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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 11, 2015

    By MedStar Health

    Safe Heart Trial Seeks Right Balance Between Survival and Safety

    In a clinical trial spanning two hospitals and two specialties, MedStar Health physicians are studying how to maximize the use of highly successful targeted therapies for HER2- positive breast cancer, while minimizing adverse affects on the heart. If successful, the investigator-initiated study could open the door to the life-prolonging cancer regimen for a subset of patients who are currently denied access to its benefits.

    The powerful class of cancer deterrents has an unintended, and unfortunate, consequence: 10 to 20 percent of those treated with the monoclonal antibody trastuzumab (Herceptin®) develop cardiovascular dysfunction. However, specialists have no way of knowing who might be affected.

    As a result, trastuzumab, pertuzumab (Perjeta®) and other newer, related therapies are contraindicated for patients presenting with even mildly decreased left ventricular ejection fraction (LVEF). If the LVEF of a patient on the therapy dips by 10 percent from his or her baseline, or drops at any time below 50 percent, treatment must be stopped.

    The dilemma lies in the lack of effective alternatives.

    “Until the late 1990s, patients with HER2- positive breast cancer, who comprise up to 20 percent of all cases, faced an aggressive form of disease and a poor outcome,” says Sandra M. Swain, MD, FACS, medical director of Washington Cancer Institute at MedStar Washington Hospital Center and principal investigator for study. “In trastuzumab, for the first time, we had a targeted treatment that worked wonders against most advanced and local disease. Yet its use was restricted because of its potential to harm the heart.”

    However, retrospective data and one small prospective study in patients with trastuzumab-induced cardiotoxicity have recently revealed that the damage is mostly short-lived and reversible. Those findings led Dr. Swain and her co-principal investigator Ana Barac, MD, PhD— a cardiologist at both the Hospital Center and MedStar Georgetown University Hospital, and director of the MedStar Heart & Vascular Institute’s Cardio-Oncology program—to wonder if intensive monitoring and care could maintain heart function well enough for patients with borderline cardiovascular disease to complete a full course of HER2-targeted therapy.

    In 2013, Drs. Swain, Barac and oncologist Filipa Lynce, MD, who wrote the protocol and received a grant from the American Society of Clinical Oncology for its implementation, launched SAFE-HEaRt to find out.

    In this investigator-initiated study, the team recruits breast cancer patients with HER2-positive disease and mildly decreased heart function as determined by an LVEF between 40 and 49 percent, a cohort normally contraindicated for HER2-targeted therapy. Patients who are already receiving HER2 therapy when their ejection fraction drops below the 50 percent threshold are also eligible. All candidates are further evaluated through a stress test, echocardiogram and other diagnostics to rule out those with ischemia, valve problems, active heart failure and other cardiovascular conditions.

    Trial participants follow a regimen of trastuzumab, pertuzumab and/or ado-trastuzumab emtansine (Kadcyla®)—alone or in combination, as dictated by stage of disease, along with standard cardiovascular monitoring and therapies, based upon extrapolation from heart failure trials. Approximately six weeks after starting cancer therapy, patients undergo another echocardiogram to check for changes in heart function, and are re-tested every three months thereafter. A final echocardiogram is administered six months after cancer therapy is completed. Throughout the study, all echocardiographic images are reviewed by MedStar Health Research Institute’s Cardiovascular Core Lab.

    “What sets SAFE-HEaRt apart is the involvement of cardiology from the very beginning,” says Dr. Barac, who notes the trial is the only one of its kind in the nation. “Patients are followed throughout the study by both cardiologists and oncologists. As a result, the study coordination requires a huge amount of effort from multiple, extremely dedicated individuals.”

    SAFE-HEaRt’s primary goal is to maintain or even improve each participant’s LVEF concurrent with HER2 therapy to assure the safest and most optimal outcomes from both standpoints. In the process, however, the research team will also describe correlations between specific imaging and biomarkers and cardiac events, which may help identify patients at higher risk for HER2 therapy-induced damage in the future.

