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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.
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    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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  • June 28, 2021

    By MedStar Health

    Did you know that the average adult loses around 100 hairs each day? This amount of hair loss is a perfectly normal part of the hair growth cycle, in which follicles continually shed old hairs and grow new hairs.

    This normal hair loss isn’t generally noticeable, but when it accelerates, it can become a concern. According to the American Hair Loss Association, about 85 percent of American men are balding; over 50 percent of women are likewise experiencing some level of hair loss.

    For many people, this can be emotionally distressing. But hair loss can happen for a variety of reasons—many of them treatable with help from a medical professional who specializes in this condition.

    Frequently, patients will come to me saying that they’ve already received a diagnosis of alopecia. But the term “alopecia” simply indicates hair loss. In order to strategize effective treatment, I work with the patient to determine the precise type of hair loss they may be experiencing, and to rule out any potential health problems that might be causing or aggravating the condition.

    A typical consultation includes a complete medical history and a physical examination of the area of hair loss. Sometimes, blood tests may be needed to determine if an underlying problem, such as a thyroid condition, anemia, or a vitamin deficiency, might be involved. In some instances, a scalp biopsy may be done to help establish a diagnosis and particular cause for hair loss.

    Causes of Hair Loss

    Hair is produced from structures known as follicles in the outermost layer of skin. At birth, we already have our lifetime supply of hair follicles—an average of about five million! The scalp itself has approximately 100,000 of these follicles.

    Like skin cells, individual hairs grow, rest, and shed in a continual cycle throughout our lives. Hair loss occurs when something disrupts that normal cycle. Common disruptors include:

    • Androgenetic alopecia: a hormonally induced hereditary type of hair loss that causes pattern baldness
    • Alopecia areata: an autoimmune disorder in which the immune system attacks and shrinks hair follicles, rendering them inactive
    • Telogen effluvium: sudden, usually temporary loss of hair that may be caused by physical or psychological stress
    • Certain medications
    • A nutritional imbalance, particularly of iron or vitamin D
    • Physical trauma, such as continual hair pulling or long-term wear of tight hairstyles
    • Advancing age, which slows skin growth and causes scalp hair to thin
    • Hormonal imbalance, such as a thyroid condition or polycystic ovary disease
    • Other genetic and autoimmune conditions
    Hair loss can be caused by a number of things and is frequently treatable. For best results, work with a medical professional specializing in hair loss. Advice from Dr. Monique Chheda, dermatologist https://bit.ly/2U6fyYD via @MedStarWHC
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    Androgenetic Alopecia

    Worldwide, the most common and widely recognized form of hair loss is androgenetic alopecia, or pattern baldness. Caused by a variety of factors related to a patient’s hormones, this type of alopecia can affect both men and women.

    In men, it causes a characteristic pattern of overall thinning, receding hairline, and loss of hair on the crown (the very top of the head). The loss of hair may begin at any time, but most typically in a man’s 30s. In women, the thinning is generally more subtle but can also cause a visible widening of the hair parts.

    Although pattern baldness shrinks hair follicles, the follicles are not permanently damaged and often respond well to medical treatment.

    We often first try a prescription-strength formulation of Rogaine® (minoxidil), applied directly to the scalp. Generally well tolerated, Rogaine has proven safe over decades. Rogaine is also available as a pill, and can be used when topical Rogaine does not work or is too cumbersome to use. Use of minoxidil is a long-term commitment—the hair will stop growing if the patient stops using it.

    Other oral medications may gradually help to restore hair growth as well. Propecia® (finasteride) can help regrow hair in men with pattern baldness. It’s well tolerated and, like minoxidil, is a long-term treatment. Aldactone (spironolactone) reduces the effects of hormones on the skin and the hair and may help slow or reverse the progress of women’s pattern baldness.

    Another approach, platelet-rich plasma therapy (PRP), may show promise in fighting hair loss, especially for people who have not responded to medical treatment. Blood plasma is rich in growth factors that can stimulate follicles and promote growth. An individual’s blood is drawn and spun in a centrifuge to extract those growth factors, which are then injected directly into the scalp, all within the same visit.

    Another option in treating hair loss is hair transplantation—in essence, productive follicles are harvested from a donor site, then surgically grafted into the scalp. Costlier and more time-consuming than other options, transplantation is generally used when other treatments fail, and carries the risks normally associated with surgery.

