MedStar Health Blog
Featured Blog
-
January 14, 2022Whether 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 Sun2. 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 Skin4. 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:
- Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
- Apply cream or ointment to your skin.
- 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.
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
Featured categories
Browse blogs by hospital
Share this
All Blogs
-
January 22, 2019When the first minimally invasive surgery—also called laparoscopic surgery—was performed in the early 1900s, a surgeon would use a hollow wooden tube with a candle to look in a patient’s body through a small incision. Nobody could have imagined the impact it would have.
By the early 1990s, surgeons operated every day through small incisions with what was then a new tool called a laparoscope, which is a slender tube with a tiny video camera and a light on the end. Today, minimally invasive surgery has expanded through the use of robotic technology to include intricate thoracic surgeries for lung conditions, esophageal problems, and other thoracic conditions. What a difference 100 years makes!
The robotic technology our surgeons use includes a camera and mechanical arms with surgical instruments attached. The console also provides a surgeon with a more enhanced, 3-D view for the surgery. Nothing is automated, so the surgeon is still in total control through the use of a console. The robot helps doctors perform safer, more precise surgeries that result in:
- Quicker recoveries
- Less pain
- Smaller incisions/less scarring
- Lower risk of infection
For thoracic surgery, which includes everything in the thorax (the part of the body between the neck and the abdomen), we treat both cancerous and benign conditions. The most common surgery I perform related to the esophagus is for paraoesophageal hernias and gastroesophageal reflux disease, also known as GERD. We also treat lung cancer and various benign diseases of the mediastinum, or the mass of tissues and organs separating the sternum in front and the vertebral column behind.
LISTEN: Dr. Lazar discusses minimally invasive robotic technology in the Medical Intel podcast.
Recovery from minimally invasive robotic surgery
Patients typically have less pain after a minimally invasive robotic surgery than after a traditional open surgery because the incisions are smaller. Traditional surgery usually involves a large incision, anywhere from six to 12 inches. Robotic assisted minimally invasive surgery is what we call a port-based surgery. For the patient, this means less pain and better incision healing since the instruments used in the operation pass from outside the body to inside through the port without injuring the muscle and skin. This often results in patients taking less narcotics and getting back to their daily lives quicker.
Most people recovering from traditional surgery are in the intensive care unit (ICU) anywhere from one to five days, whereas those who have robotic surgery typically don’t need to go to the ICU at all. They’re walking up the stairs, eating, and drinking by the next day or so. Usually a patient’s biggest complaint is they’re a little bit sore, but nothing compared to open surgery. A patient is typically at least 90 percent better 10 to 14 days after surgery.
The thoracic surgeons at MedStar Washington Hospital Center are outstanding. Everyone is committed to patients’ well-being and we have many years of experience performing minimally invasive robotic surgeries. Advances in surgery have brought us from a time where small incisions for operation were risky to being practiced regularly with the assistance of robotic technology. Imagine what the next 100 years could bring!
If you are interested in learning more about robotic thoracic surgery, call 202-877-3627 or click below to make an appointment.
Request an Appointment
-
-
January 18, 2019Physicians regularly make a difference in the lives of their patients. For Meghan MacCleary, DO, it was the other way around.
The Arizona native had initially ruled out obstetrics and gynecology as a career when she enrolled in the Arizona College of Osteopathic Medicine. But an obstetrics rotation changed that.
"I met and got to know the patients quite well, while learning a lot of interesting techniques and procedures,” Dr. MacCleary says. “Women’s health had always been important to me, and it was quite rewarding to be caring for women at a particularly vulnerable time.
By the end of her rotation, Dr. MacCleary says, “I was sold.”
Work at the Hospital Center
While in medical school, Dr. MacCleary was elected to Sigma Phi, the national osteopathic medicine honors fraternity. She then came to MedStar Washington Hospital Center and MedStar Georgetown University Hospital for her residency in Obstetrics & Gynecology. That experience was punctuated by opportunities to to give presentations on high-risk pregnancy at several conferences, and a year serving as Chief Resident.
