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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 


    Follow these six tips to prevent and treat skin damage caused by winter dryness.


    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 


    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.


    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.


    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.


    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.


    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.


    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.


    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 


    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.


    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 


    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog: https://bit.ly/3KbVUA1.
    Click to Tweet

     

    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.


    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.

     

    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • January 07, 2018

    By MedStar Health

    Christina (Tina) Stanger, MA, CRA, Director of MHRI’s Office of Contract and Grant Management, was recognized as the fourth quarter 2017 SPIRIT of Excellence Award recipient. The award was presented by Neil Weissman, MD, President, and Karen J. Wade, Vice President of Research Administrative Services, at a gathering at the University Town Center offices.

    Several associates from the University Town Center office spoke in recognition of Tina’s award. “She supports her associates,” said Amy Crupiti. “We always feel that we can come to her with new ideas, comments, or concerns that associates may have that will improve the department, the associate or MHRI as a whole.”

    In addition to her welcome attitude, she also encourages her associates to reach further through professional development actives, actively works with other departments to facilitate teamwork efforts, and helps to empower change throughout systems within MHRI.

    The SPIRIT Award is given to recognize and reward one associate (management or non-management) each quarter, who excels in Service, Patient First, Integrity, Respect, Innovation, and Teamwork. Nominations for the first quarter of 2018 are due by February 15, 2018. Learn more on the SPIRIT StarPort page or contact MHRI-HR@medstar.net.

  • January 07, 2018

    By MedStar Health

    Researchers have found that in adolescents being treated for acne, dietary and herbal supplements have led to liver injury. This research was led by Cynthia Marie Carver DeKlotz, MD at MedStar Washington Hospital Center and Georgetown University. The research team included Keith D. Roby and Sheila Fallon Friedlander, MD.

    Published in Pediatrics, “Dietary Supplements, Isotretinoin, and Liver Toxicity in Adolescents: A Retrospective Case Series” sought to evaluate the symptoms, diagnosis, treatment, and outcome of patients taking or preparing to take isotretinoin therapy who were also taking protein or herbal supplementation and developed transaminitis.

    Transaminitis occurs when there are high levels of liver enzymes, called transaminases. Transaminitis itself doesn’t produce any symptoms but can be a symptom of several serious conditions.

    The small case study found that in 100% of the cases, dietary supplementation was determined to be at least a possible cause of elevated liver transaminases. In six of eight cases studied, dietary supplement appears to be the most likely cause of liver toxicity. The elevated liver transaminases were most likely caused by the use of over-the-counter protein, creatine, or herbal extracts, rather than prescribed isotretinoin or tetracycline antibiotics for acne.

    “By evaluating adolescents who were preparing to take isotretinoin for treatment of acne, we incidentally found that several patients had elevations in liver function tests while also taking over the counter protein or herbal supplements,” said Dr. Dekoltz. “As supplement usage appears common in teenagers, we recommend that clinicians should consider counseling their patients to avoid these products, particularly when prescribing known hepatotoxic drugs.”

    Pediatrics, 2017. DOI: 10.1542/peds.2015-2940

  • January 07, 2018

    By MedStar Health

    An analysis of the effect of diet on postmenopausal women as part of the Women’s Health Initiative shows that reducing fats and increasing vegetable, fruit, and grain intake can reduce the risk of needing insulin in the future.

    Published in Diabetes Care, “A Low-Fat Dietary Pattern and Diabetes: A Secondary Analysis From the Women’s Health Initiative Dietary Modification Trial” utilizes the data from the Women’s Health Initiative to investigate the effects of dietary intervention on diabetes and diabetes treatment in postmenopausal women.

    The Women's Health Initiative (WHI) is a long-term national health study which focuses on strategies for prevention of heart disease, breast and colorectal cancer, and osteoporotic fractures in postmenopausal women. The MedStar Research Institute joined the study as a collaborating center in 1994, under the direction of Barbara Howard, PhD.

    Launched in 1993, the WHI enrolled 161,808 women aged 50-79 into one or more randomized Clinical Trials (CT), testing the health effects of hormone therapy, dietary modification, and/or calcium and Vitamin D supplementation or to an Observational Study. A total of 48,835 women were randomized to a comparison group or an intervention group that underwent a behavioral/nutritional modification program with the goal to decrease fat intake and increase vegetable, fruit, and grain intake.

