingredient in Retin-A, Renova, or in generic form) can have a positive effect. Because tretinoin can stimulate elastin synthesis, remodel collagen in the dermis, and improve skin’s texture and color, it can be a strong (though not curative) ally for improving the appearance of stretch marks. A 0.05% or 0.1% concentration of tretinoin is recommended, and the best results are seen when this drug is used at the first signs of stretch marks.
Other than topically applying tretinoin there are other medical cosmetic corrective procedures that can have very good results. These methods include chemical peels and non-ablative laser treatments. Studies have been conducted using Intense Pulsed Light (IPL) and Pulsed Dye Laser (PDL) treatments emitting 585 nanometers (nm) of light. Results after five sessions were labeled as a clinical improvement, with microscopic analysis showing improvement in the length, depth, and coloration of stretch marks. This type of laser carries a low risk of side effects and complications when operated at appropriate treatment parameters and time intervals.
Beyond non-ablative lasers, you can also consider a series of chemical peels. Trichloroacetic acid (TCA) peels may be of some help for improving the appearance of stretch marks when used at the proper concentration (typically 20% TCA) and applied by a dermatologist or cosmetic surgeon skilled in the use of this type of peel. A benefit of TCA peels (and the reason it can help improve the appearance of stretch marks) is their skin-tightening effect. Because TCA peels penetrate further than AHA or BHA peels, they are believed to have a greater ability to stimulate collagen and elastin for the depth of damage seen in stretch marks. As you may recall, deep damaged strands of these skin-supporting substances are chiefly responsible for the emergence of stretch marks.
One more myth to bust: you may have heard that specific moisturizing ingredients such as cocoa butter, vitamin E, or other various plant oils can prevent or reduce the appearance of stretch marks. As soothing and moisturizing as these ingredients are, they have no impact on how stretch marks are formed. Stretch marks are not caused because skin is dry or needs a special supplement. Rather stretch marks develop far below the skin's surface due to extreme strain, stress, and trauma that eventually breaks down the skin's support structure. No moisturizer in the world can prevent that kind of injury and damage to the skin from taking place.
Thursday, October 4, 2007
Facial Lift Exercises
I am completely bewildered by the enthusiasm facial exercises seems to generate. I get swarms of letters from women telling me that I have my non-exercised head screwed on wrong when I suggest that facial exercises don't work. But is there any research that explains the mania surrounding all this stretching of the face muscles?
For the most part, facial exercises are more a problem for skin than a help. Facial exercises provide little or no benefit because loss of muscle tone is not a major cause of wrinkles or sagging skin. In fact, muscle tone is barely involved in these at all. The skin's sagging and drooping are caused by four major factors:
1) Deteriorated collagen and elastin (due primarily to sun damage);
2) Depletion of the skin's fat layer (a factor of genetic aging and gravity);
3) Repetitive facial movement (particularly true for the forehead frown lines and for smile lines from the nose to the mouth);
4) Muscle sagging due to the loosening of facial ligaments that hold the muscles in place.
Facial exercise is not helpful for worn-out collagen, elastin, or the skin's fat layer, because none of that is about the muscles. It is especially not helpful for the lines caused by facial movement! Instead, facial exercises only make those areas appear more lined. The reason Botox injections into the muscles of the forehead and facial lines work to create a smoother face is because Botox prevents the muscles from moving!
Facial exercises won't reattach facial ligaments; that is only possible via surgery. One procedure in a surgical face-lift is to re-drape the muscle of the cheek and the jaw, drawing it back and then literally stitching it back in place where it used to be. Exercise doesn't reattach the ligaments, it just tones the sagging.
The ads for facial exercises often tout the fact that the facial muscles are the only muscles in the body that insert (or attach) into skin rather than into bone. They then use this fact to explain why, if you tone facial muscles, they directly affect the appearance of the skin. What this doesn't say is that skin movement is one of the things that causes the skin to sag. If you are doing facial exercises and can see your skin move or frown lines and laugh lines look more apparent, it only makes matters worse.
