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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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  • July 25, 2016

    By MedStar Health

    Meet Dr. Lauren Wiesner, an emergency doctor and one of the Hospital Center's Celebrated Physicians.
  • July 22, 2016

    By MedStar Health

    When you think of summer, images of swimming, camping and barbecues with friends and family probably spring to mind. But while you’re out having fun in the sun, it’s important to remember you need to protect yourself from the heat. This is especially true since the National Weather Service is warning of a record-breaking heat wave that will push heat index temperatures over 100 degrees across the central United States and into the East Coast this weekend.

    And the two most common heat-related illnesses to watch out for are heat exhaustion and heat stroke.

    heat-exhaustion-vs-heat-strokeWhat’s the Difference Between Heat Exhaustion and Heat Stroke?

    Though heat exhaustion and heat stroke sound similar and are both caused when your body is unable to keep itself cool, they are very different. So it is imperative that you understand the symptoms of each, as well as how to respond if you or a loved one begins to exhibit signs of either heat exhaustion or heat stroke.

    Allen Taylor, MD, chief of Cardiology at MedStar Heart & Vascular Institute says, "What to watch for is early symptoms like thirst, dizziness, but it can progress. If there’s confusion, nausea, it could indicate more severe heat injury - if it gets worse than that, it can even be fatal."

    Heat Exhaustion Symptoms and Treatments

    Often caused by exposure to hot weather or participation in physical exercise, those who are suffering from heat exhaustion may experience the following symptoms:

    • Feeling faint or dizzy
    • Excessive sweating
    • Nausea or vomiting
    • Pale, cool, clammy skin
    • Weak, rapid pulse
    • Muscle cramping

    You will need to move a person suffering from heat exhaustion to somewhere cool, with air conditioning, as quickly as possible. Have them drink water if they are fully conscious, but avoid alcohol or beverages with caffeine. If they are able, have them take a cool shower or use cold compresses to lower their body temperature. Consult a doctor if they do not feel better within 30 minutes, or if they vomit more than once.

    Heat Stroke Symptoms and Treatments

    While you can often treat someone with heat exhaustion at home, heat stroke is considered a severe medical emergency and is characterized by the following symptoms:

    • No sweating
    • Throbbing headache
    • Red, hot skin
    • Body temperature above 103 degrees
    • Rapid, strong pulse
    • Loss of consciousness or altered mental state

    If you think someone is exhibiting symptoms of a heat stroke, you should call 911 or get them to a hospital immediately, as a failure to do so can be fatal. In the interim - either before help arrives or while you are in transit - move the individual to a cool, air-conditioned environment.

    In addition to cold compresses, you can also use a fan - but only if the heat index is below the high 90s. Otherwise, a fan can make someone feel hotter, rather than cooler. Finally, unlike treatment for heat exhaustion, you do not give someone suffering from a heat stroke fluids.

    Heat Exhaustion and Heat Stroke Prevention

    When hot weather strikes, you can keep you and your family safe by staying in air-conditioned buildings, but do not rely solely on fans to keep cool. Limit outdoor activity, especially during the midday hours, which are the hottest part of the day. If you do go outside, wear clothing that is loose-fitting, light-colored and lightweight, and take cool showers or baths.

    Also, make it a point to check in on at-risk friends and family members - particularly those who are elderly or may need additional assistance.


    Have any questions? Call 301-891-8080 to reach a MedStar Washington Hospital Center team member.

    Request an Appointment

  • July 21, 2016

    By John Steinberg, DPM

    If you or a loved one suffers from diabetes, you may be aware of one of the more troubling aspects of diabetes: limb loss. It's true that diabetes can have dramatic effects on the body's vascular system. Over time, diminished blood flow means that wounds to extremities, such as feet, legs and hands, heal more slowly. And in worst-case scenarios, this can mean the limb itself may be jeopardized.

    As a podiatric (foot and ankle) surgeon who specializes in preserving the limbs of diabetic patients – a field called limb salvage – I work with a team of specialists and our patients to implement a strategic plan to preserve the limb and restore healthy blood flow.

    But a key part of what I do is educating patients and their family members on the importance of prevention. Because if you can identify the signs of diabetic foot damage, you can work with your doctor to treat your limb as problems arise, and you're less likely to need limb salvage at a later date.

    The Hidden Dangers of Diabetes

    While many diabetic patients and their families know that limb loss from diabetes is possible, patients often don’t know how to spot symptoms they may be experiencing from diabetic limb damage.

    The three top signs of diabetic limb damage are:

    Neuropathy, or nerve damage, is one of the most important signs of diabetic foot damage. High or unstable blood sugar levels, over time, cause vascular changes that can choke off or damage nerves. Diabetic neuropathy first affects the body's smallest nerves, such as those in the hands, feet, eyes, and kidneys. Neuropathy initially feels like a pins-and-needles or tingling sensation, and with time it can become a burning feeling that can impede sleep. But in later stages, neuropathy can cause numbness, which is far more dangerous, because the diabetic can no longer feel pain in the limb. Since pain is an important sign of injury or infection, this can lead to serious complications.

    Vasculopathy, or peripheral arterial disease, is another significant complication. Diabetes can cause blockages in veins and especially arteries in diabetic patients. This can cause color changes or thinning of the skin, or atrophy. One of the most common signs of vasculopathy is pain when at rest or elevating the legs.

    Finally, diabetes can result in a compromised immune system, making fighting off infections – even routine ones – much more difficult. For example, what would otherwise be a small, trivial wound can fail to heal for a diabetic patient, creating a major infection. So it’s important to keep an eye on any changes in your ability to recover from injuries or infections.