    “Other studies continue to show that the monoclonal antibodies trastuzumab and pertuzumab produce a huge survival benefit for breast cancer patients with HER2-positive disease in either the advanced or adjuvant setting,” says Dr. Swain. Indeed, the latest report, appearing in the February 19 issue of The New England Journal of Medicine and authored by Dr. Swain, found a median survival increase of 16 months for advanced disease.

    “We hypothesize that these therapies are safe for patients with borderline or slightly diminished heart function when under a cardiologist’s care,” she concludes. “If we’re right, we can rewrite the treatment guidelines for HER-2 positive breast cancer, and prolong even more lives.”

    Clinical Trial Needs Candidates

    The SAFE-HEaRt team is seeking patients >18 years old, male or female, with HER2-positive breast cancer and mildly reduced LVEF. All patients will undergo additional cardiac testing before final selection. Those meeting requirements will be eligible to receive their planned HER2- targeted treatment, along with cardiac monitoring to safeguard their current and future health.

    For more information, please contact Ronla Prince, MPA, manager, Oncology Research, at 202-877-8839 or Click here to email us.

  • August 10, 2015

    By MedStar Health

    Expertise, Experience and Excellent Care of Cardiology Team Restore Heart Patient to Former Self

    Steven Jones, 61, could have lost his life when his unique mix of symptoms baffled another hospital. Fortunately, his wife, Sandra Swain, MD, medical director of Washington Cancer Institute at MedStar Washington Hospital Center, knew exactly what to do. Within hours, she had Steven transferred to the MedStar Heart & Vascular Institute at her place of work, where experts quickly revived hope and health.

    The drama began in the early hours of a wintery Wednesday morning, when Steven, who was cleaning up after the couple’s kitchen remodelers, finally called it quits for the day. Using strong chemicals, the retired Treasury Department executive was startled but not alarmed when his heart suddenly started pounding. Not feeling well, he blamed the noxious fumes, took some aspirin and went to bed.

    Before nodding off, however, Steven wisely woke his wife, to tell her about the incident. Soon afterward, his breathing became labored, prompting her to pack her husband in the car and head to the nearest emergency room.

    It was the right decision.

    Searching for Solutions

    The couple arrived at the closest hospital at 3 a.m., where hospital staff gave their new patient a nebulizer to help ease his breathing. They also performed an ECG to get a snapshot of how well his heart was functioning.

    But despite close monitoring and medication, Steven’s condition worsened. He lost consciousness and was placed on a ventilator, prompting the ever-more-anxious Dr. Swain to call colleagues at the Hospital Center. She was soon working with Andrew Shorr, MD, pulmonologist and medical director of the Hospital Center’s Medical Intensive Care Unit, on an emergency transfer for her husband.

    Her motivation wasn’t solely based on familiarity, but on facts: MedStar Washington Hospital Center, founding hospital of MedStar Heart & Vascular Institute, is a major referral center for the region’s most complex cases, highly respected in pulmonology and nationally ranked in cardiovascular care and surgery.

    Right Diagnosis, Right Treatment

    At 2 p.m. Thursday, Steven was admitted to the Hospital Center where Dr. Shorr was on duty.

    “Steven was clearly in shock, with low oxygen and blood pressure levels,” he says. “However, his symptoms didn’t fit the original hospital’s explanation of chemical inhalation. So we started from scratch to try to find the root of the problem.”

    In a breakthrough moment, one specialist detected a heart murmur, confirmed by a cardiologist. Throughout the evening, Steven underwent several sophisticated tests, including two different types of echocardiograms, to further define what was happening. By 10 p.m., the team had the right diagnosis: a sudden rupture of the mitral valve, which allowed extensive fluid to build up in his lungs.

    “Most of the cords that hold the valve flap in place ruptured, causing a torrential backward flow,” explains cardiac surgeon Ammar Bafi, MD, an expert in mitral valve repair. “While I’ve encountered this situation before, it’s quite rare.”