    Alopecia Areata

    In cases of alopecia areata, the immune system mistakenly targets and disables hair follicles. The condition may begin with patchy hair loss on the scalp, and can progress to other parts of the body, including eyelashes and eyebrows. Although this disorder is not scarring, it may progress to alopecia universalis, a near-total loss of body hair.

    We often treat this type of hair loss with topical steroid formulations or steroid injections into the scalp to help reduce the effects of the immune system on the hairs. When the hair loss is more extensive and rapidly progressive, a new category of medicines, JAK inhibitors, have shown great potential to stimulate hair follicles. These inhibitors are in late-phase clinical trials and likely to gain FDA approval in the near future.

    Telogen Effluvium (TE)

    TE causes hair shedding, often in clumps, with a sudden onset. Almost invariably, TE results from physical, physiologic, or psychological stressors—for example, an emotional shock such as death of a loved one, or a major illness or hospitalization. Stressful situations that place the patient in fight-or-flight mode for an extended period may contribute as well. People with COVID-19 have also experienced TE after recovery, especially in cases of moderate to severe illness requiring hospitalization and medical treatment.

    Pregnancy and anemia (low blood iron) may also cause TE—a possible reason why women are more prone to it than men.

    In most cases of TE, hair loss resolves on its own over time. If we’ve ruled out other possible causes, watch-and-wait is often the best approach. In the more serious cases, certain medications/therapies may be tried to help reduce shedding and promote hair growth.

    Scarring Hair Loss

    Certain situations may cause scarring—permanent harm to hair follicles. In these cases, treatment is geared toward halting progression of the condition, because regrowing hair is not always possible. A scalp biopsy is often needed in the case of scarring hair loss to help differentiate the type of hair loss. Examples of scarring hair loss include:

    • Tight hairstyles—weaves, braids, or a tight bun worn for an extended period—can damage the roots of hair and lead to a type of hair loss called traction alopecia. It’s important to minimize the tension on the hair associated with these styles, or avoid these hairstyles altogether.
    • Traumatic hairstyles/hair styling practices can also contribute to scarring alopecia in genetically predisposed people. Central centrifugal cicatricial alopecia (CCCA) initiates an inflammatory condition in the scalp—often in African American women—that causes a scarring hair loss on the crown of the scalp. Avoiding heat, relaxers, and tight hairstyles is recommended. We often also recommend use of topical steroids, steroid injections, and oral antibiotics to calm the inflammation and help follicles heal.
    • Hair-pulling disorder, or trichotillomania, is a compulsive hair-pulling behavioral disorder in which people—most often children or teens responding to stressors—continually pull at and twist their hair, damaging the roots. Behavioral modification and, occasionally, oral medications can help. Psychiatry may be consulted to help co-manage.
    • Ringworm, an itchy fungal infection of the scalp, can cause temporary hair loss and requires oral anti-fungal therapy to prevent progression. This is most common in children.
    • Lichen planopilaris (LPP) is another rare condition that occurs when the immune system attacks the follicles. Unlike areata, however, it does cause scarring—it can permanently destroy the follicles it affects. Topical and oral anti-inflammatory medications are used to help stabilize this condition.

    Hair Loss Treatment

    I don’t recommend spending money and time trying any magic formula of vitamins, scalp oil, shampoo, or herbal preparations that you may see advertised.

    At the Hospital Center, we can prescribe several types of medications to make a positive difference in hair regrowth; however, sometimes full regrowth of hair is not achievable.

    Hair loss treatments can vary depending on the patient’s type of hair loss, age, sex, and medical history. The most important thing is the initial consultation to determine the cause of hair loss. After a diagnosis is determined, a combination of oral, topical, or injection therapy may be recommended. Hair loss treatment may require repeated visits to a dermatologist for monitoring of medications, injection therapy, and assessing response to treatment. Hair regrowth is slow, and results often take months to see. We generally take photos to document regrowth.

    Final Thoughts

    In summary, many forms of hair loss are quite treatable, but all of them show best results when they’re addressed early. The more hair is lost, the more time and effort it may take to regrow it.

    If you’re experiencing hair loss, consult a dermatologist who specializes in this type of diagnosis and treatment for best results. The doctor can help eliminate other issues as a potential cause of the hair loss, and help plan a treatment strategy that works best for you.