As I was researching this article I found the name of one dermatologist whose name showed up repeatedly on Web sites selling facial exercise programs. Dr. Wilma Bergfeld, Head of Clinical Research, Department of Dermatology at The Cleveland Clinic and the first woman president of the American Academy of Dermatology (1992) was quoted as someone who thought facial exercise was worthwhile. I had to hear this for myself. I spoke with Dr. Bergfeld and it turns out she isn't quite a supporter of facial exercises. "While there is no research or studies demonstrating facial exercises as being helpful, it is a reasonable assumption that it may be useful," she said. "Though I don't recommend them I do believe they could work in some controlled situations. However, you would never want to do anything that moves the facial skin, especially as it ages, or overmanipulate the skin," Bergfeld added, "because it would create more wrinkling, increasing the loss of elasticity in the skin."
If facial exercises that move the skin are problematic, what about electrical stimulation for the facial muscles? Wouldn't that form of involuntary stimulation tone the muscles without causing movement of the skin? The answer to that question is a resounding yes. It would exercise the muscle without moving skin. But there is no research demonstrating that this wouldn't make matters worse by creating surfaced capillaries, and it doesn't address the issue of the muscle being toned in the wrong area (since most women start this treatment only after the muscles are already sagged and stretched). And it won't affect the ligaments that have caused most of the sagging and drooping in the first place.
For the most part, facial exercises are more a problem for skin than a help. Facial exercises provide little or no benefit because loss of muscle tone is not a major cause of wrinkles or sagging skin. In fact, muscle tone is barely involved in these at all. The skin's sagging and drooping are caused by four major factors:
1) Deteriorated collagen and elastin (due primarily to sun damage);
2) Depletion of the skin's fat layer (a factor of genetic aging and gravity);
3) Repetitive facial movement (particularly true for the forehead frown lines and for smile lines from the nose to the mouth);
4) Muscle sagging due to the loosening of facial ligaments that hold the muscles in place.
Facial exercise is not helpful for worn-out collagen, elastin, or the skin's fat layer, because none of that is about the muscles. It is especially not helpful for the lines caused by facial movement! Instead, facial exercises only make those areas appear more lined. The reason Botox injections into the muscles of the forehead and facial lines work to create a smoother face is because Botox prevents the muscles from moving!
Facial exercises won't reattach facial ligaments; that is only possible via surgery. One procedure in a surgical face-lift is to re-drape the muscle of the cheek and the jaw, drawing it back and then literally stitching it back in place where it used to be. Exercise doesn't reattach the ligaments, it just tones the sagging.
The ads for facial exercises often tout the fact that the facial muscles are the only muscles in the body that insert (or attach) into skin rather than into bone. They then use this fact to explain why, if you tone facial muscles, they directly affect the appearance of the skin. What this doesn't say is that skin movement is one of the things that causes the skin to sag. If you are doing facial exercises and can see your skin move or frown lines and laugh lines look more apparent, it only makes matters worse.
As I was researching this article I found the name of one dermatologist whose name showed up repeatedly on Web sites selling facial exercise programs. Dr. Wilma Bergfeld, Head of Clinical Research, Department of Dermatology at The Cleveland Clinic and the first woman president of the American Academy of Dermatology (1992) was quoted as someone who thought facial exercise was worthwhile. I had to hear this for myself. I spoke with Dr. Bergfeld and it turns out she isn't quite a supporter of facial exercises. "While there is no research or studies demonstrating facial exercises as being helpful, it is a reasonable assumption that it may be useful," she said. "Though I don't recommend them I do believe they could work in some controlled situations. However, you would never want to do anything that moves the facial skin, especially as it ages, or overmanipulate the skin," Bergfeld added, "because it would create more wrinkling, increasing the loss of elasticity in the skin."
If facial exercises that move the skin are problematic, what about electrical stimulation for the facial muscles? Wouldn't that form of involuntary stimulation tone the muscles without causing movement of the skin? The answer to that question is a resounding yes. It would exercise the muscle without moving skin. But there is no research demonstrating that this wouldn't make matters worse by creating surfaced capillaries, and it doesn't address the issue of the muscle being toned in the wrong area (since most women start this treatment only after the muscles are already sagged and stretched). And it won't affect the ligaments that have caused most of the sagging and drooping in the first place.
Tuesday, October 2, 2007
Battle Plan for Eczema
Eczema is a very personal issue for me because it was a skin disorder I struggled with from the age of 8 until my early 30s. Even now I occasionally get patches of eczema and I always have a tube of prescription strength tube of cortisone cream nearby. It was at its worst when I was very young. More than 70% of my body was covered with itchy, raw, reddened, crusted areas of skin. I was in and out of dermatologist offices trying to find some kind of resolution, which never really came until much later in life when the condition resolved itself. I have the deepest empathy for those afflicted with this condition. While we know more about how skin functions than ever before, eczema is still a mystery. Medicine has taken some leaps forward in this arena, but it has also fallen back in dealing with this enormously uncomfortable skin affliction.