In addition, Dr. MacCleary was named the Hospital Center’s 2016 Maternal Fetal Medicine resident of the year, and received the Department of Obstetrics & Gynecology’s Peterson Award, presented to the graduating resident who represents the best educator and patient advocate.
Now as an attending physician at the Hospital Center, Dr. MacCleary enjoys the diversity her work brings.
"You never know what’s going to happen,” she says of a typical day. “I may see patients in my office in the morning and perform c-section deliveries in the afternoon. Every patient is different, and brings a new challenge.”
Being an Ob/Gyn also allows Dr. MacCleary opportunities to consult and collaborate with colleagues in different parts of the Hospital Center. “I get to see more of what’s happening in medicine,” she adds.
Outside the Hospital
Dr. MacCleary’s already-busy life will become busier in March, when she marries another Ob/Gyn who’s currently finishing his residency. Together, they enjoy hiking, trying out restaurants, wineries and craft breweries. The couple have also brewed several varieties of beer on their own, including a Belgian wheat and a Scotch Ale.
“It’s good to have a lot of mutual interests,” she says, “but I’m sure we’ll find ourselves talking about work and medicine a lot.”
-
January 15, 2019Total joint replacement, comprised of hip or knee replacements, is one of the most common surgical procedures in the U.S. These devices have given millions of people continued or increased activity and mobility even as they age— they’ve gotten a new lease on life.
Now, younger people are seeking primary joint replacements. Many of them are active and want to live pain-free to work and do more into their golden years. These devices may last a lifetime post-surgery, but people increasingly need to have them replaced due to instability or wear and tear.
As such, we’re seeing an increase in the number of total joint revision surgeries in younger adults. This procedure is the replacement of a total knee or hip device. Total joint revision can restore or even improve mobility for decades. By 2030, total hip replacement revisions will reach 72,000 (a 142 percent increase), and total knee replacement revisions will reach 120,000 (a 190 percent increase), according to data from the American Academy of Orthopaedic Surgeons.
Most patients who are living with total joint replacements and who develop pain or instability are candidates for total joint revision. A revised knee or hip can give some patients up to another 30 years or more of the improved activity that they’ve gotten used to.
LISTEN: Dr. Savyasachi Thakkar discusses total joint hip or knee revision in the Medical Intel podcast.
Signs a patient might need total joint revision
A patient might need a revision if their implant fails because of wear and tear with subsequent loosening of the device. Less common causes of implant failure are infection, fracture or stiffness. Patients usually first notice one or two indicators when a knee or hip implant needs to be replaced:
- Instability: After having a stable, pain-free joint, patients find they’re tripping or falling more. Sometimes they need a cane or walker to get around.
- New or worsened pain: They may notice a specific incidence that is associated with the pain. This sometimes leads to increased reliance on pain medications.
Most of our patients seeking a revision hip or a revision knee replacement are 60 to 70 years old. They’ve had their primary hip or knee for 15 or 20 years, and they’re typically active individuals who want to live pain-free with the maximum mobility they can.
How long do knee or hip replacements and revisions last?
This is largely dependent upon the particular patient and the type of implant they received. Older implants often would last only about 10 or 15 years. Current primary knee or hip replacements last an average of 20 to 30 years.
Typically, revised joint devices don’t last as long as primary joint devices. On the higher end, they last 20 to 25 years. As people tend to live longer, we may need to revise their knee or hip joint more than once. However, re-revisions happen less commonly as devices continue to improve.
What should total joint revision patients expect?
First and foremost, we need to understand why the primary joint device needs to be replaced, whether it is from a fracture, wear and tear or some other reason. Total joint knee or hip revisions tend to be more complicated than first-time replacements, and many doctors who perform initial joint replacements refer patients to experts for revision surgery. We often see patients who are referred to us from the surgeons who performed their initial joint replacement surgeries.
