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Although acne traditionally has been considered a disease of teenagers, it is also extremely common in adult women. Studies show that acne affects more than 50 percent of women between the ages of 20-29 and more than 25 percent of women between the ages of 40-49 (1). In fact, after age 20, women are far more likely to report having acne than men. While there is no cure for acne, dermatologists are finding that hormonal therapies can help some women fight bothersome acne that occurs in adulthood.
At the American Academy of Dermatology’s Summer Academy Meeting 2009 in Boston, dermatologist Bethanee J. Schlosser, M.D., Ph.D., FAAD, assistant professor of dermatology and director of the Women’s Skin Health Program at Northwestern University Feinberg School of Medicine in Chicago, discussed the most widely used hormonal therapies available for women with acne and the best candidates for this type of treatment.
Factors that contribute to the formation of acne include excess oil gland production, skin inflammation, abnormal maturation of skin cells lining the hair follicle and an increased number of the acne-causing bacteria Propionibacterium acnes. However, hormones also influence both oil gland production and the maturation of skin cells thereby contributing to the formation of acne lesions. For example, when androgens (the male hormones present in both men and women) over-stimulate the oil glands and hair follicles in the skin, hormonal acne flares can occur.
“Women over the age of 20 may experience worsening of their acne or a change in the nature of their acne. This can include increased lesions on the lower one-third of the face (including the jaw line and upper neck), pre-menstrual flares, and resistance to oral antibiotics and other traditional acne therapies,” said Dr. Schlosser. “For these women, hormonal therapy in the form of combination oral contraceptives and/or anti-androgen medications, such as spironolactone, flutamide and dutasteride that work by reducing the activity of the male hormone testosterone, may provide significant benefit.”
Dr. Schlosser noted that the use of hormonal therapies for acne, including combination oral contraceptives, requires careful screening of patients. For example, there are numerous contraindications (or factors that increase the risks of a particular medication) that must be considered before hormonal therapy is prescribed for treating acne. Such contraindications for combination oral contraceptives include a personal history of breast cancer, heart attack or stroke, uncontrolled high blood pressure, migraines with neurological symptoms, or abnormal vaginal bleeding, to name a few. Dermatologists will review these factors with patients to determine if hormonal acne therapy poses any potential risks for patients.
Based on a physical examination, a patient’s medical history and the success or failure of previously prescribed acne treatments, dermatologists may recommend hormonal therapy to enhance the results of acne treatment in women. Hormonal therapy in the form of combination oral contraceptive pills has been shown to help treat both inflammatory acne lesions (the papules, pustules and painful nodules under the skin), and non-inflammatory acne lesions (blackheads and whiteheads). Dr. Schlosser suggests that hormonal therapy should not be used in isolation but instead recommends that combination oral contraceptives or anti-androgen medications be used in conjunction with topical retinoids for optimal results.
While there are numerous types of oral contraceptives available that can be used to treat acne in women, three combination oral contraceptive pills have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of acne. All combination oral contraceptives contain an estrogen (ethinyl estradiol for most contraceptive pills) and a progestin. The estrogen component decreases the production of testosterone and other androgens by the ovaries and decreases the amount of active testosterone in the body.
Some progestins may actually mimic the activity of testosterone on the oil gland and thereby worsen acne. Therefore, Dr. Schlosser primarily recommends oral contraceptives that contain one of the following progestins: norgestimate, desogestrel, or drospirenone, all of which demonstrate low or no risk of increasing the activity of the testosterone receptor.
“Combination oral contraceptives can be very beneficial in the treatment of acne in appropriately selected women, and several different oral contraceptives have been shown to be effective in clinical studies,” said Dr. Schlosser. “But the treatment of acne with combination oral contraceptives needs to be targeted to each patient’s individual needs, and patients should be monitored regularly to ensure the safety and effectiveness of their particular therapy.”
Dr. Schlosser cautioned that improvement of acne with hormonal therapy does not occur overnight and requires at least three months of continuous use before a judgment about effectiveness should be made. In many cases, patients need to continue using oral contraceptives to sustain their results over time. However, some patients can stop hormonal therapy and maintain clear skin with the regular use of a topical retinoid.
