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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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  • October 10, 2018

    By MedStar Health

    Teens today seem to experience depression and anxiety more than ever before. While social pressure to make friends and get along with others in school has always played a role in mental health, today’s teens face unique challenges because of technological developments, like social media, that allow for constant interpersonal exchanges without natural downtime.

    We can see social media’s impact on teen depression and anxiety, as it can cause:

    • Pressure to fit in: Teens’ desire to fit in with classmates can be magnified by social media, as they naturally can compare themselves to their peers who post pictures of themselves at social events, such as concerts or birthday parties.
    • Cyberbullying: Bullying can go to the next level with social media, as teens can message one another instantly and spread secrets or other information to classmates much more easily.
    • Decreased social skills: Social media can make it easy for teens to stay home and rely on online interactions rather than real life ones. As a result, teens can miss out on learning important social skills.

    Parents often feel confused because some of these effects are similar to common adolescent behaviors. However, there are key symptoms parents should look for to reduce risks associated with anxiety and depression, and red flags that a teen needs behavioral health care.

    Low energy, trouble sleeping, and irritability are three symptoms of #Depression and #Anxiety in #Teens. Learn how parents can help and when to seek medical attention. via @MedStarHealth

    Click to Tweet

    Spotting symptoms of depression and anxiety

    Depression is continuous or cyclical severe despondency and dejection; anxiety is feeling worried, nervous, or uneasy without a specific cause, or about events over which the teen has no control. Some parents report that their children make negative comments about themselves, such as, "I'm stupid,” “School is dumb or boring,” or “I'm just not as good as the other kids."

    Other symptoms of depression and anxiety can include:

    • Irritability
    • Low energy
    • Lack of interest in favorite activities
    • Risk-taking behaviors, such as drug use, dangerous driving, or self-harm
    • Trouble sleeping

    Repeated behavior for weeks or months is a key way to differentiate typical teenage mood swings from depression or anxiety. For example, if you notice your teen waking up late and hardly getting out of bed on the weekends, look for patterns or triggers to determine whether this is routine behavior or out of the ordinary for your child. If these behaviors seem to be out of the ordinary, consider talking to your child’s doctor.

    Tips for parents, and how a doctor can help

    When it comes to social media, we often suggest that parents monitor their child’s usage to help them avoid the implications it can have to their mental health. The American Academy of Pediatrics and Family Practice suggests no more than two hours of screen time (cell phones, laptops, etc.) per day, and none at night. A good tip for helping limit the use is to ask your child to keep their phone in the kitchen at night. Additionally, make sure you have access to your child’s phone so you have the ability to monitor what apps they’re using or websites they’re visiting.

    If you visit with a family doctor, we typically act as a “central dispatch.” You can bring your problems to us, and we will help you create a path based on where you and your child want to go. This can include meeting with a therapist and receiving behavioral therapy, taking medication, or making lifestyle modifications that can help relieve symptoms of depression and anxiety. Some helpful lifestyle modifications may include:

    • Eating a healthy diet
    • Exercising at least 30 minutes a day, four days a week
    • Sleeping eight to 10 hours per night

    As parents, one of our most important roles is to help our children love themselves. If something seems off with your teen’s mental health, don’t hesitate to speak to them about it and seek medical attention, when necessary.

    Want to learn more about our behavioral health services? Click the button below to view the list of our services.

    Learn More

  • October 09, 2018

    By Patricia B. Wehner, MD

    Ductal carcinoma in situ (DCIS) is the earliest form of breast cancer. DCIS is confined to the milk ducts of the breast, and it’s often considered “stage zero.” Each year, 51,000 women are diagnosed with DCIS during their mammogram.

    Women naturally feel anxious when they learn they have DCIS breast cancer. However, DCIS is different from more aggressive cancers—it is highly treatable. For the majority of patients, the primary concern with DCIS is whether it returns after treatment and, if it does, whether it spreads beyond the milk ducts. It’s important to seek treatment for DCIS, and patients today have more options than ever.

    Years ago, we treated most forms of breast cancer with mastectomy, which removed cancer cells but also removed the entire breast and required women to undergo chemotherapy and radiation therapy. Today, we know more about DCIS and can offer women a broader range of treatment options—including the potential to avoid surgery all together.

    LISTEN: Dr. Patricia Wehner discusses DCIS breast cancer treatment in the Medical Intel podcast.

    How is DCIS detected?