    Several effective options are available to manage hair loss and can be tailored to your individual needs. And in many cases, progress can be made toward successfully restoring hair.


    Excess hair loss?

    Consult our dermatology team.

    Call 202-788-0402 or Request an Appointment

  • June 23, 2021

    By Darling Ruiz Cerrato, MD

    Approximately 16 million Americans have been diagnosed with chronic obstructive pulmonary disease (COPD), a progressive lung condition that makes it difficult to breathe. Yet, because many people do not realize they have it, the actual number of people suffering with COPD is likely much higher.

    It is the third leading cause of death by disease in the U.S., and it is a progressive disease that currently has no cure. Here in the Washington, D.C., region, it’s estimated that the disease affects about six percent of the population.

    COPD Symptoms

    Healthy lungs receive oxygen from the air and move it into the blood, then expel carbon dioxide back into the air. This exchange occurs within the alveoli, small balloon-shaped air sacs residing in spongy lung tissue. The average adult has at least 500 million alveoli, so tiny that oxygen and CO2 molecules easily pass through them.

    In people with a history of smoking, alveoli can become seriously damaged—malformed and less functional. Inflammation subsequently occurs around the alveoli, narrowing bronchial tubes. The airway can become clogged with mucus, making it difficult for air to move in and out of the lungs.

    Warning signs of COPD may include:

    • An enduring, persistent cough that produces phlegm or mucus from the lungs
    • Chronic shortness of breath, often during simple everyday activities
    • Wheezing, gasping for breath, or labored breathing
    • Frequent respiratory infections
    • Blue lips or fingernail beds
    • Fatigue

    COPD can increase and decrease in intensity. As more and more alveoli are damaged, most patients have periods of exacerbation, episodes of worsening that can make hospitalization necessary. Each exacerbation can leave the lungs increasingly damaged, accelerating the disease’s progress.

    Comorbidities or complications associated with COPD include sleep apnea, infection, and pulmonary hypertension—elevated blood pressure in the vessels that feed the lungs.

    COPD Risk Factors

    The primary risk factor is smoking—about half of all tobacco smokers eventually develop this disease. However, about one in four COPD patients have never smoked—some of them may have been affected by second-hand smoke or by long-term exposure to other environmental contaminants like dust, gas, or wood smoke.

    COPD had a higher prevalence in men in the past; however, COPD is now commonly seen in women, as the prevalence of smoking in females has progressively increased. In many developed countries, COPD is now even more prevalent in women than men, and female smokers are about 50% more likely to develop COPD than males.

    Other people at higher risk for COPD are asthma sufferers, as well as those with alpha-1 antitrypsin (AAT) deficiency, an inherited disorder in which AAT—a protein that protects the lungs—cannot effectively reach them.

    Diagnosing COPD

    When diagnosing COPD, we consider the patient’s complete medical history, particularly any episodes of shortness of breath and sputum production that have persisted for three months or more. With spirometry testing, we can obtain a practical measure of the volume of air that the patient can forcibly exhale.

    CT imaging can help us evaluate damage to the air sacs (emphysema). We also monitor blood oxygen, since the lungs have greater difficulty moving oxygen into the blood as COPD progresses.

    Co-existing with a patient’s COPD may be respiratory infection, heart failure, or severe asthma. At MedStar Washington Hospital Center, we work collaboratively with specialists across our network to help manage such underlying conditions, especially cardiovascular issues (high blood pressure, heart failure, heart attack, arrhythmias, and vascular disease) that can worsen—or be worsened by—poor lung function. COPD patients may also be at higher risk for lung cancer, and COPD can make that cancer harder to treat in its later stages.

    Not surprisingly, COPD can take an emotional toll on patients. It can severely limit activity, particularly for patients who depend on the use of supplemental oxygen. Shortness of breath, especially during an exacerbation, can be uncomfortable, distressing, and frightening; for some, anxiety and depression can result.

    Although there is not yet a cure for COPD, it can be managed with effective treatments—especially when those treatments start early. More from pulmonologist Darling Ruiz Cerrato, MD https://bit.ly/2SVqIzd via @MedStarWHC
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    Treating COPD

    At MedStar Washington, we work closely with our COPD patients to help proactively manage their condition. Treatment must be carefully tailored to the needs of the individual patient—one patient may have adequate airflow yet display other severe symptoms of COPD; another may have a more suppressed airflow but few additional symptoms.