“For many women with adult-onset acne, combination hormonal therapy can provide excellent results,” added Dr. Schlosser. “Women who think they might be good candidates should discuss their options with their dermatologist who can offer a customized treatment regimen and continual monitoring to ensure optimal results.”
For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.
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As we age, brown spots and splotchy skin are all too often a fact of life. But for people with darker skin, changes in pigmentation can occur without warning at any age and can be very difficult to treat. Fortunately, dermatologists can help people with skin of color diagnose and treat bothersome pigmentation problems.
At the American Academy of Dermatology’s Summer Academy Meeting 2009 in Boston, dermatologist Jonith Y. Breadon, M.D., FAAD, co-chair of Dermasurgery at John H. Stroger, Jr. Hospital of Cook County in Chicago, discussed pigmentation problems that occur more frequently in darker-skinned patients and how early diagnosis is key to stopping the progression of these skin conditions.
“Even though people with skin of color have less moles and experience less premature aging from the sun than lighter-skinned individuals, in some ways their darker pigmentation makes their skin more vulnerable to other skin problems,” said Dr. Breadon. “While these skin discolorations can be stubborn, there are treatments that offer noticeable improvement.”
Hyperpigmentation
One of the most common pigmentation problems in darker-skinned individuals is hyperpigmentation (or the darkening of the skin). Usually the result of some type of inflammation or injury to the skin, such as a cut, burn or scrape, hyperpigmentation produces darkened areas of the skin that can last months or years. Even healed acne lesions can leave permanent dark spots in darker-skinned people that, in some cases, can be more distressing than the original acne.
Dr. Breadon noted that treatments for hyperpigmentation are based on whether or not the dark areas are confined to the surface of the skin or if they have penetrated to the deeper layers of the skin. For superficial dark spots, a prescription topical medication consisting of hydroquinone, retinoic acid and mild hydrocortisone can be effective in fading skin discoloration. Deeper dark areas require an in-office surgical procedure, such as dermabrasion, chemical peels, or microdermabrasion with an infusion of hydroquinone solution. In patients with lighter skin, intense pulsed light (IPL) or one of the pigmented lasers could be considered.
“Patients with any type of hyperpigmentation problem need to use a sunscreen with a high sun protection factor (SPF) regularly - the higher SPF the better,” said Dr. Breadon. “There is no cure for this condition, so even when patients experience clearing, it can come back. For most patients, I usually recommend a three-month topical regimen then long-term maintenance with a sunscreen.”
Melasma
Often referred to as the “mask of pregnancy,” melasma is a skin condition marked by brown patches on areas such as the face, neck and arms that most often affects dark-skinned people and women in particular. Many dermatologists have long believed that there may be a hormonal component to melasma, and a recently published study found that there were an increased number of estrogen receptors in areas where patients developed melasma.
For this reason, Dr. Breadon advises patients with melasma to consider stopping oral contraceptives and hormone replacement therapy due to the large amount of estrogens in these medications. Regular sunscreen use is vital to protect the skin from further hyperpigmentation.
With melasma, the skin can be affected in three different ways: on the epidermis (superficial layer), in the dermis (deep layer) or a mixture of both the epidermis and dermis. Dermatologists use a light device known as the Woods lamp, which shows skin diseases as specific colors, to determine how deep melasma has penetrated the skin.
For superficial melasma, the triple cream combination of hydroquinone, retinoic acid and mild hydrocortisone with regular sunscreen use can be effective, with clearance occurring in about three months for most patients. Dr. Breadon noted that cases where melasma has penetrated the dermis are very difficult to treat and the combination triple cream medication will not be effective in these patients. However, some patients may experience improvement with microdermabrasion, dermabrasion, chemical peels or lasers. In cases where both the epidermis and the dermis are involved, the triple cream medication may offer some improvement for some patients.
“Melasma is hard to define, as it can occur in women during or after pregnancy or in women who have never been pregnant or used oral contraceptives,” said Dr. Breadon. “While lasers can be effective, there are risks of further hyperpigmentation and results vary greatly from person to person. Dermatologists can help patients decide the best course of treatment, depending on the severity of the condition.”
Lichen Planus
Lichen planus is a common inflammatory disease of the skin and the mouth that is characterized by a rash of round, or oval, violet-colored lesions. While lichen planus can affect people of all races and genders, it is more pronounced in people with darker skin since, as the lesions heal, the affected skin can develop very dark, leopard-looking spots.
