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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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  • August 12, 2016

    By MedStar Health

    The 2 Main Types of Non-melanoma Skin Cancer

    Melanoma is the leading cause of death among skin cancer types, so it's understandable that it has become a major focus of the healthcare community. Non-melanoma skin cancers account for over 90 percent of all skin cancers in the United States, and while they are usually more easily managed, they can pose a serious problem if left unchecked.

    The distinction between melanoma and non-melanoma skin cancer is important to discuss, as prognosis and management are different for each. Melanoma typically requires targeted therapy or immunotherapy, whereas surgical resection (a procedure to remove part of an organ or gland) and chemotherapy are more common approaches for non-melanoma skin cancer. Newer, targeted therapy approaches have also emerged for non-melanoma skin cancers.

    What follows is an overview of the two most common types of non-melanoma skin cancer: basal cell carcinoma and squamous cell carcinoma.

    Basal Cell Carcinoma

    Basal cell carcinoma originates from cells called keratinocytes. When these cells become cancerous, they may form a localized lesion. The lesion usually appears hard and slightly raised, often with a pearly color and some vascular markings. If a patient presents a lesion of this kind, a biopsy should be performed to confirm the diagnosis.

    Basal cell carcinoma is more common in patients who have been exposed to high levels of ultraviolet rays (such as tanning bed use or chronic sun damage), or in those who have compromised immune systems. The disease is fairly common and treatment is usually highly effective. The most common route is surgical excision; if the lesion is small and localized enough, a dermatologist or surgeon will be able to remove it with no further complications.

    Cryotherapy and topical treatment are also options, but they are generally reserved for specific situations. For example, if a tumor grows too large for surgery or if it becomes metastatic (when cancer spreads to another part of the body), radiation or a combination of radiation and systemic therapy can be administered.

    In the past, chemotherapy regimens, such as carboplatin and paclitaxel, have been offered to patients with unresectable, locally-advanced or metastatic basal cell carcinoma. Recent research has identified a critical pathway in most basal cell carcinoma tumors that can be blocked with targeted therapy. This is called the Hedgehog pathway (no specific relationship to hedgehogs) and the class of drugs are called smoothen (SMO) inhibitors. Vismodigib (Erivedge®) and sonidegib (Odomzo®) are the two FDA approved drugs. Both therapies can be very effective in treating basal carcinoma and have become standard practice.

    It should be noted that, even with successful treatment, a case of basal cell carcinoma leaves one at a higher risk for further skin cancers. It is recommended to have regular medical checkups to monitor the condition of your skin.

    Squamous Cell Carcinoma

    Squamous cell carcinoma, like basal cell carcinoma, originates from keratinocytes, and its risk factors also include ultraviolet ray exposure and a compromised immune system. Lesions from squamous cell carcinoma can appear similar to those of basal cell carcinoma, but often they have a more flesh-colored, scaly and inflamed or irritated appearance. A biopsy is necessary to confirm a diagnosis.

    Just as in basal cell carcinoma, surgical excision is the most common treatment option. It's usually cured by surgery alone and other local treatment options can be considered. Squamous cell carcinoma may invade and destroy surrounding tissue or spread to lymph nodes or distant organs if left untreated, so it's important to have any suspicious lesions examined.

    In advanced cases, radiation and/or systemic therapy may be offered. Systemic therapy usually involves chemotherapy with regimens such as carboplatin and paclitaxel or capecitabine. However, newer approaches with EGFR targeted therapy and immunotherapy are showing great promise and can be considered.

    Final Thought

    Basal cell and squamous cell carcinomas are similar in their risk factors, treatment approaches and remission rates. Although they are not as lethal as melanoma, they are very common and are capable of doing significant damage and be deadly if left untreated. For that reason, screening is crucial for every patient, especially those with risk factors like sun exposure, a previous incidence of skin cancer or a compromised immune system.

    When seeking treatment for skin cancers, it's often beneficial to hear a second opinion from a multidisciplinary clinic that involves a dermatologist, surgeons and medical oncologists. If you have a large or recurrent tumor that isn't amenable to surgery, there may be effective alternative approaches. Discuss this with your healthcare provider to make sure you are exploring every option available to you.