Our work for total joint revisions is centered on learning patient’s expectations. We have conversations about their usual activity level and their hopes for what they’d like to be able to do after surgery.
Second, we learn their overall physical condition in collaboration with our experts in cardiology, neurosurgery and other specialties. Many of our patients are older and some have complex needs or other concurrent conditions. It’s important to care for each patient as a whole, not just the knee or hip that we’re replacing.
Next, we create a detailed medical plan for the patient, which spans from pre-surgery imaging to post-surgery recovery and includes:
- Dedicated imaging studies focused on X-rays, computed tomography (CT) scans and sometimes magnetic resonance imaging (MRI) scans to get detailed information as to why that joint replacement prosthesis has failed
- Blood work to make sure there’s no infection
- Surgical planning, including assessment of the appropriate implant
- Physical therapy evaluation to assess the patient’s mobility before surgery
- Anesthetic protocols for the surgery
- Multimodal pain control post-surgery
Most patients who have a single knee or a single hip revised can go home and have an outpatient physical therapist visit them for the first two weeks after surgery. Then they can transition to outpatient physical therapy. However, if a patient’s recovery needs are more significant, they can go to a rehabilitation facility for the week or two after surgery and then transition home.
Recovery time from a total knee or hip revision will depend on the reason for the revision. For example, if the revision is for a simple bearing surface that has worn out, recovery will not be lengthy. However, if the revision is for a more significant problem, such as an infection or a fracture, the period of recovery may last three to six months. After that time, most patients come back to their pre-revision activity level and even surpass that because there’s relief from instability or pain.
Tips for patients with total joint revisions
Total joint devices are mechanical objects, which means they’re subject to failure. However, one of the things that we routinely discuss with patients is to use these joints for the maximum activity with which they are comfortable. The device is working as it should when they can take part in their normal daily activities without compromising on pain or worrying about instability.
Patients who have a total joint replacement and have developed an issue should never ignore new symptoms. For example, we saw a patient who was being treated for lupus, an autoimmune disorder. This patient had undergone several hip replacement surgeries that had failed due to instability issues. We identified and then replaced a certain component that had worn out in the prosthesis. Today, the patient is back to regular daily activities.
We recommend primary and revision knee and hip replacements be checked regularly, continuing in the years after surgery, even if the joint feels good. It’s better to check for early loosening of the implant or another minor problem before it causes a bigger problem. And if you ever develop pain, instability or another issue with your joint, get an appointment right away.
For many patients, a total joint revision can give them their lives back. They can do the things they love without pain and instability. It truly is a second chance to live the kind of lives they want to lead, and we’re proud to play a part in their successes.
Call 202-877-3627 or click below to make an appointment with a joint revision specialist.
-
-
January 08, 2019A vasectomy is one way men can prevent their partners from becoming pregnant—without affecting sexual function or the ability to orgasm.
A vasectomy is a noninvasive surgery that prohibits sperm from being delivered to a partner by cutting off the small tubes in a man’s scrotum that carry sperm. The procedure is quick and effective—in fact, it prevents pregnancy nearly 100 percent of the time. Let’s go through some of the questions patients commonly ask us about this safe, effective birth control procedure and get some answers.
LISTEN: Dr. Venkatesan discusses vasectomies in the Medical Intel podcast.
Who is a candidate for vasectomy?
Practically all sexually active men are good candidates, although we most often treat those in their 30s to early 50s. These men typically have children and are in stable relationships where they’ve mutually agreed with their partner to have a vasectomy. We occasionally see single fathers, however, who have decided they don’t want any more children.
Rare cases when men aren’t considered candidates include those who have had surgery to their testicles, either to bring an undescended testicle down during childhood or to fix their spermatic cord (which supports the testicle in the scrotum), and those who have had a hernia surgery, as they can cause the surgery to be less effective.