When caught early, steroid injections are used to reduce the inflammation thereby minimizing hyperpigmentation. However, if the condition progresses before it can be treated and dark spots appear, Dr. Breadon explained that the triple cream topical medication, mild or systemic steroids, or lasers can be used with varying degrees of success to try to lighten the darkened areas of the skin.
“Detecting lichen planus early can make all the difference between spots that heal without hyperpigmentation and spots that are extremely pronounced and do not fade on their own,” said Dr. Breadon. “That’s why it is critical that people who experience an unexplained rash see their dermatologist immediately for proper diagnosis and treatment.
Ashy Dermatosis
Another skin condition that affects people of color, and especially African-Americans, is ashy dermatosis. While the cause of ashy dermatosis is unknown, it usually starts as a flat, dark grayish-brown rash that appears bi-laterally (or on both sides of body, such as both arms or both legs).
Ashy dermatosis closely resembles a condition known as fixed drug eruption, which causes the same type of pigmentation problem and is the result of an allergy to a food, medication or workplace trigger. For example, one of Dr. Breadon’s patients with this type of rash noticed a flare when she would consume a particular sugar substitute - which was eventually identified as the trigger.
“Based on my evaluation of numerous cases of ashy dermatosis and fixed drug eruption, my theory is that these two conditions are actually one in the same,” said Dr. Breadon. “That’s why I think it is so important to identify the trigger, as this can help alleviate the rash and prevent its spread. I encourage my patients to keep a food diary or a list of any medications or items with which they come into contact to see if we can identify the source of the problem.”
Dr. Breadon noted that ashy dermatosis and fixed drug eruption can be very difficult to treat. A compound lotion of salicylic acid, a mid-potency steroid and hydroquinone can offer gradual clearing. Regular use of sunscreen with a high SPF also is highly recommended to avoid further hyperpigmentation.
“It is important for people with darker skin to be aware of any changes in their skin and to see a dermatologist at the first sign of anything unusual,” said Dr. Breadon. “Dermatologists not only can diagnose and provide the best treatment options for a particular pigmentation problem, but also can rule out a serious condition, such as skin cancer.”
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.
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Despite having access to some of the best health care in the world, many Americans with the most common form of eczema, known as atopic dermatitis, have sought relief from “alternative medicines.” However, dermatologists caution that patients seeking alternative treatments to alleviate symptoms of this common, chronic, inflammatory skin disease marked by red, itchy rashes, risk developing more severe symptoms by delaying treatment.
At the American Academy of Dermatology’s Summer Academy Meeting 2009 in Boston, dermatologist Peter A. Lio, M.D., FAAD, assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine in Chicago, discussed why eczema patients try alternative therapies and how certain therapies used in conjunction with clinically tested medical treatments could hold promise in further improving the condition.
“Part of the difficulty in understanding why people seek alternative medicine lies in defining this term,” said Dr. Lio. “Broadly speaking, it encompasses treatments such as acupuncture, homeopathy and holistic medicine outside of the form of medicine taught in most U.S. medical schools. But people use the term for anything from chicken soup to any lotion or potion sold on the Internet to a new dietary supplement. Unfortunately, a great deal of snake oil can hide under the umbrella of alternative medicine.”
Dr. Lio believes there are two main reasons that patients try alternative therapies for eczema. The first reason is that since the cause of eczema is not fully understood nor why it occurs in some people and not others, treatments are based on controlling the symptoms rather than fixing the root cause. Secondly, an increasing number of patients are looking for natural non-medical therapies that do not pose the known side effects of some of the traditional medications.
However, many non-medical therapies, especially herbal treatments, marketed for treating eczema are not governed by the U.S. Food and Drug Administration (FDA) or any agency, and contaminants could cause health problems or drug interactions could occur when used with other medications.
“The biggest risk posed by alternative medicines is worsening symptoms due to delayed treatment. In my practice, most of my patients have used some form of alternative therapy, but largely with little or no measurable improvement,” said Dr. Lio. “In fact, one large-scale study found more than half of the eczema patients participating reported using one or more forms of alternative medicine for their disease. The study concluded that the majority of patients reported no improvement or even worsening of their condition after using these alternative treatments.”