    Ninety-three percent of participants completed the intervention over an average of 8.1 years. More than 70% participated in the follow-up through September 2015.

    This secondary analysis found that the dietary intervention in postmenopausal women did not increase the risk of diabetes and may have actually slowed progression. This was measured by the number of women who began insulin while part of the study. Women who were part of the intervention group had lower rates of initiation of insulin therapy, and women with baseline waist circumference ≥88 cm and worse metabolic syndrome scores had the greatest reduction in risk of initiating insulin therapy.

    These results are important because weight control is a key objective for persons with type 2 diabetes and this shows in a long-term study that reducing fat intake is not harmful and can be beneficial.

    This data was substantiated by data collected during the cumulative follow-up years. During the follow-up period, baseline glucose was measured in years 1, 3, and 6. In those participants with measured biomarkers, the intervention reduced the risk of developing glucose ≥100 mg/dL by 25%.

    Dr. Howard is the lead investigator on this study and remains an active Senior Scientist and former President of MedStar Health Research Institute.

    Diabetes Care, 2017. DOI: 10.2337/dc17-0534

  • January 07, 2018

    By MedStar Health

    In December, MHRI associates took some time out of their busy schedules to celebrate the successes of 2017 with their fellow associates. These events are also our opportunity to recognize associates with milestone years of service with MedStar Health.

    Hosted at three locations by the Associate Engagement Committee, each celebration brought together leadership and associates to recognize pride in our work and pride in our team. Embracing our theme, “MHRI Team Pride”, the collaborative video celebrated our “Research Super Heroes” from across the system. It was a chance to highlight the work of many departments within MHRI who are committed to making a difference through research.

    Many thanks to all the associates who assisted with planning, set-up, and clean up at each location. Your efforts made the events a success! Thank you to all the associates who brought a donation for Dr. Bear’s Closest at Children’s National Hospital in Washington, D.C., More than 100 toys were donated to help children and their siblings celebrate this season.

    Congratulations to our service award recipients for your years of dedicated service to MedStar. Your work and support allow us to continue our commitment to advancing health in our community.

    5 Years of Service

    • Kezia Alexander
    • Dawn Fishbein
    • Alexander Geboy
    • Melissa McLawhorn

    10 Years of Service

    • Amy Avergas
    • Kimberley Kemp
    • Karen Green
    • Adrian Marguiles
    • Mihriye Mete
    • Ashlee Tidwell
    • Rebecca Torguson

    15 Years of Service

    • Michelle Deville
    • Jean Flack
    • David Hellinga
    • Madhula Khandlwal
    • Maureen McNaulty
    • Carine Nassar
    • Rachel Schaperow
    • Iataushia Wideman-Shepard
    • Getachew Woldemichael

    20 Years of Service

    • Tonya Bishop

    25 Years of Service

    • Laura Want

    40 Years of Service

    • Donald Brown
     
  • January 07, 2018

    By MedStar Health

    Recently published research at MedStar investigated the link between the educational level of study participants and treatment preferences for type 2 diabetes medication. This stratification study sought to clarify treatment preferences for participants with type 2 diabetes based on their educational level: completed high school or less, completed some college, or completed college or more education.

    This study was a collaborative between Joan K. Bardsley, MBA, RN, COE, FAADE, of MedStar Health Research Institute and MedStar Nursing, with colleagues at Virginia Commonwealth University and Johns Hopkins Bloomberg School of Public Health.

    Diabetes is a chronic disease that affects 29.1 million people (9.3%) and is the seventh leading cause of death in the US. Research has shown that people with lower income and less education are two to four times more likely to develop diabetes and more likely to be affected by complications of diabetes.

    Treatment preferences for different aspects of diabetes medication were measured using a discrete-choice experiment (DCE). In a DCE, it is assumed that a treatment profile (in this case diabetes medication) is defined by a variety of characteristics, or attributes that can exist at different levels. Participants were asked to complete several choice tasks in which they are presented with one or more distinct treatment profiles, comparing pairs of treatment profiles composed of six attributes: A1c decrease, stable blood glucose, low blood glucose, nausea, treatment burden, and out-of-pocket cost.

