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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 16, 2017

    By MedStar Health

    Bunions—those unsightly bony protrusions that can develop over the first metatarsal bone or big toe joint—remain a bit of a mystery. Aside from their definition, everything else varies, including how and why they develop, who gets them and when, and what symptoms they may cause. But one thing is certain:  Bunions can be hard to ignore, especially when they’re painful.

    Fortunately, there are early steps you can take that may help you from ever reaching that stage.

    "My best advice is to have an evaluation with a foot specialist when you first see a bunion developing or have any pain in your big toe joint,” says Katherine Raspovic, DPM, a podiatric surgeon at MedStar Washington Hospital Center. “There are a few conservative treatment options that can help improve discomfort.”

    The luck of the draw, genetics, often plays a role in determining who gets bunions. But shoes are another likely culprit, with high heels and shoes with narrow toe areas leading the list of suspects. While many high-heel wearers may never have problems, Dr. Raspovic advises those who do to step away from the stilettos, pointy toes and any other shoe that aggravates the sore joint.

    "One of the best preventative and therapeutic measures for bunions is wearing the right shoe for your foot, especially one that avoids excessive pressure on your toes,” she says. “It can be helpful to go to a good store where you can get your feet accurately measured so you can then find the proper size and fit.”

    Beyond a change of footwear, other helpful tactics include using orthotics for arch support, modifying or taking a break from some activities for a time and taking anti-inflammatory medication.

    Surgery is only recommended when other approaches have failed and the pain is so severe that daily activities and quality of life are affected. Depending on the type of surgical correction, some patients are completely off their feet for six weeks, followed by a walking boot and physical therapy. Post-surgical swelling—which may quickly subside or last for several months—can affect a patient’s ability to wear regular shoes for 10 to12 weeks after surgery. The recovery can be different for each patient based on what surgical intervention is needed to correct the bunion properly.

    But with early detection and specialty medical care, many people can avoid surgery, says Dr. Raspovic.

    Tune in to the full podcast interview with Dr. Raspovic.

    Our specialists are experts in the diagnosis and treatment bunion and other podiatric conditions. Ready to schedule an appointment? Call us at

    202-877-3627

    Katherine Raspovic, DPM Bunion

    Dr. Katherine Raspovic, DPM

    For an appointment, call 240-273-1915.

  • January 13, 2017

    By MedStar Health

    This year, we celebrate Martin Luther King, Jr. Day by supporting Wheatley Elementary School.
  • January 10, 2017

    By MedStar Health

    Esophageal cancer is found in the esophagus, the tube that connects the mouth to the stomach. It can occur at any point on that route and will be treated differently depending on its location and severity.

    While the treatment for esophageal cancer has changed drastically over the decades, recent trends have seen the treatment options shift from highly invasive and destructive procedures to more minimally invasive procedures designed to uphold the patient's health and well-being throughout treatment.

    Treatment Options for Various Types of Esophageal Cancer

    Over the last several decades, adenocarcinoma (a type of esophageal cancer near the stomach) has become more widespread.

    Unfortunately, because of the widespread availability of over-the-counter acid reflux medications, patients may not ever know they have this type of cancer and may write their chronic acid reflux off as nothing to worry about.

    Cancer can present very few or no symptoms, so in most cases, patients with esophageal cancer don't know they have the disease until it's in an advanced stage. In many instances, esophageal cancer is diagnosed by accident when it has reached an advanced stage. At one point the only available treatment for late stage patients was a highly invasive" open case" treatment which involve large incisions in the abdominal and chest cavities), with a 50 percent risk of complications and chronic pain.

    Fortunately, minimally invasive procedures are available that offer minimal pain, fast healing and the ability to go home and eat normally, rather than through feeding tubes.

    Procedures for Early-Stage Patients

    On the other hand, patients with very early-stage cancers can avoid to the removal of their esophagus, and instead only remove a portion of the tissue around the cancer, leaving the remainder of the stomach and esophagus without damaging the nerves or the valve that prevents reflux.

    On the other hand, patients with later stages will need to remove more extensive amounts of tissue including the nerves to the stomach. While patients will have reflux and potential long-term stomach issues, it is a life-saving procedure for many.

    Patients who have had previous open operations will still be able to access minimally invasive approaches, although it may take longer and be more challenging because of scar tissue.

    What Minimally Invasive Options Mean for Patient Care

    Minimally invasive surgery is the preferred, and often the best option vs. an open method. In addition to providing a faster healing time, minimally invasive procedures may offer a better cancer outcome than more invasive open approaches. Though doctors aren't exactly sure why this is true, it could be attributed to the fact that minimally invasive procedures minimize damage and are less stressful on the body during recovery.

    It should be noted that minimally invasive surgical options are not the right course of action for all esophageal cancer patients. However, they can go a long way toward minimizing damage and expediting the healing process for these patients.

    Looking Ahead

    While further treatment options are sure to be developed in coming years, the current treatment options show great promise to patients and their families who are struggling through the murky waters of esophageal cancer and its many invasive and minimally invasive treatment options.

    Between better outcomes and faster recovery times, it's easy to see why minimally invasive treatment options are becoming so popular among patients today.