    With treatment, we have two main goals: improving airflow for better daily quality of life and preventing dangerous exacerbations. We consider each patient’s unique state of disease, lifestyle needs and limitations, and the frequency and severity of exacerbations. We also track the patient’s response to various activities—for example, how they feel after exercise or after climbing stairs.

    This assessment helps us gauge the severity of the disease and its impact on the patient’s day-to-day life. We can then tailor a variety of possible treatments, depending on the patient’s condition and response to medications:

    • Patients generally use an inhaler to deliver bronchodilators to the lungs—relaxing the muscles around the airways, improving airflow to make breathing easier, and helping to clear phlegm. A “rescue inhaler” delivers fast-acting agents for speedy relief of symptoms, while a longer-acting bronchodilator can help moderate the disease day to day, over the long term.
    • Steroids can play a critical role in controlling the inflammation that comes with COPD. We may prescribe regular use of an inhaled steroid or, if symptoms intensify, temporarily supplement treatment with a steroid tablet.
    • For some patients, a nebulizer, allowing the patient to inhale medication using a machine that creates a fine mist, can also aid breathing.
    • Antibiotics may be used to both treat and prevent infection, a common complication of COPD.
    • If needed, supplemental oxygen can be used to aid lung function and keep blood oxygen at a healthy level. For some patients, we also recommend pulmonary rehabilitation, a strengthening and conditioning program to help the lungs and body process oxygen more efficiently.
    • Exacerbations tend to begin with a worsening cough, more severe shortness of breath, and increased sputum production. The patient’s rescue inhaler may lose effectiveness, and blood oxygen may drop dramatically. Because an exacerbation can last a week or more, hospitalization of the patient may be necessary, allowing Hospital Center staff to actively manage medication and other treatment.

    It’s also important that COPD patients stay up-to-date on their vaccines—both flu and COVID-19 can cause life-threatening respiratory problems.

    At MedStar Washington Hospital Center

    Our highly qualified team has extensive experience in treating all respiratory diseases and disorders. We perform comprehensive respiratory function testing in our pulmonary lab, including spirometry and walk testing. We are trained in interventional techniques, using advanced endoscopy to clear the airway when growths or tumors interfere with breathing.

    In addition, the Hospital Center’s lung cancer screening clinic provides screening services and smoking cessation support for those with a history of tobacco use.

    COPD is a progressive disease that creates permanent damage in the lungs. The longer it is untreated, the more complex it can be to manage. If you are a smoker or are regularly exposed to contaminants, it’s important to watch for warning signs. Consult your healthcare professional if you or someone you care about has a persistent cough with phlegm or is regularly short of breath.

    Expert assessment and early treatment can make COPD easier to control and give you or a loved one a much improved quality of life.


    Persistent cough? Short of breath?

    Trust our team to help.

    Call 202-788-0402 or Request an Appointment

  • June 22, 2021

    By Jasmeet Singh Bhogal, MD, MBA

    Whether you’re heading off to vacation or enjoying the long days of summer at home, the warm months are a great opportunity to get outside for some fun. The following summer safety tips can help ensure you spend most of your time outside rather than inside a hospital getting treated for an accidental summer injury.

    Headed for an adventure or enjoying the warm months at home? On the #LiveWellHealthy blog, read Dr. Bhogal’s summer safety tips to ensure you spend your time outside rather than bedside in a hospital: https://bit.ly/35GeWM6.

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    Summer safety tips.

    1. Cover your skin in sunscreen and bug spray.

    Whether you’re swimming at the beach or hiking in the mountains, it’s important to protect your skin from harmful ultraviolet (UV) rays from the sun and bug bites. Too much sun exposure can lead to sunburn—or even skin cancer. Likewise, ticks can carry infection-causing bacteria, such as Lyme disease.

    To protect your skin in the sun, use a broad-spectrum sunscreen of 30 SPF or higher. Be sure to reapply frequently, especially if you’re sweating or in the water. Other sun precautions include wearing protective clothing, sunglasses, and a wide-brimmed hat—all of which can minimize your skin’s exposure to the sun.