    In this study, a DCE was used to show that persons with type 2 diabetes do not only value reductions in their A1c levels but also had preferences for medications that stabilized their daily glucose levels and that reduced burden/harms of medication.

    Those with a higher education were willing to pay more for all medication attributes than those with lower educational attainment, possibly due to their higher average income. Participants with a college education were willing to pay more than people with high school or less to avoid nausea, low blood glucose events during the day/night, or two pills per day.

    The findings in this study also suggest that people with diabetes patients with lower levels of education are willing to allocate more of their budget to avoid a higher treatment burden and that they might place more value on keeping their glucose levels within a daily target range.

    “Being aware of patient preferences and that these preferences might vary by demographic characteristics can help clinicians tailor treatment approaches to patients by either adapting treatment or increasing educational efforts on the importance of lowering A1c,” the study concluded.

    Dove Press, 2017. DOI: 10.2147/PPA.S139471

  • January 05, 2018

    By Jeffrey Shupp, MD

    With expected low temperatures in the single digits for the D.C. area this weekend, pay attention to the early stages of frostbite. Every year, we see anywhere from a handful to dozens of patients who have tissue loss on their hands and feet from frostbite.

    But a groundbreaking treatment traditionally used to save stroke patients’ lives also can be used to save frostbite victims’ extremities: blood clot-busting drugs that increase blood flow to affected limbs. The key is to seek treatment as soon as you can.

    Often, individuals come to us days or even weeks after they suffered frostbite, and at that time, there’s not a lot that can be done to help the injured tissue. They then come to the Burn Center because treatment and reconstruction after the frostbite injury is similar to that of burns. The skin and the soft tissue below the skin are often destroyed from the cold. Those patients will then need grafting or amputation in order to restore function in their hands and feet.

    Groundbreaking early treatment: clot-busting drugs

    If treatment for frostbite is begun within the first several hours of injury, we sometimes can use clot-busting drugs typically used for people experiencing a stroke to try to save tissue in frostbitten fingers and toes. These drugs are given in the arm or the leg early after the incident of frostbite. In some studies, especially in places of colder climate, they show an improvement in saving tissues and fingers and toes.

    This therapy may work because tissues become inflamed when they have been frostbitten and then are re-warmed. This inflammation is similar to clotting that blocks blood vessels. Since the drugs used for strokes break up the inflammation, blood flow is increased before permanent injury occurs. To be able to use this cutting-edge treatment, we need to see you within the first several hours of your potential frostbite.

    Related reading: Dr. Shupp discusses frostbite in a WTOP Radio news article.

    What are the symptoms of frostbite?

    Frostbite often causes numbness or a pins-and-needles feeling in fingers and toes. Sometimes it feels more like fiery, burning pain, and this can come and go and until the extremities are back to their normal temperature. Another thing to pay attention to is color changes to hands and feet, either red, or pale color, or even blue in the nail beds.

    People tend to watch and wait when they have numbness or tingling because it doesn’t seem urgent. However, by the time there are changes to their skin, it’s a bit late. Damage can be permanent. It’s better safe than sorry, so if you’ve had an extended exposure to cold temperature and you have sensory or color changes to any of your extremities that persist beyond 30 minutes, it’s time to seek professional help. Go to your local emergency room to be evaluated. If there’s an indication that you have frostbite, we at the Regional Burn Center can give you the best care possible.

    Related reading: Dr. Shupp discusses frostbite prevention tips with WRC-TV (Channel 4).

    With lows remaining in the single digits for the #D.C. area this weekend, pay attention to the early stages of #frostbite. via @MedStarWHC

    Click to Tweet

    The best thing you can do is prevent frostbite in the first place

    If you can, stay indoors when temperatures are bitterly cold. If you must go outside, wear multiple layers of loose, warm clothing. If you’re outside for extended periods, take frequent breaks to reassess how you’re feeling before going back out in the cold. Stay as dry as possible, especially when out shoveling snow, and change out of wet clothes immediately. Sweating or any other type of moisture under gloves or clothing make the frostbite process worse.

    Is there a chance you could have frostbite? Call 202-877-3627.

    Request an Appointment