At MedStar Washington Hospital Center, we perform at least 50 to 100 vasectomies per year. The popularity likely is due to the fact that vasectomies allow patients to:
- Go home the same day of surgery with minimal pain
- Stop using other less convenient forms of birth control, such as oral contraceptive pills or condoms
- Receive a much easier treatment than a female partner could have, such as a tubal ligation surgery, or when women have their “tubes tied”
How does a vasectomy work?
A vasectomy involves six steps:
- Identify the vas deferens—a tube that delivers sperm from the testicles to the urethra—which starts at the top of the scrotum.
- Bring the vas deferens out through a small incision in the skin.
- Cut out a small segment of it.
- Burn each side of the vas deferens on the inside.
- Tie off each end and fold them away from each other.
- Put them back into the scrotum in different tissue layers to help ensure the tubes don’t reconnect.
Although a vasectomy can be reversed, it is intended to be permanent. Only select surgeons have experience doing reversals, and it’s usually not covered by insurance.
What can I expect during recovery from a vasectomy?
Sperm count
Men must understand that they aren’t immediately sterile after surgery. Because the body constantly produces sperm, some sperm will remain from where we cut the vas deferens. As a result, patients should refrain from sexual intercourse for two weeks. After that, they can resume sexual activity but must use contraception—condoms or oral contraceptives with their partner—for another six weeks.
At the eight-week mark, patients usually will have a doctor’s visit to ensure they’ve healed and provide a semen sample to make sure they have no sperm count. If this checks out OK, patients are cleared to stop birth control if they desire.Pain and activity restrictions
Recovery is relatively easy in terms of pain and getting back to everyday activities. We’ll typically do vasectomies later in the week so patients can recover over the weekend. Patients might be sore for a few days, but they generally resume all activities one to two weeks after the procedure.
Patients might need medication, but it depends on their pain tolerance. Oftentimes, Tylenol or ibuprofen can be sufficient, but narcotic pain medication also is available if needed. Additionally, we recommend that men put ice packs on their incisions for the first few days to help them feel more comfortable.Are there any risks from having a vasectomy?
A vasectomy has some risks, just like any other surgery. This includes the risk of infection and bleeding, as well as injuring organs, nerves, or veins, which could result in chronic pain in the testicle. Patients also could become fertile again if the two ends of the vas deferens somehow remain connected or find their way back to each other and reconnect. However, it’s important to understand that these risks are very low.
Birth control can come in many forms. However, not all options can provide nearly 100 percent accuracy like a vasectomy.
Call 202-877-3627 or click below to make an appointment with a urologist.
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100
- 101
- 102
- 103
- 104
- 105
- 106
- 107
- 108
- 109
- 110
- 111
- 112
- 113
- 114
- 115
- 116
- 117
- 118
- 119
- 120
- 121
- 122
- 123
- 124
- 125
- 126
- 127
- 128
- 129
- 130
- 131
- 132
- 133
- 134
- 135
- 136
- 137
- 138
- 139
- 140
- 141
- 142
- 143
- 144
- 145
- 146
- 147
- 148
- 149
- 150
- 151
- 152
- 153
- 154
- 155
- 156
- 157
- 158
- 159
- 160
- 161
- 162
- 163
- 164
- 165
- 166
- 167
- 168
- 169
- 170
- 171
- 172
- 173
- 174
- 175
- 176
- 177
- 178
- 179
- 180
- 181
- 182
- 183
- 184
- 185
- 186
- 187
- 188
- 189
- 190
- 191
- 192
- 193
- 194
- 195
- 196
- 197
- 198
- 199
- 200
- 201
- 202
- 203
- 204
- 205
- 206
- 207
- 208
- 209
- 210
- 211
- 212
- 213
- 214
- 215
- 216
- 217
- 218
- 219
- 220
- 221
- 222
- 223
- 224
- 225
- 226
- 227
- 228
- 229
- 230
- 231
- 232
- 233
- 234
- 235
- 236
- 237
- 238
- 239
- 240
- 241
- 242
- 243
- 244
- 245
- 246
- 247
- 248
- 249
- 250
- 251
- 252