  • August 11, 2016

    By MedStar Health

    In the United States, skin cancers are diagnosed annually more than other cancers combined. Most are caused by over-exposure to ultraviolet (UV) rays, either by way of the sun or through man-made sources, such as tanning beds. In fact, according to the American Cancer Society, over 5 million cases of basal and squamous cell skin cancers are documented each year, and over 76,000 cases of melanoma - the deadliest form of skin cancer - are estimated to occur in 2016.

    However, being aware of your skin and knowing the warning signs of melanoma to watch out for can go a long way toward increasing the likelihood of positive outcomes from treatment.

    What Are the Warning Signs?

    While many moles are harmless, you can conduct a simple self-examination of new moles or growths against a simple “A-B-C-D-E” checklist. If you have spot on your skin and are able to answer “Yes,” to any of the questions below, you should consult with a dermatologist and have a biopsy performed to see if the spot is, in fact melanoma.

    • Asymmetry
      Does one half of the mole not match the other?
    • Border
      Are the edges or borders blurred, irregular or notched?
    • Color
      Is the color not uniform across the growth? Does it include shades of brown or black, or patches of blue, pink, red or white?
    • Diameter
      Is the mole larger than 6mm - about the size of a pencil eraser?
    • Evolving
      Over time, does the growth change in color, shape or size?

    That said, not all melanomas meet these criteria. So if you notice any changes in your skin - for example, a new growth that does not appear to match the others, or a change in a mole already present - contact an experienced dermatologist. Other symptoms of melanoma to be aware of include pigmentation spreading beyond the border of a growth, changes in surface texture or sensation, or sores that do not heal.

    Prevention of Skin Cancers

    Your skin is a vital organ that not only protects you from germs, but also your internal organs from injury. So remember, while it is important to be proactive about detection of melanoma or other skin cancers, you also should be proactive about preventing sun damage to your skin that increases the risk of skin cancer.

    This is especially true in the summer months, where you may be spending more time outside having fun with friends and family. For example, apply and frequently reapply sunscreen, particularly if your skin burns easily. Also avoid being outdoors midday and in the early afternoon hours for long periods of time without some sort of protection, or the use of tanning beds.

  • August 10, 2016

    By MedStar Health

    There’s no such thing as a “routine” surgery, even for procedures that have been performed thousands of times. But that doesn’t stop MedStar Washington Hospital Center surgeons such as Luis Hernandez, MD, from trying to make operations as simple and risk-free as possible for patients.

    Dr. Hernandez is a colorectal surgeon with the MedStar Colorectal Surgery Program, based at the Hospital Center. He says robotic technology has been particularly advantageous for pelvic procedures, including rectal cancer and prolapse. Dr. Hernandez says space in the pelvis area is extremely limited, so using a surgical robot’s high-definition visualization with precise maneuverability is extremely valuable for the intricacies of delicate and complex surgeries.

    “We are always pushing the envelope on performing the same surgery with more minimally invasive maneuvers and technology,” Dr. Hernandez says, “whether it’s laparoscopy or robotics.”

    Minimally Invasive Surgery

    That’s why Dr. Hernandez is particularly excited about the latest addition to the Hospital Center's array of advanced surgical tools—the da Vinci® Xi™ surgical system, which features a 3D HD vision system and wristed instruments that bend and rotate well beyond the human hand’s capabilities.

    “It’s also less bulky and easier to set up than other robotic systems, and allows for easier access for multiple abdominal quadrant surgery,” he adds.

    Dr. Hernandez enjoys having a broad array of approaches to complex surgery—whether it be laparoscopy, robotic, or traditional open surgery—to helping patients overcome colon cancer, the third leading cause of cancer death in the U.S.

    “I enjoyed the concept of potentially curing some patients from this disease surgically if they were diagnosed early enough,” he says. “At the same time, I can support those patients dealing with chronic conditions, such as Crohn’s disease and ulcerative colitis.”

    Dr. Hernandez is quick to add, however, that the path toward making a diagnosis and choosing an optimal course of treatment is not always easy. He recalls caring for a very young patient who, because of a complicated presentation, was nearly overlooked for cancer.