  • January 10, 2017

    By MedStar Health

    Exercising, eating right, getting plenty of sleep, and not smoking are four New Year’s resolutions you can make to improve your health. But it’s also important to get the right screening tests at the right time. This year, resolve to get the screenings you need to prevent and catch potential health problems before they become major concerns. Knowing which tests to get and when to get them can be a challenge, given that screening guidelines are changing frequently, as concerns grow that overusing such tests might lead to unnecessary procedures.

    To make this as simple as possible, Sadaf Mustafa, MD, a primary care physician on the medical staff of MedStar Good Samaritan Hospital, has prepared the following guides tailored to the unique needs of men and women of any age. While these are useful general guidelines, she recommends, “Each individual should talk to their doctor first, who will then be able to take the personal and family history into account and suggest the screening test that‘s right for you.”

    Dr. Mustafa highlights three important preventive health measures that are especially prone to being overlooked: mental health screenings, Human Papilloma Virus (HPV) vaccinations and osteoporosis screenings for both men and women. She believes that having your doctor ask a few questions about your mental health is as equally important as many of the other health screenings.

    “The single most important screening is for your mental health,” she explains. “Your physician can use one of several short, validated questionnaires that are available to check your mental health every time you get your routine physical exam.” She recommends starting these brief screenings as early as 18 years of age. Dr. Mustafa also recommends that young people should get the HPV vaccines to help prevent a variety of cancers.

    This article appeared in the winter 2016 issue of Good Health. Read more articles from this issue.

    Location Information

    Sadaf Mustafa, MD, Internal Medicine
    201 E. University Parkway
    Baltimore, MD 21218
    410-554-2284

    Learn More

    Download Our Screening Guides

    Click below to view and download our FREE screening guides.

    A Man’s Guide to Health Screenings

    Click below to download and print the screening guide below.

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    A Woman’s Guide to Health Screenings

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  • January 10, 2017

    By MedStar Health

    For people with thyroid cancer surgery is usually the best treatment. Yet how the procedure is done and by whom can make a telltale difference.
  • January 06, 2017

    By MedStar Health

    If you have been diagnosed with breast cancer, your thoughts might jump ahead to the possibility of needing a mastectomy and/or breast reconstruction, as part of your treatment. But just as each cancer is unique, so are your breasts.

    There are several methods of breast reconstruction and you will need to speak with your breast surgeon and plastic surgeon to determine which is best for you. Pre-pectoral reconstruction involves placing the breast implant over the chest muscle.

    But what are the advantages of pre-pectoral reconstruction? And are there any challenges you should be aware of?

    Traditional Procedures and Drawbacks

    During mastectomy, breast tissue is removed along with the cancer. Many times the cancer is located in a portion of the breast where the nipple can be spared, Traditionally, the plastic surgeon inserts a tissue expander or breast implant either partially or completely under the muscle.

    Tissue expanders are meant to gradually stretch the skin, however it’s often painful because the chest muscle is slowly stretched as well. In addition to the post-operative discomfort, the aesthetic outcome tends to look flat and unnatural since the implant is under the muscle.

    Due to the pain of stretching muscle and the aesthetic deficiencies of under the muscle implants, other methods have been developed, including one that involves partial muscle coverage. But like the previous method, this type of breast reconstruction method also has disadvantages.

    For example, this procedure often produces a flat, unnatural look because the implant is located under the muscle. Furthermore, given the fact that it is directly under the skin, the muscle is visible especially when the patient uses their chest muscles. This is similar to watching a body-builder flex their chest muscles. This tends to be distracting when women are exercising in public, since every time they use their chest muscles, the implant shows visible distortion.

    Looking beyond the individual outcomes for each of these procedures, traditional reconstruction techniques overall can result in chronic soreness for patients, in the years following their procedure.

    How Pre-Pectoral Reconstruction Works

    These drawbacks have left an opening for a more advanced option: pre-pectoral breast reconstruction. With this method, the implant is placed over the muscle. This means there is little to no muscle deformity or pain associated with the procedure, since the muscle does not have to be cut. Instead, the implant is placed directly under the skin.

    Of course, like most surgeries, there are some disadvantages. Early complications may include bleeding, infection, pain or seroma, which is fluid collection around the implant. Once you heal, there is a small chance your implants will rotate so they look upside down, and or they may rupture. In addition, most implants last for 10 to 15 years, so most women will need to have another procedure for new implants in future.

    It should be noted that, women who benefit from this procedure are in relatively good shape and have small to medium sized breasts that are not overly saggy. Additionally, the breast cancer cannot have been located in the nipple area, which must be left intact.

    Finding the Right Surgery Team for You

    If you are considering pre-pectoral breast reconstruction, you should set up an appointment with a board-certified plastic surgeon who specializes in this area and can offer individualized care. This way, your doctor can guide you toward the right type of surgery for your circumstances.

    The top priority of breast cancer treatment is to remove cancer and do an extensive enough surgery to ensure the risk of recurrence is low. The second goal is to give you a safe, aesthetically pleasing breast reconstruction. For this reason, you need a team of surgeons and specialists working closely together with constant communication between doctors.