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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:
    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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  • August 30, 2016

    By MedStar Health

    Head and neck cancer can be difficult to manage, but thanks to recent developments in medical technology, surgeons now have more effective ways to treat it. In the past, certain tumors in the head and neck could only be removed by either cutting through the neck or opening the jaw.

    These rather morbid procedures resulted in poorer functional outcomes and carried a higher risk of complications than their modern-day counterpart, transoral robotic surgery - commonly referred to as TORS.

    What Is Transoral Robotic Surgery (TORS)?

    TORS is a minimally invasive procedure in which a series of robotic arms are passed through the mouth in order to reach a tumor and resect it. It's most commonly used for tumors in the throat, particularly tonsil and tongue tumors. TORS is a good option for treating head and neck cancers not only because it's minimally invasive, but also because it can reduce the need for additional therapy. Patients who elect to undergo TORS often find that they require a lower dose of radiation --and some can even avoid radiation and chemotherapy altogether.

    However, effective as the procedure is, it's important for you to understand what to expect before, during and after TORS, so that you can prepare yourself for the best outcome possible.

    Before Surgery

    Before undergoing TORS, your surgeon will need to conduct some tests to understand exactly how to approach the tumor. A PET/CT scan is usually necessary to visualize the tumor, and a biopsy to confirm the diagnosis and determine the extent of its development. Preparation for surgery will also include common preparations such as blood testing so that your surgeon may have a thorough understanding of your health.

    You may be asked to avoid certain medications during the week prior to the operation, such as aspirin or other anti-inflammatories, as these can cause complications. Your surgeon will advise you on the steps to take prior to your surgery to make sure you are in the best condition possible.

    The Day of Surgery

    As is common for many surgeries, you will be advised not to eat any food after midnight the night before your TORS. It's important that you arrive two hours before the scheduled surgery so that the nurses, anesthesiologists and surgeons have time to admit you and get everything in place.

    Immediately after the operation, you may find that your tongue feels somewhat swollen. This is a common side effect that should subside after a few weeks, and it is unlikely to seriously impair your speech. Either the day of the TORS or the day after, you will have a bedside swallow evaluation to ensure that your throat is functioning well. If necessary, a speech pathologist will be involved to help you along the way.

    After Surgery

    It's common for patients who undergo TORS to be concerned about whether they will be able to speak or eat. The fact is that TORS results in great functional outcomes, and within just one or two days of the operation, most patients are speaking and eating comfortably. Once you demonstrate that your pain is under control and you are capable of eating and moving around comfortably, you will be able to return home. Hospital stays rarely exceed two or three days.

    Although very uncommon, some bleeding may occur around the site of surgery. A sudden case of bleeding in the throat can be dangerous, so be vigilant for the first week or two after your TORS. In the interest of safety, surgeons recommend having someone nearby for that short period after the operation.

    Final Thought

    TORS is an exciting development for head and neck cancer patients, as it has revolutionized how those diagnoses are treated. Because it is minimally invasive and can reduce the need for further treatment, patients like you are experiencing faster, more complete recoveries. Use this overview of what to expect from the procedure to be more informed when you speak with your doctor.

  • August 28, 2016

    By MedStar Health

    It is estimated that up to 10 percent of women with gestational diabetes are diagnosed with type 2 diabetes soon after delivery. Over 10 years, the risk can increase up to 50 percent.  But the risks can be mitigated if preventative screenings are scheduled. Yet, too many women are skipping the required postpartum glucose tolerance test, usually given to women six to 12 weeks after they’ve delivered. Recent studies show that up to 50 percent of patients do not show up for this important test.  The low compliance is likely because too many women are overwhelmed after bringing home a newborn baby and simply forget.

     Dr. Sara Iqbal, a high-risk obstetrician at MedStar Washington Hospital Center says, “Educating the patient and providing test reminders is essential in order to improve the rate of testing postpartum."

    Type 2 diabetes can be prevented by simple, easily applicable lifestyle modifications. Dr. Iqbal advises patients to:

    • Exercise
    • Choose healthy food portions and monitor caloric intake
    • Avoid gaining too much weight, as obesity is a major risk factor for type 2 diabetes
    • Follow up for the postpartum glucose tolerance test
    • Have your blood sugar levels tested every one to three years, depending on the glucose tolerance test results

    Our specialists are focused on the health of you and your baby. Call us today to schedule an appointment at


    As heard on WTOP Radio:

    Sara N. Iqbal, MD

    Sara N. Iqbal, MD
    MedStar Washington Hospital Center

    For an appointment with a high-risk pregnancy specialist, call 202-877-3627.