    “It made an impression on me to always consider all diagnosis regardless of age or presentation,” he says. “That’s why I emphasize careful history-taking and physical exam, because it tells a story that labs and X-rays can’t always put together for you.”

    A Biology Course Led to Medicine

    Born in New York and raised in Florida, Dr. Hernandez traces his interest in medicine as a career to a high school course in advanced biology. “I was amazed by the human body and all its intricacies,” he says. “That experience drove me to major in biology in college, with a pre-med focus.”

    After graduating from Florida State University College of Medicine, Dr. Hernandez performed his surgical residency at the University of Miami/Jackson Memorial Hospital, and a fellowship in colon and rectal surgery at MedStar Washington Hospital Center.

    Because no one is immune to colon cancer, Dr. Hernandez is a strong proponent of high-fiber, low-fat diets and regular exercise, an example he tries to set by staying physically active through running and travel. He also urges patients to undergo colonoscopies for early detection of polyps and other pre-cancerous warning signs.

    And if the diagnosis is cancer, surgery may not necessarily be a patient’s only option.

    “Our colorectal surgery and oncology groups are participating in rectal cancer research to help determine who may or may not need to undergo surgery versus just chemoradiotherapy,” Dr. Hernandez says. “Minimally invasive procedures are good, but having no procedures at all may be the future.

    Have any questions?

    Contact us for more information about Dr. Luis Hernandez III or to schedule an appointment. Call us at 202-877-3627.

  • August 09, 2016

    By MedStar Health

    More than 300 donors, former patients, healthcare staff, elected officials, and guests gathered at MedStar Washington Hospital Center on June 16 to witness the dedication of the Nancy and Harold Zirkin Heart & Vascular Hospital, the first dedicated cardiovascular hospital located in the greater Washington, D.C., area. The occasion marked the end of years of planning, design and construction, as well as the beginning of a new era of tightly coordinated, centralized specialty care for the most complex cardiovascular cases in the region.

    “This is an extraordinary milestone for our patients,” said Stuart F. Seides, MD, physician executive director of MedStar Heart & Vascular Institute. “Every aspect of the new hospital was designed with patients’ comfort, convenience and safety in mind as we worked to create an environment conducive to healing.”

    About the Nancy and Harold Zirkin Heart & Vascular Hospital

    The new four-story, 160,000 square-foot, state-of-the-art facility unites virtually the entire heart and vascular healthcare delivery staff—cardiologists, cardiac and vascular surgeons, nurse practitioners, cardiac care nurses, and other specialized caregivers—into one cohesive team in one location, for more effective, streamlined care.

    “Previously, patients with heart problems could have received care on one of 10 different nursing units,” says Allen J. Taylor, MD, FACC, FAHA, chief of Cardiology at both MedStar Washington Hospital Center and MedStar Georgetown University Hospital. “This new configuration eliminates variability in care, while fostering communication and collaboration among team members.”

    Adds Nancy Bruce, RN, BSN, MBA, assistant vice president for Nursing, “It also makes it possible for us to ensure that the patient/family experience is seamless, and care is coordinated every step of the way.”

    From admission to discharge, all aspects of the new hospital-within-a-hospital help promote that goal. Patients are now housed according to condition, treatment and acuity of care, leading to increased proficiency and teamwork for staff members accustomed to caring for patients with diverse heart and vascular diagnoses. Patient floors feature their own echocardiography, X-ray and other non-invasive services for faster, more convenient examinations and evaluations. Stress testing is done on the first floor of the new space. The majority of the 164 patient rooms are also private, furnished with couches and other amenities, to increase the comfort and satisfaction levels of patients and their families.

    An Expanded Cardiac Critical Care Unit

    July found the opening of the last phase of the project, an expanded 44-bed cardiac critical care unit (CVICU) that combines the functions of the previous three units into one: recovery room, coronary care unit and cardiovascular surgery ICU. A unique feature is a central boom suspended from the ceiling, for medical gasses, electrical and data outlets. By doing away with the old wall mounts, the design gives staff unfettered 360-degree patient access.