While topical corticosteroids (the mainstay in the treatment of eczema), antibacterial agents, topical calcineurin inhibitors and moisturizers are among the most effective medical treatments dermatologists prescribe to treat eczema, Dr. Lio suggested certain alternative therapies may be beneficial for some patients, perhaps by reducing stress.
For example, studies show that physical or emotional stress can worsen atopic dermatitis, and one study concluded that stress directly slows the healing of the skin barrier - or its protective outer layer. In another study, psychosocial stress and sleep deprivation were found to disrupt skin barrier function in healthy patients.
“It is possible that some forms of alternative medicine, such as hypnosis and acupuncture, may help eczema patients by reducing stress,” said Dr. Lio. “The areas of stress reduction and behavior modification are promising and deserve further exploration as a means to complement traditional medical therapies.”
In his practice, some of Dr. Lio’s patients report improvement in their condition with acupuncture, but there are no scientific studies examining this potential benefit. Currently, Dr. Lio is trying to initiate a study on the effects of acupuncture on eczema patients at his institution to examine why acupuncture reportedly benefits some patients but not others.
“I think it is important for patients to inform their dermatologist if they are using alternative therapies, as some could cause dangerous drug interactions with traditional medicine,” said Dr. Lio. “I always tell my patients that the fact that there are thousands of alternative treatments for eczema suggests that not one of them works really well. But if patients are committed to trying alternative medications, they should consult their dermatologist and not forgo their recommended medical regimen.”
For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.
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Say goodbye to melting makeup … and hello to gorgeous! Makeup artist to the stars, Mally Roncal, and actress and best-selling author, Tori Spelling, are teaming up with Q-tips cotton swabs, the ultimate beauty tool, to reveal their beauty secrets to rescue women from summer makeup meltdown.
Spelling is stepping into the window of Macy’s Herald Square today, where she will unveil the new Q-tips Vanity Packs - stylish Q-tips dispensers that are finally attractive enough to sit on countertops, helping rescue the beauty routines of women everywhere. Women in New York City and across the country can visit select Macy’s for free makeovers and a free sample of the Q-tips vanity pack all summer long.
“I, like many women, look for convenient, affordable beauty tools that can simplify my beauty routine and quickly touch-up any makeup mishaps,” says Spelling. “Q-tips cotton swabs have rescued me from smeared mascara so many times so I’m thrilled about the new pretty packs - they’re perfect for my vanity area and easy to have on-hand whether I’m getting ready for a play date or the red carpet.”
Makeup wearing women have an average of 19 beauty products cluttering their vanity - from makeup brushes to applicators — according to a survey commissioned by Q-tips cotton swabs. And, no matter what the economy holds, women are still in search of the perfect beauty tool. Women who wear makeup would be willing to spend an average of $24 for one beauty tool that could correct all makeup blunders.
“Women clean out their closets every season, so why not their makeup areas?” says Roncal. “Every beauty routine should begin with a beautiful, clutter-free vanity area or bathroom countertop with only the beauty essentials you really need. That’s why makeup artists rely on Q-tips to rescue their routines - they are an affordable beauty tool (around three dollars for the new pack) and perfect for applying, blending and touching up makeup every day.”
Women everywhere can visit www.qtips.com to enter for a chance to win* a “VIP Beauty Rescue,” which includes a New York City beauty shopping spree, complete with a personal stylist. At the website, they can also find out where to get their free “summer beauty rescue” makeover and free sample of the new Q-tips Vanity Pack.
Mally’s Top Summer Rescue Tips
Rescue Your Vanity Area
- Simplify your space and stick to five beauty essentials: one of Q-tips four new beautifully designed Vanity Packs (a must-have for any vanity area for makeup application, touch-ups or removal), tinted moisturizer, a multi-purpose makeup stick for eyes, cheeks and lips, concealer and one tube of mascara.
Make a Splash with Smokin’ Eyes
- Create a colorful smoky eye by trading black eyeliner and grey eye shadows for striking shades of purple or jade green. Use a Q-tips cotton swab to gently apply color on the eyelid for a sheer effect. To complete the look, apply eyeliner to the lash line and smudge with a Q-tips cotton swab – perfect for precision in the eye area.