    Age is the most important risk factor for developing breast cancer. The older a woman is, the greater her risk. As such, DCIS often is diagnosed later in life during a woman’s annual mammogram, which is a breast health check-up and a screening for potential breast cancer.

    DCIS can appear as little white dots on the mammogram imaging. If the dots are new, increasing in size, or clustered together, it could indicate that DCIS is present. The doctor may recommend a minimally invasive needle biopsy, in which we numb the area of the breast that potentially contains DCIS and remove a small sample of breast tissue. Under a microscope, a pathologist will determine whether the dots indicate cancer or a benign condition such as calcium deposits.

    If we diagnose DCIS, we will recommend a few more tests to help us start a conversation with patients about what type of treatment is best for them.

    How is DCIS treated?

    The standard treatment is a team approach. In the lab, we’ll test the breast tissue to determine whether the cancer has hormone receptors. If it does, patients have the option to take an anti-hormone medication to treat the cancer.

    If the affected area of the breast is small, we generally can remove it by doing a partial mastectomy, or a lumpectomy, in which we remove only the cancerous tissue and a small portion of healthy tissue that surrounded the cancer. We generally recommend radiation therapy after a lumpectomy, which generally starts a month after surgery and continues for three to six weeks. Radiation is localized to treat just the cancer site and, in combination with surgery, can reduce the risk that the cancer will return.

    We do not use chemotherapy to treat DCIS. It affects the whole body, and the negative side effects outweigh the benefits for this type of cancer. Radiation therapy reduces the risk of DCIS coming back by about 50 percent.

    Observation alone might also be an option for patients with low-risk DCIS. We are involved in the COMET trial, in which women are given mammograms every six months to check for changes in the cancer. The goal is to determine whether more women can avoid breast surgery and effectively manage DCIS through monitoring only.

    A new trial, called COMET, is looking at whether women with low-risk #DCIS #breastcancer can avoid #breastsurgery through active surveillance. bit.ly/2NwWMB1 via @MedStarWHC

    Click to Tweet

    What can women expect during recovery?

    Most patients who have a partial mastectomy can go home the day of surgery. Patients wear a bandage to cover the incision on their breast and a supportive bra that we recommend wearing for a week after surgery to support the breast. Many patients use prescribed pain medication for just a day or two after surgery, and patients have very few restrictions during recovery.

    Being diagnosed with any type of cancer is scary. Thankfully, women with DCIS have several options to treat the cancer and reduce the risk that it will return.

    Call 202-877-3627 or click below to make an appointment with a breast cancer specialist.

    Request an Appointment

  • October 04, 2018

    By MedStar Health Research Institute

    Research Grand Rounds are sponsored by MedStar Health Research Institute and Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) and bring together the MedStar Health community for a learning experience focusing on a different topic each month.

    Addressing the Opioid Crisis: Strategies for Engaging and Retaining Persons with Opioid Use Disorder in Effective Treatment
    Richard Schottenfeld, MD
    Professor and Chair of Psychiatry and Behavioral Sciences, Howard University

    November 2, 2018
    12 Noon to 1 PM – Presentation
    1 PM to 1:30 PM – Lunch
    MedStar Washington Hospital Center, 6th Floor, CTEC Theater
    110 Irving Street, NW, Washington, D.C., 20010

    Live-Stream Link: http://georgetownu.adobeconnect.com/mhri

    Research Grand Rounds are open to all members of the research team, from principal investigators to clinical and research coordinators and trainees. Topics covered in the Research Grand Rounds range from community-focused research to best practices and are intended to increase collaboration within the research community in and outside of MedStar Health. View the currently scheduled 2018-2019 Grand Rounds.

    For more information, please contact Research@medstar.net or visit http://www.georgetownhowardctsa.org.

  • October 04, 2018

    By MedStar Health Research Institute

    Open Enrollment for 2019 benefits starts next month. This is your opportunity to choose benefits for you and your family. From October 30 through November 19, 2018, you will have the option to review your current benefit selections and determine which coverage best meets your needs for 2019. You may enroll in medical, dental and vision plans; flexible spending accounts; supplemental life insurance; supplemental accidental death and dismemberment (AD&D) insurance; dependent life coverage; legal resources; and voluntary benefits during Open Enrollment.

    Enrollment Process

    Associates must enroll online at myHR, where they have access to an updated enrollment site with a new look and feel, as well as features to help them choose the right level of coverage and covered dependents. If associates want to keep their current benefits for 2018, they do not need to enroll online. All 2018 benefit selections and enrolled dependents will roll over to 2019, except for Flexible Spending Account elections. Associates must enroll each year to participate in these accounts.  