    “The new, cutting-edge ICU will allow surgeons, intensive care physicians, nurses, and mid-level practitioners to constantly improve care, comfort and efficiency for the sickest patients in the region,” says Paul Corso, MD, chairman, Cardiac Surgery. “The unit is structured for ever-expanding, high-tech monitoring and communication among caregivers, patients and families. Cardiovascular surgery will continue to innovate and add new procedures because of the capabilities of the new ICU. The new Zirkin Heart & Vascular Hospital is the culmination of a dream for cardiovascular care in the mid-Atlantic region.”

    Turning a Dream Into Reality

    MedStar Washington Hospital Center is one of the busiest cardiac surgical centers in the United States and is nationally recognized for excellence in cardiovascular care. MedStar Heart & Vascular Institute, founded at MedStar Washington Hospital Center, is engaged in a clinical and research alliance with the world-renowned Cleveland Clinic Sydell and Arnold Miller Family Heart & Vascular Institute to improve patient outcomes and operational excellence.   

    With the opening of the dedicated heart and vascular hospital, the patient and family experience now matches the hospital’s reputation for outstanding clinical expertise. Thanks go to Nancy and Harold Zirkin and their $10 million leadership gift. “When Nancy and I learned about the vision of MedStar Heart & Vascular Institute and its important alliance with Cleveland Clinic,” Mr. Zirkin says, “we saw this as an ideal opportunity to bring together our strong interest in better health with the region’s need for world-class heart care. We’re thrilled we were able to help make MVHI’s dream a reality.”

    Dr. Seides concludes, “We’ve always been blessed with some of the most talented and dedicated physicians and nurses in the country. Now we are providing them with an environment that allows that teamwork to flourish--and ultimately allows us to provide the best possible patient care.”

    Have questions?

    We are here to help! If you have any questions about MedStar Washington Hospital Center, call us at 202-877-3627.

  • August 07, 2016

    By MedStar Health

    The recipients of the 2016 John L. Green Generation of Leadership Scholarship, given to MedStar associates who exemplify excellence, leadership and commitment, have been announced. Congratulations to Jose Pineda, Treatment Navigator with the MedStar Clinical Research Center located at MedStar Washington Hospital Center, who was one of the six recipients.

    The scholarship, named in memory of John L. Green, a former MedStar Health executive, is reserved for exceptional individuals who effectively demonstrate their drive and determination for success in health care.

    Mr. Pineda has been with MedStar for more than five years. He is pursuing his bachelor’s degree in Public Health at Universidad Del Este. He has created support groups for HIV-infected patients and collaborated with physicians across departments to ensure these patients receive the care and attention they need. His goal is to continue working in Public Health for MedStar after he graduates.

    In addition to Mr. Pineda, the following MedStar Health associates were recipients of the scholarship:

    • Leslie Arce, Manager, Radiology, MedStar Montgomery Medical Center
    • Eldho Chacko, RN III, MedStar Good Samaritan Hospital
    • Praxedes Fofung, Clinical Consultant Manager, MedStar Health Home Care
    • Chinenye Nwatu, Applications Analyst, White Oak Data Center
    • Terrence Polston, Manager, Bedside Delivery Service, MedStar Harbor Hospital.

    Congratulations to all recipients and best of luck with your studies.

  • August 07, 2016

    By MedStar Health

    The U.S. Department of Health and Human Services (HHS) has released a new guidance on ransomware and HIPAA at a time when healthcare organizations are increasingly faced with new cybersecurity threats. The guidance aims to provide healthcare organizations with information about ransomware attack prevention and recovery. This guidance is intended to assist HIPAA-covered entities and business associates to prevent and recover from ransomware attacks, and it offers information on how HIPAA breach notification processes should be managed in response to a ransomware attack.

    The new guidance is a summary of industry’s best practices. The guidance recommends that organizations identify the risks facing their patient information, create a plan to address those risks, set up procedures to protect systems from malware, train users to spot malware, limit access to sensitive information to only the people who need it most, and have a disaster recovery plan that includes frequent data backups. The guidance fact sheet can be found here. Read more on this topic at the hhs.gov blog.

    If you have any questions or concerns, please contact the MHRI Office of Research Integrity.