- Rescue Tip: Don’t worry about buying expensive makeup brushes or having to wash them regularly to avoid mixing colors, just use Q-tips cotton swabs instead – they are affordable, biodegradable and packaging is 100% recyclable** so you can use once and toss!
Pucker Up for Summer
- A sheer coral lip is one of the hottest looks for the season. To keep your pout looking light and natural, be sure to ditch the lip liner. Create the illusion of a fuller lip by using a Q-tips cotton swab to apply a dab of iridescent lip gloss to the middle of your pout.
- Rescue Tip: Avoid bleeding lip color by dipping a Q-tips cotton swab into translucent powder and then applying along the outer edge of lips.
Eliminate Runaway Makeup
- Hot summer temperatures can cause mascara and eye shadow to smear and smudge. Keep your face looking fresh by using Q-tips cotton swabs to quickly eliminate runaway makeup – they are made with 100% cotton and have more cotton at the tip than any other cotton swab*** so they are gentle enough for the delicate eye area.
- Rescue Tip: Use a Q-tips cotton swab to swipe away any mascara that has run under the eyes or concealer that has caked up on the face without having to reapply all your makeup.
Avoid “Makeup Meltdown” with New Q-tips Vanity Packs
Q-tips cotton swabs are The Ultimate Beauty Tool to help rescue any beauty routine, vanity area and beauty budget. Made from 100% pure cotton and with more cotton at the tip than any other swab,*** Q-tips are soft, gentle and an affordable alternative to expensive makeup brushes so you can get gorgeous without breaking the bank! Q-tips new Vanity Packs are offered in a 285-count package in four fabulous colors, including purple, blue, red or yellow (SRP: $3.19) and are available at food, drug and mass retailers nationwide. Q-tips are also available in a wide variety of packages, including a 30-count Purse Pack (SRP: $0.99), perfect for on-the-go makeup touch-ups anytime, anywhere.
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What is Cataract?
Cataract Definition:-
Cataract is clouding of the eye lens, mostly due to aging, barring a small percentage of other secondary reasons like diabetes, sustained exposure to ultraviolet light.
The primary effect of cataract is blurred vision.
Cataract Types:-
(1) Secondary cataracts:-
An after effect of eye surgery, like in the case of glaucoma.
(2) Congenital cataracts:-
In new born babies, which in rare cases lead to lens replacement.
(3) Traumatic cataracts:-
Due to eye injuries. These have very late onsets.
Cataract Symptoms:-
(1) Faded colors and blurred vision
(2) Poor night vision but headlights and sunlight may appear all too bright with a halo around the source.
(3) Temporary double or multiple visions which gets cleared as cataract develops further.
(4) Frequent need to change contact lenses or spectacles.
Cataract Causes:-
Those who indulge in alcoholism or those who are exposed to UV light for a long time are at danger of developing cataract. Even diabetics face the same risk.
Cataract Treatment Cure Care:-
The only treatment for cataract is surgery to remove it. Cataract surgery is very successful in restoring vision.
There are 2 types of surgery that can be used to remove lenses that have a cataract First is Extracapsular surgery consists of surgically removing the lens, but leaving the back half of the capsule (the outer covering of the lens) whole.
High-frequency sound waves (phacoemulsification) may be used to soften the lens to help removing it through a smaller cut second is Intracapsular surgery involves surgically removing the entire lens, including the capsule.
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Leading Women’s Health Expert Provides Tips for Better Health from Teeth to Toes
The hectic, tiring schedule many women experience today often leaves little personal time as they frequently place others’ needs before their own. Yet it’s never too early to prioritize daily health practices that promote wellness, reduce stress and improve one’s appearance from the inside out. There are many simple things you can do for better health, many of which require little change to your current lifestyle. A few common, but often-overlooked women’s health issues include bone loss, skin damage, and oral health problems.
Strong bones start with frequent exercise and a diet rich in calcium. Youthful, healthy skin must be protected each morning and night. And while many people know to limit sugary snacks and beverages, women may not be aware that certain healthy foods, like some fruits and yogurt, can cause dangerous tooth enamel loss. But there is power in proactive prevention and many tips for better health-from teeth to toes-that are available now.
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