  • August 26, 2016

    By MedStar Health

    Patients with advanced illnesses face a variety of side effects. But little thought may be given to the concern of compromised physical intimacy.
  • August 25, 2016

    By MedStar Health

    Not only is bone cancer a worrisome diagnosis for patients and their families, the prospect of treating any cancer can be frightening, as you may not know what challenges you can expect or how to overcome them.

    In this article, we'll be looking specifically at bone sarcomas, which are cancers that arise in the body's bone, muscle and connective tissue. There are several other types of bone tumors, including:

    • Other cancerous tumors that arise in the bone marrow;
    • Benign tumors of the bone; and
    • Non-bone cancer that spreads into the bone.

    Each of these types of tumors brings its own unique care challenges and treatment strategies.

    Alleviating Fears

    When patients learn they have bone cancer, one of the most common fears is that they'll need to have a limb amputated. Historically, this kind of aggressive treatment was the first line of attack against bone cancer, and many prominent cases were treated this way.

    But for many patients today, this is no longer the case. The limb is spared, and amputation is not necessary. Modern treatments for bone cancer treat the tumor(s) with a combination of medical and surgical methods. Doctors do this while preserving as much limb function as possible, maximizing the patient's ability to function and ensuring a high quality of life, both during and after treatment.

    The Diagnosis Process

    Providing an accurate diagnosis, with vital information about the type and stage of cancer, is critical to treatment. An accurate, thorough diagnosis helps your team of doctors create a treatment plan that's safe, effective and thorough, and minimizes unnecessary treatment.

    One of the most vital aspects of the diagnosis is the biopsy, which is an examination of a tissue sample collected from the body. A good biopsy should be minimally invasive, only testing parts of the tissue suspected to be affected. CT-guided or ultrasound-guided needle biopsies, or needle biopsies performed in a major clinic, allow precise, careful testing of tissue.

    An appropriately-placed biopsy takes just enough tissue to test, and no more. But at the same time, some doctors – especially those who do not commonly work with bone cancers – take too little tissue for a definite diagnosis, forcing a re-biopsy. Our doctors always work to take the proper amount for the biopsy – not too much, and not too little.

    Devising a Treatment Plan

    Different types of bone cancer require different treatments. The limbs affected and the stage of cancer will also affect the treatment plan. For some cancers, chemotherapy is needed prior to a limb-salvaging surgery. Other cancers don't respond as well to chemotherapy and require surgery (not necessarily an amputation) to treat. This is why obtaining an accurate diagnosis is so crucial.

    Primary bone cancer is very rare, and its treatment is often highly specialized and complex. One of the best ways you can assure swift, safe and thorough treatment is to receive diagnosis and treatment at a large center that employs a team of experienced oncologists, surgeons, radiologists, pathologists and other doctors. This way, you know you'll get the care you need, and your quality of life will be assured.

    Final Thought

    When your doctor suspects bone cancer, one of the most important ways to ensure successful treatment and a high quality of life is to receive an accurate diagnosis at a major medical center. If you do indeed receive a bone cancer diagnosis, receiving comprehensive treatment from a team of experienced doctors at a major care facility is vital to ensuring you receive the best care possible.

  • August 23, 2016

    By MedStar Health

    While the causes were historically considered to be smoking-related, throat and mouth cancers are increasingly being attributed to the Human Papilloma Virus. Here is what you need to know about the link between HPV and oropharygneal cancer.

    What Is HPV?

    Human Papilloma Virus, or HPV, is the most common sexually transmitted infection in the United States. With approximately 79 million Americans currently affected by the virus and an estimated 14 million new infections occurring each year, almost all sexually active adults will be infected by at least one form of the virus at some point during their lives.

    Most HPV infections resolve themselves without any intervention and have no noticeable health impacts. However, some types of the virus cause small bump-like growths (papillomas) in the genital region, often referred to as genital warts. Other types of the virus can also cause cancer, especially cervical cancers and throat cancers.

    Epidemic Proportions

    HPV has been widely recognized as the most common cause of cervical cancer for many years. More recently, the frequency of HPV-related oral cancers has also become apparent. HPV is now the most often diagnosed cause of oropharyngeal cancers, which includes tonsil and base of tongue cancers.

    If rates of diagnosis continue to increase at their present pace, the number of HPV-related throat cancers will surpass the number of HPV-related cervical cancers within a relatively short period of time. HPV-related throat cancer is quickly becoming an epidemic.

    Compared to Smoking-Associated Oral Cancers

    HPV-related oral cancers are completely different from their smoking-associated cousins. While still capable of causing significant health problems, HPV-related cancers tend to strike a different population and exhibit a different cure rate when compared to throat cancers stemming from tobacco use. In most cases, patients who develop oropharyngeal cancers as the result of an HPV infection are younger and come from a higher socioeconomic background than their smoking-associated cancer counterparts.