Eczema (also known as atopic dermatitis) is a general term used to describe a strange variety of skin rashes ranging from small sections of skin that are slightly itchy, somewhat dry and irritated to chronically inflamed, oozing, crusted areas covering the entire body and accompanied by incessant itching. Though some similarities exist, interestingly, eczema can have multiple appearances, looking and feeling completely different person to person. The most common areas for eczema to occur are in the folds of the arms and legs, the back of the neck, back of the hands, tops of feet, and the wrists.
Despite years of research, the actual cause of this condition remains unknown. One of the predominant theories is that someone with eczema has a short-circuited immune response. What that means is the skin reacts abnormally when a substance comes in contact with the skin. In severe cases of eczema, the substance can be as benign as water. For others the trigger can be anything from clothing, detergents, soaps, grass, food products, allergens (including dust mites) to a lack of humidity, or a combination of elements. Even more frustrating is that the reaction can be intermittent with no real rhyme or reason for why or when. There also appears to be a hereditary component to eczema. For example, children whose parents suffer from eczema run an 80% chance of developing it themselves. Further, in both children and adults, stressful situations tend to trigger, prolong, or worsen eczema flare-ups.
Regardless of the source, eczematous skin reacts to a substance or environmental condition by spinning out of control and generating mild to severe inflammation, which produces itching and scratching.
Some of the more typical forms of eczema are:
Atopic eczema (also referred to as atopic dermatitis): Perhaps the most pernicious and painful types of eczema, it's characterized by its severity and intolerable sensation of itching and irritation leaving skin raw, fissured, and vulnerable to infection.
Allergic or irritant contact dermatitis: This specific form of eczema occurs when a particular substance comes in contact with the skin causing the immune system to overreact, becoming inflamed and sensitized. Most typically this can be caused by fragrance, nickel, detergents, wool, grass, citruses, household cleaning products, and vinegar. Once you’ve identified the specific substance, avoiding it often solves the problem. A subset of this condition is eyelid dermatitis. Typically mild to moderate redness is present, as well as scaling, flaking, swollen skin. This is extremely common and almost exclusively affects women in relation to their use of hairstyling products, makeup, and nail polish when it comes in contact with the eye area with the most common culprits being nail polish, perfume, and preservatives. The best way to solve the problem is to stop use of the offending product(s) and find options that don’t trigger a reaction.
Infantile seborrhoeic eczema: Better known as cradle cap, this form of eczema generally only affects babies during the first year of their life. The crusty, thick, sometimes reddened lesions may look problematic, but this disorder is rarely itchy or even felt by the child.
Adult seborrhoeic eczema: Shows up for most people past the age of 20 and 40. It is usually seen on the scalp as mild dandruff, but can spread to the face, ears and chest. The skin becomes red, inflamed and starts to flake. The condition is believed to be caused by a yeast growth. If the condition becomes infected, treatment with an anti-fungal cream may be necessary.
Nummular eczema: Typically localized on the legs, nummular eczema is characterized by coin-shaped patches of pink to red skin that may take on an orange cast if crusting or scaling is present. If treatment is not used, the dry, scaly spots typically darken and thicken. This type of eczema is most common in adolescent girls and women between the ages of 50–60 and the condition tends to occur in winter.
Treating Eczema
With no cure on the horizon, there are still a number of treatments that can help reduce symptoms and mitigate the level of discomfort.
Gentle, effective skin care: Surprisingly, the first line of defense is a gentle skin care routine that prevents or reduces inflammation and keeps the skin moist and intact. Improving the skin’s outer structure by providing it with antioxidants, ingredients that mimic the substances found in normal, healthy skin, anti-irritants, and emollients can offer amazing results for most forms of eczema. Those specific recommendations are at the end of this article.