    Changes for 2019

    • Medical premiums—Medical plan premiums are increasing slightly
    • Emergency care copay—The copay for emergency care is increasing from $125 to $250 for both the MedStar Select and CareFirst medical plans.

    Benefits fairs are scheduled throughout the system beginning October 29 through November 14, 2018. Representatives from our retirement plan (Fidelity), voluntary benefits (The Warner Company), and our internal benefits team will be present at the fairs for questions and conversations. Looking for more information about the total rewards package offered to you and your dependants? Take some time to attend a benefits fair and learn more. The full schedule of fairs is available here.

  • October 04, 2018

    By MedStar Health Research Institute

    The MedStar Health Research Institute (MHRI) is offering a one-day orientation session on Tuesday, November 13, focused on conducting research at MedStar Health. This orientation session is for both early-career investigators as well as experienced investigators who recently moved to MedStar who wish to learn more about the services and resources available for every stage of the research lifecycle.

    This 1-day orientation helps both experienced and early-career investigators learn to successfully conduct research within the MedStar system and access the research support services available from MedStar Health Research Institute (MHRI). Topics include:

    • An overview of the core business and research support services available to you
    • Tips and tools for finding funding and research collaborators
    • Research informatics and statistical support
    • The IRB process
    • An overview of study contracting mechanisms and financial management procedures
    • Answers to the most frequently asked compliance questions
    • Best practices for effective proposal preparation and submission

    Tuesday, November 13
    8:00am – 4:00pm
    MHRI Administrative Offices at University Town Center
    6525 Belcrest Road, Suite 700
    Hyattsville, MD 20782

    Please email Research@MedStar.net to RSVP.
    Note: breakfast and lunch will be provided.

    Orientation occurs twice per year, in the spring and fall. If you have any questions about this program, please contact us at research@medstar.net.

  • October 04, 2018

    By MedStar Health Research Institute

    An analysis led by MedStar researchers to evaluate two options for Transcatheter aortic valve replacement (TAVR) was recently published in Circulation. The study, “Hemodynamic and Echocardiographic Comparison of the Lotus and CoreValve Transcatheter Aortic Valves in Patients With High and Extreme Surgical Risk: An Analysis From the REPRISE III Randomized Controlled Trial,” compared the valve hemodynamics and the impact on outcomes for patients who were part of the REPRISE III clinical trial after one year.

    Federico M. Asch, MD from MedStar Cardiovascular Research Network and the MedStar Health Research Institute was the lead author on the paper which was done in collaboration with researchers from Piedmont Marcus Heart Valve Center, Cedars-Sinai Medical Center, Luke’s Medical Center, DeBakey Heart and Vascular Center, Boston Scientific Corporation, and Northshore University Health System.

    The REPRISE III (Repositionable Percutaneous Replacement of Stenotic Aortic Valve through Implantation of Lotus Valve System – Randomized Clinical Evaluation) study is a multicenter, randomized clinical trial evaluating two transcatheter aortic valve replacement devices, the mechanically expanded Lotus and the self-expanding CoreValve. The Lotus Valve System is a mechanically expanded, fully repositionable and retrievable valve. The CoreValve is a self-expanding valve.

    The primary effectiveness endpoint for the trial was the composite one-year rate of all-cause mortality, disabling stroke, and moderate or greater paravalvular aortic regurgitation (blood flowing between the structure of the implanted valve and cardiac tissue as a result of a lack of appropriate sealing) based on core laboratory assessment by the Cardiovascular Core Laboratories at the MedStar Health Research Institute.

    The study enrolled 912 patients who were considered high or extreme surgical risk. The patients were evaluated at four points in the first-year after the procedure, with plans for annual follow-up over an additional four years.

    The study did find that the Lotus had significantly greater freedom from moderate or severe paravalvular leak and smaller valve area and higher gradients than CoreValve. The CoreValve did have a better hemodynamic profile, though the study concluded that both valves were favorable. The study found no statistically significant differences between the two groups in any of the clinical baseline characteristics. The hemodynamic differences between the two valves did not translate into worse clinical outcomes.

    Dr. Asch is Director of the Echocardiography Core Lab at MedStar Health Research Institute and Associate Professor of Medicine (Cardiology) at Georgetown University. 

    Circulation, 2018. DOI: 10.1161/CIRCULATIONAHA.118.034129