    Before choosing a location for hiking or camping, do your research to make sure you’re avoiding tick-infected areas. While there, consider wearing long-sleeved shirts and pants and using an insect repellent containing Deet to minimize the likelihood of getting bitten. After your hike, a thorough bath is a great way to get rid of any ticks that may be lingering on your skin but haven’t latched on. You should also carefully check for ticks on your body and remove them promptly.

    2. Drink water…and then drink some more.

    Drinking lots of water is the best way to prevent heat-related illnesses because it helps your body stay hydrated and regulate its temperature. Heat-related illnesses can range from mild heat cramps to heat exhaustion and stroke, all of which can come on quickly after too much time in the sun.

    To avoid dehydration, take breaks when outside and carry water with you wherever you go. Minimize your sun exposure by seeking shade, when possible, and wearing appropriate clothing. If your clothes become soaked in sweat, be sure to change clothing because wet clothes will make it harder for your body to cool down. If you’re hiking or participating in another outdoor activity with a group of people, make sure you know the signs of heat-related illnesses. If someone shows symptoms, everyone should stop the activity because chances are high that others have it, too.

    3. Keep a first aid kit nearby.

    On top of heat exhaustion, summer recreation can bring on unexpected injuries that range from cuts and scrapes on the skin to muscle-related accidents, like sprains and fractures. As an urgent care physician, I’ve seen my fair share of bike accident injuries and fishhooks lodged in fingers from boating trips.

    There are safety precautions you can take to minimize your risk of both of those things from happening. But if an accident occurs, it’s good to be prepared with a stocked first aid kit. A simple first aid kit should include:

    • 1 bottle of saline solution
    • 5 antibiotic ointment packets
    • 5 antiseptic wipe packets
    • 5 sterile gauze pads
    • 25 adhesive bandages, 1 roller bandage, 1 adhesive cloth tape
    • 2 adhesive compress dressings
    • Tweezers
    • 1 oral thermometer
    • 1 instant cold compress

    Learn more about common summer injuries and how to avoid them.

    4. Be proactive about water safety.

    Did you know drowning is one of the top causes of accidental deaths in the country? The good news is that drowning is almost always preventable with the proper precautions.

    Adults should practice water safety for themselves, and kids will follow their lead. If you’re in or around water, avoid using alcohol or illicit drugs, which can impair your judgment. If you’re on a boat, wear a lifejacket.

    Pools, lakes, and other large bodies of water aren’t the only places where kids can drown. Toilets and buckets with even just a few inches of water pose risks to babies and toddlers. That’s why children should always be actively monitored by an adult who is within an arm’s reach anytime they’re near water.

    The best way to minimize drowning accidents is to ensure that kids can’t access water without help. Pools should be protected with a proper fence on all four sides. And, families with young children at home should make sure bathrooms are secured so little ones can’t accidentally access the tub or toilet.

    Learn more about preventing water injuries and drowning.

    5. Exercise caution around grills and campfires.

    From s’mores to barbecue, some of the best summertime food is tastiest when cooked over a fire. But, the dangers associated with grills and campfires aren’t to be taken lightly.

    Adults and children alike are at risk of severe burns caused by getting too close to a hot grill or fire. To minimize the risk of burns and other fire-related injuries, make sure kids are closely supervised at BBQs and around a campfire. And, never leave either unattended.

    In addition, both campfires and grills should be placed in an open area away from anything that could be flammable. All grill equipment should be properly inspected and maintained to prevent any malfunction, including the gas tank. Consider using fireproof mitts and long-handled utensils to handle food over a fire or on a grill to avoid skin exposure to flames. Wearing form-fitting clothing with short sleeves can also ensure you don’t accidentally catch your clothes on fire.

    This is an updated version of an article previously posted on July 22, 2020.


    If an accident does happen this summer, MedStar Health Urgent Care is here to help.
    Click the button below for more information on our urgent care services.

    Learn More

  • June 21, 2021

    By Glenn W. Wortmann, MD

    The human immunodeficiency virus—commonly known as HIV—can destroy vital cells that resist infection and disease. This can gradually cause critical and eventually life-threatening weakness to a person’s immune system.

    In the U.S., June 27 is National HIV Testing Day, dedicated to encouraging Americans who may be at risk to understand HIV, reach out for testing, and establish a regular connection with a healthcare provider if needed.