    And quite dangerous. Before Dr. Bafi could repair the valve, Jones needed an intra-aortic balloon pump to stabilize his heart. That was inserted at 2 a.m. Four and a half hours later, Dr. Bafi successfully removed the damaged part of Steven’s valve, reconstructing what was left using the patient’s own tissue. He then inserted a ring, the only foreign material used in the procedure, to narrow the opening so the valve leaflets could close perfectly.

    “Steven was very lucky,” Dr. Bafi says today. “The other hospital may not have discovered the real problem in time, or have had the right resources and staff to mobilize quickly, 24 hours a day.”

    But the expertise and experience of Dr. Bafi and the team were the real keys to Steven’s successful recovery, and to Dr. Swain’s personal appreciation of MedStar Washington Hospital Center.

    “MedStar Heart & Vascular Institute is a fabulous place with extremely professional, engaged and passionate people,” she states. “Though I knew from everyone else that the whole surgical team was exceptional, I was just amazed.”

    Steven wholeheartedly agrees.

    “I was on the edge of death and, without batting an eye, they figured it out, fixed it, and within days, I was up walking around,” he says. “I am forever grateful.”

    To learn more about the MedStar Heart & Vascular Institute, please call 202-877-3627.

    Record-Breaking $10 Million Gift Transformative for New Heart Hospital

    On May 28, MedStar Washington Hospital Center announced the single largest gift in MedStar Health’s history: $10 million from Nancy and Harold Zirkin, designated for the new Heart Hospital. The world-class, 164- bed facility, to be completed next summer, will be the first and only in the nation’s capital dedicated exclusively to cardiovascular health.

    “Nancy and I share an abiding respect for this city, where we have enjoyed success in our careers,” says Mr. Zirkin, a third-generation Washingtonian who was only 15 when his father died from a heart attack. “So when we learned about the vision of MedStar Heart & Vascular Institute, and its important alliance with Cleveland Clinic, we saw an ideal opportunity to share our success in a way that would benefit the entire community.”

    “We are deeply grateful for the Zirkins’ generosity,” says Hospital Center President John Sullivan. “This gift will make a huge difference in the lives of the people in our region and beyond for many years to come.”

  • August 04, 2015

    By MedStar Health

    New Glaucoma Surgery Provides Less Risk

    glaucoma-surgery-mwhcGlaucoma is a leading cause of blindness in the United States. While medication can help, surgery is sometimes necessary. New, minimally invasive glaucoma surgeries can be done at the same time as standard cataract surgery and provide significantly less risk than traditional glaucoma surgery. Some involve the placement of a tiny stent in the eye, while others use endoscopic laser.

    Many patients who have been on glaucoma medication for years are able to reduce, and in some cases, eliminate their need for these medications after surgery, says Mark Gonzalez, MD, ophthalmologist with the MedStar Eye Institute.

    For an appointment with one of our ophthalmologists, call
    202-877-3627.

    Don’t miss other Medical Intel segments featuring MedStar Washington Hospital Center physicians, airing Mondays at 7:27 a.m. on WTOP 103.5 FM.

    Visit MedStarWashington.org/Intel to catch up on past segments.

  • August 04, 2015

    By MedStar Health

    Body contouring surgery is often the next step for patients who have had a dramatic weight loss. This surgery removes hanging skin and stored fat deposits that remain after weight loss surgery. Board-certified plastic and reconstructive surgeons are the best choice for the best results.
  • August 04, 2015

    By MedStar Health

    Treatment of the incontinence and prolapse enables them to regain their confidence, engage in social activities and exercise comfortably again.
  • August 04, 2015

    By MedStar Health

    That “phantom pebble” and its accompanying pain may not be your imagination, but rather a common condition known as Morton's neuroma. Most often found in the spaces near the second or third toe, Morton's neuroma results from a swelling of a nerve or adjacent tissue.