Avoid irritants: Aside from using a gentle skin care routine and a well-formulated moisturizer, avoiding the things that can trigger skin reactions is also of vital importance. Steering clear of known irritants and prolonged contact with water can be incredibly beneficial. It also helps a great deal to reapply moisturizer within seconds of washing any part of the body, but especially the hands because soaps and cleansers are notorious for triggering a reaction. If you know what substance is causing your skin to react, don't wear or use it ever again, if possible. And if you use bar soaps or bar cleansers, definitely switch to a water-soluble liquid cleanser that contains gentle detergent cleansing agents (avoid any that contain sodium lauryl sulfate or sodium C14-16 olefin sulfonate).
Topical steroids: The most typical and successful medications used are prescription-strength topical steroids (cortisone creams). Over-the-counter cortisone creams can be effective for very mild or transient forms of eczema but when those fail, prescription cortisone creams can save your skin. Though there are no short-term detrimental side effects of using most strengths of cortisone cream, it is still important to only apply it on the affected areas and then only as needed. Repeated, prolonged application of cortisone creams (over years, not short-term treatment) can cause thinning of the skin and prematurely age skin.
Oral steroids: In severe cases of eczema when topical steroids have failed to produce any relief, oral steroids may be prescribed, but only under a doctor's scrutiny due to the serious side effects associated with this type of medication.
Topical Immunomodulators: In 2000 and 2001, Protopic (active ingredient tacrolimus) and Elidel (pimecrolimus) were approved by the FDA as new topical drugs for the treatment of eczema. These are not cortisones or steroids but drugs that can regulate the skin's immune response. Initial studies were extremely positive and "The FDA based its approval on the results of three 12-week studies which indicated that 28-37% of patients using Protopic experienced greater than or equal to 90% improvement of their skin condition, as measured by physicians, and two one year studies that indicated that the drug is safe for intermittent long term use." (Source: http://www.fda.gov/bbs/topics/ANSWERS/ANS01060.html.) Elidel works in the same manner and studies were equally positive. In other words, by suppressing the immune system it prevents the skin's own problematic immune response to otherwise benign substances from causing red, itchy, inflamed rashes.
Regrettably, in March 2005, the FDA announced a public health advisory for Elidel (pimecrolimus) Cream and Protopic (tacrolimus) Ointment "to inform healthcare providers and patients about a potential cancer risk from use of Elidel (pimecrolimus) and Protopic (tacrolimus)…" The FDA went on to explain that "This concern is based on information from animal studies, case reports in a small number of patients, and how these drugs work [suppressing the immune system can cause cancer cells to proliferate that would otherwise be attacked and destroyed by a normal functioning immune system]. It may take human studies of ten years or longer to determine if use of Elidel or Protopic is linked to cancer. In the meantime, this risk is uncertain and FDA advises that Elidel and Protopic should be used only as labeled, for patients who have failed treatment with other therapies." (Source: http://www.fda.gov/cder/drug/advisory/elidel_protopic.htm.)
Phototherapy: Research has shown that exposing skin to UVA or UVB light can help reduce the symptoms of chronic eczema. Under medical supervision the use of specially designed bulbs encased in a box can allow affected parts of the body to be exposed to the light source. More severe or chronic eczema can be treated with UVA light in combination with a prescription medication called psoralen. Psoralen can be administered either orally or topically, increasing the skin’s sensitivity to light. This treatment is known as PUVA (Psoralen + UVA light).
Phototherapy treatments are complicated and expensive. They are administered several times per week over a span or one week to several months at a doctor’s office. Moreover, the risk of accelerated aging of the skin and increased risk of skin cancer from ultraviolet radiation therapy can be the same as for sunbathing.
Alternative treatments: For those looking for alternatives to prescription treatments and methods over and above the ones mentioned above, an interesting study on eczema appeared in the January 2001 issue of The Archives of Dermatology. This study reports research in Japan that d emonstrated that two-thirds of the patients with eczema improved after a month of drinking a liter of oolong tea daily. According to the study "118 patients … were asked to maintain their dermatological treatment. However, they were also instructed to drink oolong tea made from a 10-gram teabag placed in 1000 milliliters of boiling water and steeped for 5 minutes. After 1 month of treatment 74 (63%) of the 118 patients showed marked to moderate improvement of their condition. A good response to treatment was still observed in 64 patients (54%) at 6 months."
The study concluded that "The therapeutic efficacy of oolong tea may well be the result of the anti-allergic properties of tea polyphenols." While the study didn't look at the effect of tea drinking if the topical treatments were stopped, the patients did receive some benefit. So by combining topical treatments (moisturizers and possibly cortisone cream) with some oolong tea, perhaps the benefits will add up so those with eczema can breathe a sigh of relief.