    HPV-related cancer patients also tend to experience better outcomes than smoking-related cancer patients. Whether approached surgically, or with chemotherapy or radiation, cure rates are better across the board for HPV-associated tumors.


    In most cases, people who develop HPV-related oral cancers were exposed to the virus decades earlier. And while recent advances in vaccines are an excellent way to prevent future infections, they don't provide protection from previous encounters, meaning awareness is your first-line defense, especially if you've had exposure to HPV in the past.

    The presence of unexplained masses in the neck or throat are often the first symptom of HPV-related oral cancers. If you notice a growth in these regions that doesn't go away, seek professional care as soon as possible. Other possible symptoms may include trouble swallowing, throat discomfort, or throat pain, although these are less common than with smoking-related oral cancers.

    Final Thought

    A successful publicity campaign has helped raise awareness regarding the link between human papilloma virus and cervical cancer. HPV's association with cancer isn't restricted to the reproductive organs, however. As the number one cause of oropharyngeal cancers, including tonsil and tongue tumors, it is important for anyone who has been sexually active to be aware of the possibility of developing throat cancers many years after the initial exposure occurred.

    Although more common than smoking-related oral cancers, HPV-associated tumors are typically very treatable using conventional approaches such as surgery, chemotherapy and radiation.

  • August 23, 2016

    By MedStar Health

    As with many Olympiads of years’ past, the conversation leading up to the 2016 Summer Olympics in Rio de Janeiro, Brazil, has been laced with controversy. But in this case of this year’s global athletic event, health concerns have dominated the headlines, as news of the Zika virus spread across the world.

    This led to public calls for athletes, in addition to attendees, to sit out the summer games this year, altogether. Their dream of Olympic glory was simply not worth the potential cost of their health. But with the end of the Olympics in Brazil, reports are becoming more positive, echoing the Center for Disease Control and Prevention’s July declaration that the Rio Olympics were “unlikely to spread” or accelerate the spread of the Zika virus.

    After all, it is currently winter in Rio, and mosquitoes carrying the virus are less likely to be active this time of year.

    Unfortunately, however, it has been reported that the Zika virus has made its way to America, with new cases reported in Florida and attributed to local mosquitoes. In light of this news, here is what you need to know about Zika to keep yourself safe at home or if you plan to travel abroad to impacted areas.

    Zika Risk Factors and Symptoms

    Following the original outbreak that began in northeast Brazil, Zika has since been linked to pediatric brain damage and microcephaly (when an infant is born with a smaller head). Adults are also at risk, as Guillain-Barré syndrome, a disorder where a body’s immune system attacks part of the nervous system, and acute disseminated encephalomyelitis, which is characterized by short, intense swelling in the spinal cord and brain, have been connected to the Zika virus.

    Currently, there are two ways an individual can contract the Zika virus:

    • Primarily through bites of an infected Aedes mosquito; and
    • Unprotected sexual contact with someone who is infected.

    According to the CDC, there is very low risk of transmission associated with blood transfusions, but that is subject to change, were the virus to spread further and become more commonplace.

    Often many individuals do not present symptoms of the Zika virus, but some include fever, rash, joint pain or red eyes, as well as muscle pain and headache. These symptoms can last up to a week, and the virus itself is not fatal. But due to other healthcare issues that may evolve as a result of contracting the virus, you should contact your healthcare provider if you are experiencing these symptoms and have recently traveled to an impacted area. Your diagnosis can be confirmed with a blood or urine test.

    Seeking Treatment for Zika

    If you or someone you know has a positive Zika virus diagnosis, unfortunately, there is no current vaccine or medicine that treats it - you can only treat the symptoms. Keep hydrated with fluids, rest, and use pain or fever reducers like acetaminophen (Tylenol®).

    You should not, however, take aspirin or other NSAIDS. If you are currently taking any other medication, consult your doctor before adding any additional medication to your regimen for treatment.

    Ultimately, the Best Strategy for Zika Is Prevention

    Since there is currently no treatment available for Zika, the best course for you and your loved ones is prevention - especially if you are currently (or plan on becoming) pregnant.

    If you are at high-risk, do not travel to areas with reports of Zika. In addition to preventing mosquito bites with EPA-registered insect repellents and adequate coverage with clothing, you should use condoms or other barrier methods with sexual partners - especially those who have also recently traveled. Also, if you are looking to grow your family, it is recommended that you wait eight weeks before trying, if you have traveled to an area impacted or under warning of the Zika virus.

    Finally, don’t be afraid to have a conversation with your healthcare provider. They can discuss your personal circumstances, as well as any questions or concerns you may have about the Zika virus.

    Have questions?

    If you're interested in learning more about the Zika Virus, or to schedule a consultation, call us at 202-877-3627.