    To help you determine if HIV testing makes sense for yourself or a loved one, here are six important things to know about the virus:

    #1 HIV Is Not AIDS, But It Can Lead to It

    HIV places your immune system under attack. Specifically, the virus damages a cell called the CD4, the helper lymphocyte, making us more prone to opportunistic infections such as pneumonia. These infections can turn deadly without medical intervention against the virus.

    A diagnosis of HIV-positive means that the patient is infected with the human immunodeficiency virus—although in early stages, there are frequently no symptoms and the patient’s immune system may still be unharmed.

    Over time, typically within 8 to 10 years, the immune system can become increasingly damaged, potentially resulting in a diagnosis of acquired immune deficiency syndrome (AIDS).

    #2 HIV Rates Decrease When People Are Better Informed

    Each year, about 1.2 million Americans are living with HIV, and another 36,000 Americans become newly infected.

    Recent statistics for the Washington, D.C., area show that approximately 1.8 percent of the population (nearly 12,500 patients) lives with HIV. Happily, in recent years, this region has seen a decline in infection rates, largely due to improved education about the virus, as well as a proactive needle exchange program for drug users.

    Part of the HIV education process involves making people aware that contracting the virus means that their immune system is compromised. However, symptoms can be elusive. An infected person may not realize they’re infected for as long as a decade—and, during that period, they could unknowingly transmit the virus to others.

    #3 HIV is Transmitted by Lymphatic Fluids

    HIV exists in the lymphatic system, and fluids that are part of the lymphatic network can carry the virus, including blood, semen, pre-ejaculate, rectal fluids, vaginal fluids, and breast milk. HIV transmission does not occur via urine or saliva.

    Over 65 percent of HIV infections occur within the MSM community—men who practice sex with men. Unprotected MSM sex is particularly risky because it can damage the mucosa of the rectum, providing a point of entry for the virus.

    HIV can also be transmitted during heterosexual sex, which accounts for 24 percent of all cases. About 7 percent of cases occur in intravenous drug users who share needles.

    HIV cannot survive for very long outside a human host, so there is little risk of becoming infected from contact with a contaminated object or surface. Mandatory testing of the blood supply, in effect since 1984, has all but eliminated any risk of infection from blood transfusion.

    As part of routine care, the CDC recommends that everyone between the ages of 13–64 be tested for HIV at least once, to protect themselves and those with whom they’re intimate. More from Dr. Glenn Wortmann. https://bit.ly/3cGDSH1 via @MedStarWHC
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    #4 The Most Effective Defense Is Prevention

    Today’s medications to treat HIV are a vast improvement over what was available even a couple of decades ago. Although great strides have been made in developing treatments, there is still no vaccine available to protect against HIV, and we still have no cure for AIDS.

    The most effective protection against HIV is through prevention: practicing safe sex and using clean needles. The Centers for Disease Control and Prevention (CDC) recommends these strategies:

    • Choose less risky sexual activities (anal sex presents the greatest risk, oral sex the least).
    • Use a condom the right way every time you have sex; condoms are highly effective at preventing HIV and other sexually transmitted diseases (STDs) such as gonorrhea and chlamydia. Use a lubricant to help keep condoms from breaking or slipping during sex.
    • Or choose abstinence—not having sex at all.
    • Never share needles, syringes, or other injection equipment; use clean new equipment every time.
    • If your partner has HIV, encourage that person to seek, and maintain, treatment.
    • Get tested and treated for HIV and other STDs—if you have another STD, you are more likely to contract HIV.

    #5 HIV Testing Is Easy—and Could Save Lives

    The CDC recommends that everyone between the ages of 13–64 be tested for HIV at least once, as part of routine care with a healthcare provider. And, of course, any individual who feels they may have been exposed to the human immunodeficiency virus should take action and be tested as soon as possible, to protect themselves and those with whom they’re intimate.

    Testing is not difficult—it can even be performed using an at-home HIV test kit available from a pharmacy; although not as dependable as an HIV blood test, this can serve as a good first step. For the most reliable results, consult a medical professional or find a testing center near you to complete bloodwork.

    • If bloodwork returns an HIV-positive test result, treatment can begin immediately to slow any negative impact to the immune system.
    • Patients who have had a known exposure, but test negative, will repeat the test a few weeks later. In the early days of infection, false negatives are possible since the virus takes three to four weeks to be detectable by testing, so a follow-up test is advisable.