Eczema (also known as atopic dermatitis) is a general term used to describe a strange variety of skin rashes ranging from small sections of skin that are slightly itchy, somewhat dry and irritated to chronically inflamed, oozing, crusted areas covering the entire body and accompanied by incessant itching. Though some similarities exist, interestingly, eczema can have multiple appearances, looking and feeling completely different person to person. The most common areas for eczema to occur are in the folds of the arms and legs, the back of the neck, back of the hands, tops of feet, and the wrists.
Despite years of research, the actual cause of this condition remains unknown. One of the predominant theories is that someone with eczema has a short-circuited immune response. What that means is the skin reacts abnormally when a substance comes in contact with the skin. In severe cases of eczema, the substance can be as benign as water. For others the trigger can be anything from clothing, detergents, soaps, grass, food products, allergens (including dust mites) to a lack of humidity, or a combination of elements. Even more frustrating is that the reaction can be intermittent with no real rhyme or reason for why or when. There also appears to be a hereditary component to eczema. For example, children whose parents suffer from eczema run an 80% chance of developing it themselves. Further, in both children and adults, stressful situations tend to trigger, prolong, or worsen eczema flare-ups.
Regardless of the source, eczematous skin reacts to a substance or environmental condition by spinning out of control and generating mild to severe inflammation, which produces itching and scratching.
Some of the more typical forms of eczema are:
Atopic eczema (also referred to as atopic dermatitis): Perhaps the most pernicious and painful types of eczema, it's characterized by its severity and intolerable sensation of itching and irritation leaving skin raw, fissured, and vulnerable to infection.
Allergic or irritant contact dermatitis: This specific form of eczema occurs when a particular substance comes in contact with the skin causing the immune system to overreact, becoming inflamed and sensitized. Most typically this can be caused by fragrance, nickel, detergents, wool, grass, citruses, household cleaning products, and vinegar. Once you’ve identified the specific substance, avoiding it often solves the problem. A subset of this condition is eyelid dermatitis. Typically mild to moderate redness is present, as well as scaling, flaking, swollen skin. This is extremely common and almost exclusively affects women in relation to their use of hairstyling products, makeup, and nail polish when it comes in contact with the eye area with the most common culprits being nail polish, perfume, and preservatives. The best way to solve the problem is to stop use of the offending product(s) and find options that don’t trigger a reaction.
Infantile seborrhoeic eczema: Better known as cradle cap, this form of eczema generally only affects babies during the first year of their life. The crusty, thick, sometimes reddened lesions may look problematic, but this disorder is rarely itchy or even felt by the child.
Adult seborrhoeic eczema: Shows up for most people past the age of 20 and 40. It is usually seen on the scalp as mild dandruff, but can spread to the face, ears and chest. The skin becomes red, inflamed and starts to flake. The condition is believed to be caused by a yeast growth. If the condition becomes infected, treatment with an anti-fungal cream may be necessary.
Nummular eczema: Typically localized on the legs, nummular eczema is characterized by coin-shaped patches of pink to red skin that may take on an orange cast if crusting or scaling is present. If treatment is not used, the dry, scaly spots typically darken and thicken. This type of eczema is most common in adolescent girls and women between the ages of 50–60 and the condition tends to occur in winter.
Treating Eczema
With no cure on the horizon, there are still a number of treatments that can help reduce symptoms and mitigate the level of discomfort.
Gentle, effective skin care: Surprisingly, the first line of defense is a gentle skin care routine that prevents or reduces inflammation and keeps the skin moist and intact. Improving the skin’s outer structure by providing it with antioxidants, ingredients that mimic the substances found in normal, healthy skin, anti-irritants, and emollients can offer amazing results for most forms of eczema. Those specific recommendations are at the end of this article.
Avoid irritants: Aside from using a gentle skin care routine and a well-formulated moisturizer, avoiding the things that can trigger skin reactions is also of vital importance. Steering clear of known irritants and prolonged contact with water can be incredibly beneficial. It also helps a great deal to reapply moisturizer within seconds of washing any part of the body, but especially the hands because soaps and cleansers are notorious for triggering a reaction. If you know what substance is causing your skin to react, don't wear or use it ever again, if possible. And if you use bar soaps or bar cleansers, definitely switch to a water-soluble liquid cleanser that contains gentle detergent cleansing agents (avoid any that contain sodium lauryl sulfate or sodium C14-16 olefin sulfonate).