    You may not consider any of these on their own as something that requires immediate medical attention, but they can point to serious problems down the road, if they’re not examined further by a doctor. But true prevention in this area means maintaining awareness around these signs and proactively seeking the care of a podiatrist, if and/or when they arise.

    Your podiatrist will be able to tell you if you’re experiencing something that’s part of a larger diabetic health issue and help you potentially mitigate the effects they have your life – that includes reducing the risk of future amputation.

    A Well-Integrated Team

    At MedStar Washington Hospital Center, the care we provide to our diabetic patients requires an integrated approach, involving professionals across several medical specialties. This increases our patients’ chances of preserving the affected limb. Infectious disease specialists, for example, prescribe antibiotics to help fight infections, and intensivists monitor the patient's medical status and optimize their nutrition for rapid healing.

    So if you are seeking comprehensive care for diabetic limb damage, look for a multidisciplinary team that takes this kind of integrated approach. Because while a podiatrist should be your first call if you’re experiencing symptoms, such as neuropathy or vasculopathy, a more dimensional set of experiences and skill sets will be needed to ensure the best possible outcomes for you or your family, if the symptoms are indeed a sign of diabetic limb damage.

    Have any questions?

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

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  • July 19, 2016

    By MedStar Health

    Growing up in a family of medical doctors, Susmeeta Sharma, MD, knew from an early age that she would one day become a physician too. Her dad was an anesthesiologist and her mother, an OB/GYN.

    "I’m not sure I’d be good at anything else,” she says with a laugh.

    As director of pituitary endocrinology at MedStar Pituitary Center at MedStar Washington Hospital Center, Dr. Sharma oversees the evaluation and treatment of pituitary and adrenal tumors, as well as other conditions such as prolactinoma, Cushing’s disease, acromegaly, and hormone deficiencies.

    "There’s a complexity and logic to evaluating pituitary disorders that I find appealing,” she says. “And the impact you can make on a patient’s well-being through diagnosis and treatment is rewarding.

    Before joining the MedStar Pituitary Center, Dr. Sharma completed a fellowship in reproductive and adult endocrinology focusing on pituitary and adrenal disorders at the National Institutes of Health (NIH). She then stayed on as a junior faculty member and the Chief of Outpatient Endocrinology at NIH.

    Dr. Sharma credits Lynnette Nieman, MD, a Senior Investigator and Chief of the Endocrinology Consultation Service at the NIH Clinical Center, for helping hone her research skills, which focus on pathogenesis and diagnosis of hormonally active pituitary tumors as well as development of non-surgical treatment modalities for management of pituitary tumors.

    Another key mentor was John E. Nestler, MD, now Chair of the Department of Internal Medicine at the VCU School of Medicine, where Dr. Sharma served her internship. Both physicians helped instill a love of mentoring young physicians along their path to clinical endocrinology and patient care—a commitment for which Dr. Sharma was recognized with the NIH Endocrinology fellowship program’s Dr. Phillip Gorden Distinguished Clinical Teacher Award, named for former director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

    Dr. Sharma hopes to develop research programs to complement those already underway at MedStar Georgetown University Hospital.

    "There are many avenues to explore, such as different types of tumors, and why various patient populations develop certain kinds and not others,” adds Dr. Sharma.

    Married to a cardiologist, Dr. Sharma practices her problem-solving skills at home by reading mysteries. She also enjoys gardening and cooking Indian food.

    Contact the MedStar Pituitary Center for more information or to schedule an appointment.

    202-877-3627

  • July 13, 2016

    By MedStar Health

    Erectile Dysfunction and Vascular Health

    At its core, erectile dysfunction is the disruption of a complex process that involves multiple systems in your body working together to increase blood flow. Though it is often identified as the primary problem, this can be a warning flag for underlying cardiovascular disease, even when other symptoms aren't immediately apparent.

    According to Lambros Stamatakis, MD, director of Urologic Oncology at MedStar Washington Hospital Center, “In younger men who present with ED, we are taught to consider a full cardiovascular evaluation, as coronary artery disease can often be identified despite the lack of symptoms.”

    This evaluation is especially important if the patient has no other typical risk factors, such as a known health condition, drug, alcohol or tobacco use, or injuries. A failure to respond to oral medications should also trigger concern that serious vascular diseases, such as atherosclerosis (hardening or narrowing of the arteries), may be to blame.

    If You Are Suffering from Erectile Dysfunction

    If you struggle with erectile dysfunction, the best course of action is to discuss the concern with your physician, or a specialist, such as a urologist. To prepare for your appointment, consider writing down any other health symptoms you've had – even if they may not appear related to your condition, at first glance.

    In addition, note any other risk factors, such as the use of tobacco or alcohol, or recent injuries, as well as the name of all medications and supplements you're taking. Also, you should make note of any significant life changes that may be causing you stress. While vascular disease may be your immediate concern, you should provide as much information as possible, so all root causes can be given due consideration.

    However, if your physician doesn't specifically mention vascular health as part of the conversation around your erectile dysfunction symptoms, ask him or her about any possible connection. Share any particular reasons for concern, such as recurring symptoms of ED, high blood pressure or a family history of cardiovascular disease.

    Final Thought

    While not everyone who has erectile dysfunction will also have a vascular disease, it is important to be aware of the connection between the two. If you are someone who struggles with the symptoms of erectile dysfunction, make it a priority to seek medical attention and be evaluated appropriately. Not only will you be helping your personal relationships, you will also be taking a proactive step to protect your own vascular health.

    Have any questions?

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

  • July 13, 2016

    By MedStar Health

    A former MedStar Washington Hospital Center nurse saved the day for an elderly man who fell ill in the audience at the Folger Theatre performance in DC. From an upper-level theater seat, Michelle Michaels, NP, who worked on our heart failure unit until about a year ago, saw the man in distress and called 911.