    Individuals at high risk should request testing at least once each year. In addition, pre-exposure prophylaxis (PrEP)—a single pill taken once daily—can help prevent infection for those who regularly engage in high-risk activities such as anal sex. Although it does not provide complete protection, it can serve as a valuable precaution when used in combination with other safeguards.

    #6 Early Treatment Delivers Positive Outlooks

    With effective drugs, ready access to testing, and highly available information on how to prevent the spread of this virus, we have all the components needed to reduce the transmission rate of human immunodeficiency virus.

    The good news for those infected with HIV: early treatment can deliver a promising outcome. The sooner we start treatment, the better the chance of reducing the viral load before an individual becomes very sick.

    With over 20 approved drugs for HIV and AIDS (most requiring a dosage of just one pill a day), physicians have a number of effective choices depending on the patient’s physical condition and medical needs. We generally tailor a combination of medications to the patient—for example, Truvada, which combines emtricitabine and tenofovir disoproxil. Because HIV can sometimes become resistant to medications, the many available options allow the patient’s healthcare professional to vary the regimen when needed.

    It’s important for patients in treatment to stick with their scheduled treatments, to protect themselves and those with whom they come in contact.

    HIV Care at MedStar Washington Hospital Center

    In addition to tailored treatment programs, we provide several helpful services to our patients: Because HIV increases the risk of cervical cancer, our nurse practitioner helps women (who represent about half of our HIV patients) to get the specialty care they need. Our social worker can help patients overcome any barriers to care; our pharmacy tech assists with prescriptions and finding lower cost medicines. We can also provide patients with access to behavioral health support as needed.

    Today, patients with HIV can live a nearly normal life when we start treatment early. And the more patients we diagnose and treat, the more we all protect others in the community. So, if you are in a high-risk group or believe you may have been exposed to HIV, don’t hesitate to reach out to your healthcare provider or local testing center.

    National HIV Testing Day is June 27!


    Take steps to prevent HIV.

    Get tested today.

    Call 202-788-0402 or Request an Appointment

  • June 18, 2021

    By Daniel Marchalik, MD

    Provider burnout is not a new issue. Conversations about the difficulty of working in healthcare and the toll this job takes have been happening for decades.

    Recently, we have begun to realize just how profound these effects can be. These issues became worse when the pandemic reached our hospital. Many providers were finding themselves working in complex conditions, while managing an unknown and difficult new disease. At the same time, many were coordinating interruptions in childcare, and worrying about the safety of their own families.

    With this in mind, MedStar Health responded by putting together a robust system-wide response to support its providers. We knew that support would require tending to both the workplace and home life stressors. Therefore, we expanded the Care.com backup adult and childcare program, to make sure that all associates and providers were covered.

    We set up a series of Recharge Stations across the system. Recharge Stations are spaces designed for our providers and associates to be able to step into to relax, grab a healthy drink or snack, and pick up materials about various ongoing wellness efforts. The most up-to-date list of recharge stations and well-being programs can be found on our website, www.medstarhealth.org/wellbeing.

    We also realized that sometimes people were simply too busy to actively seek out the resources. We launched an initiative called “wellness rounds.” Through this initiative, our teams will arrive on the frontline units to let teams know about various wellness resources and give providers and associates an opportunity to take a few minutes out of their day to connect and discuss their concerns.

    These rounds were designed to focus a small part of the day on others’ well-being. With time, this initiative has grown exponentially, and we have recruited large groups of volunteers to assist with the effort. All volunteers go through our peer-support training. In fact, we established a 24/7 hotline for peer support to make sure that this hub was available anytime somebody would need it. For others who prefer a formal mental health appointment to discuss their needs, we also put in place and expedited mental health appointment program that would ensure that our associates and providers could get plugged in with a provider within two business days.

    If you have any questions, please visit our website. For the Care for the Caregiver/Peer to Peer Support, call 866-674-9355 (866-MSH-WELL) or email c4c@medstar.net.

    Dr. Marchalik is medical director of Physician Well-being at MedStar Health, director of the Kidney Stone Program at MedStar Washington Hospital Center and an associate professor of Urology at the Georgetown University School of Medicine.