Topical steroids: The most typical and successful medications used are prescription-strength topical steroids (cortisone creams). Over-the-counter cortisone creams can be effective for very mild or transient forms of eczema but when those fail, prescription cortisone creams can save your skin. Though there are no short-term detrimental side effects of using most strengths of cortisone cream, it is still important to only apply it on the affected areas and then only as needed. Repeated, prolonged application of cortisone creams (over years, not short-term treatment) can cause thinning of the skin and prematurely age skin.
Oral steroids: In severe cases of eczema when topical steroids have failed to produce any relief, oral steroids may be prescribed, but only under a doctor's scrutiny due to the serious side effects associated with this type of medication.
Topical Immunomodulators: In 2000 and 2001, Protopic (active ingredient tacrolimus) and Elidel (pimecrolimus) were approved by the FDA as new topical drugs for the treatment of eczema. These are not cortisones or steroids but drugs that can regulate the skin's immune response. Initial studies were extremely positive and "The FDA based its approval on the results of three 12-week studies which indicated that 28-37% of patients using Protopic experienced greater than or equal to 90% improvement of their skin condition, as measured by physicians, and two one year studies that indicated that the drug is safe for intermittent long term use." (Source: http://www.fda.gov/bbs/topics/ANSWERS/ANS01060.html.) Elidel works in the same manner and studies were equally positive. In other words, by suppressing the immune system it prevents the skin's own problematic immune response to otherwise benign substances from causing red, itchy, inflamed rashes.
Regrettably, in March 2005, the FDA announced a public health advisory for Elidel (pimecrolimus) Cream and Protopic (tacrolimus) Ointment "to inform healthcare providers and patients about a potential cancer risk from use of Elidel (pimecrolimus) and Protopic (tacrolimus)…" The FDA went on to explain that "This concern is based on information from animal studies, case reports in a small number of patients, and how these drugs work [suppressing the immune system can cause cancer cells to proliferate that would otherwise be attacked and destroyed by a normal functioning immune system]. It may take human studies of ten years or longer to determine if use of Elidel or Protopic is linked to cancer. In the meantime, this risk is uncertain and FDA advises that Elidel and Protopic should be used only as labeled, for patients who have failed treatment with other therapies." (Source: http://www.fda.gov/cder/drug/advisory/elidel_protopic.htm.)
Phototherapy: Research has shown that exposing skin to UVA or UVB light can help reduce the symptoms of chronic eczema. Under medical supervision the use of specially designed bulbs encased in a box can allow affected parts of the body to be exposed to the light source. More severe or chronic eczema can be treated with UVA light in combination with a prescription medication called psoralen. Psoralen can be administered either orally or topically, increasing the skin’s sensitivity to light. This treatment is known as PUVA (Psoralen + UVA light).
Phototherapy treatments are complicated and expensive. They are administered several times per week over a span or one week to several months at a doctor’s office. Moreover, the risk of accelerated aging of the skin and increased risk of skin cancer from ultraviolet radiation therapy can be the same as for sunbathing.
Alternative treatments: For those looking for alternatives to prescription treatments and methods over and above the ones mentioned above, an interesting study on eczema appeared in the January 2001 issue of The Archives of Dermatology. This study reports research in Japan that d emonstrated that two-thirds of the patients with eczema improved after a month of drinking a liter of oolong tea daily. According to the study "118 patients … were asked to maintain their dermatological treatment. However, they were also instructed to drink oolong tea made from a 10-gram teabag placed in 1000 milliliters of boiling water and steeped for 5 minutes. After 1 month of treatment 74 (63%) of the 118 patients showed marked to moderate improvement of their condition. A good response to treatment was still observed in 64 patients (54%) at 6 months."
The study concluded that "The therapeutic efficacy of oolong tea may well be the result of the anti-allergic properties of tea polyphenols." While the study didn't look at the effect of tea drinking if the topical treatments were stopped, the patients did receive some benefit. So by combining topical treatments (moisturizers and possibly cortisone cream) with some oolong tea, perhaps the benefits will add up so those with eczema can breathe a sigh of relief.
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