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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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  • April 06, 2018

    By Robert Henshaw, MD

    Has my cancer spread?” After a woman has had the time she needs to process a cancer diagnosis, this tends to be one of her first questions.

    The process of a cancer spreading is called metastasis. When breast cancer spreads, the bones are one of the most common places it goes. One study noted that 70 percent of breast cancer patients had a cancer that spread to at least one bone. As an orthopedic surgical oncologist, I care for women whose cancer has spread to the bones and who need surgery to reduce pain and improve their quality of life. My colleagues and I work closely with our breast oncology team to provide advanced therapies and to advocate for women who are being treated for breast cancer or who have been treated for it in the past. Unfortunately, breast cancer can come back years after beating the disease, and it’s vital that women recognize the subtle signs that a cancer has spread to the bones.

    Signs that breast cancer has spread to a bone–and when to be aware

    Many times, the first symptom a woman notices is pain in certain bones, including the:
    • Back
    • Pelvis and hips
    • Ribs
    • Shoulder blades
    • Upper arms and upper legs

    These are some of the most common bone sites to which breast cancer can spread. In some cases, this can appear on an X-ray as what’s called a lytic lesion, which is a weak area in the bone due to the cancer destroying the bone’s structure, causing it to lose calcium and other minerals. This may continue for a month or two until something happens—a fall, bumping into a wall, even rolling over in bed—causing the weakened bone to break.

    A broken bone often is what spurs patients to go to the emergency room. Weakened bones can be a sign of several conditions, including osteoporosis, so it’s important for your doctors to know your complete medical history and whether you have or have had breast cancer. We can use X-rays and other scans, such as computed tomography (CT) or magnetic resonance imaging (MRI), to see if there’s a tumor or mass on the bone that’s causing it to weaken.

    The five-year survival rate, or how many people survive at least five years after receiving a breast cancer diagnosis, often is considered the gold standard of breast cancer care. But survival rates don’t tell the whole story. We’re starting to see relapses of breast cancer much later—10, 15 or even 20 years after the original diagnosis. After a cancer diagnosis, even after the five-year mark, continue to see your oncologist at least yearly to increase the chances of detecting relapses as early as possible.

    It’s also important for doctors to proactively test patients who are newly diagnosed with breast cancer, to make sure the disease hasn’t already spread to their bones. Too often, I see women who noticed a lump in their breast and immediately got a mammogram or a CT scan, but no one considered whether they should get a bone scan until much later.

    Call 202-877-XRAY to schedule your regular mammogram and stay on top of your breast cancer risk.

    Click to Call Now

    Metastatic breast cancer treatment options

    Breast cancer that spreads into the bones is considered stage 4, which is the most advanced stage of the disease. Unfortunately, cancer at this stage typically isn’t curable. However, we can treat the symptoms and manage the sites to which it has spread. Patients whose cancer has spread to the bones can continue to live for a long time with a high quality of life with new advanced treatments.

    Fighting metastatic breast cancer usually involves a two-pronged approach. The first consideration is local control, which involves treating the cancer site in which the patient is experiencing symptoms. If a patient comes to see me about a lesion on their hip, and I recommend treatment just for that location, that’s local control. Bone typically responds well to local control for cancer because it is one of the few tissues of the body that regenerates to a degree when part of it is surgically removed.

    Surgery to remove the cancer and radiation therapy to kill cancerous cells are examples of local control methods I use to treat patients’ bone metastases. Some patients need to have their existing bone strengthened with a metal pin or nail. Others need to have an area of bone resected, or removed, and replaced with a prosthesis.

    The second part of our two-pronged approach is systemic management, which addresses breast cancer as a disease that can affect the whole body. We’ve typically used chemotherapy or hormonal therapy to attack breast cancer on a systemic level, and those treatments can be effective. However, particularly with hormonal therapy, the type of cancer can determine the effectiveness of systemic treatment. Some forms of breast cancer involve proteins called receptors that respond well to hormone therapy. Other forms of the disease, including triple-negative breast cancer, don’t have these receptors, which can limit the effectiveness of traditional treatment options.

    But that doesn’t mean there’s nothing we can do. Newer treatments are being approved for breast cancer all the time, and others are still in the experimental stage. One exciting new form of treatment is called immunotherapy, which trains the body’s own immune system to target and destroy cancer cells. We’ve seen dramatic results from these treatments, especially in the area of treating triple-negative breast cancer. 

    Even if it’s been several years since your treatment and diagnosis, the difficult truth is that women must be aware of the risk of their cancer returning and spreading to the bones. Catching the disease at the first sign of symptoms gives us the most options for preventing it from spreading to the bones, and containing it if it does spread.

    Do you need to schedule a mammogram? Call 202-877-XRAY or click below.

    Schedule Your Mammogram

  • April 04, 2018

    By MedStar Health

    Diabetic foot ulcers can form quickly when a patient gets a cut on their foot and doesn’t realize it. The culprit often is neuropathy, a diabetes-related condition that deadens nerve sensation. If the cut is severe or gets infected, it can extend beyond the surface of the skin to form a deep wound, or ulcer.

    If left untreated, diabetic foot ulcers can cause severe illness that results in the need for intense therapy, surgery or even amputation. However, an advanced treatment we use called vacuum-assisted closure wound therapy (VAC or negative-pressure wound therapy) has proven effective for treating these ulcers. Data from a May 2015 study in the World Journal of Orthopedics suggest that the therapy is more effective than traditional moist wound treatments.

    This therapy has changed how we approach diabetic wound care. It’s given doctors and patients another pathway for healing. While simple in theory, negative-pressure wound therapy is a sophisticated treatment that can help people with severe diabetic sores avoid amputation. But when I tell patients they’re good candidates for this therapy, they sometimes look at me like I’m crazy, saying, “You’re going to put a vacuum on me?” Essentially—yes!

    LISTEN: Dr. Elmarsafi discusses negative-pressure wound therapy in the Medical Intel podcast.

    How negative-pressure therapy works

    The therapy starts with applying a sealed dressing to the wound. Then, we attach an external pump that creates a gentle vacuum effect. This negative pressure increases blood flow to the wound and decreases excess fluid to help the wound heal. We’re also able to use different solutions depending on the type of bacteria that’s growing.

    VAC devices are designed to clean wounds and, at the same time, provide an opportunity for deep wounds to fill in with healthy tissue. This process is essential to prevent reinfection and preserve the affected part of the foot. While negative-pressure therapy can help patients avoid amputation, we often perform some minor surgery to thoroughly clean and inspect the wound, especially if we think the bone beneath might be infected.

    There are many different types of VAC devices—some are designed specifically for in-hospital use, and others are portable for longer-term use. For the most part, most patients can get around while wearing a device by using crutches, a walker or a knee scooter.

    MedStar Washington Hospital Center's Limb Salvage and Wound Care team includes experts in customizing therapies. Patients with complex diabetic ulcers come to us from other centers that have maxed out their abilities and resources to provide advanced care. For example, we saw a patient in 2017 who was told by two hospitals in the D.C. area that he needed a below-knee amputation. Our team not only was able to save his leg but also got him back to work in just two months with negative-pressure wound therapy.

    To request an appointment with a podiatric surgeon, call 202-877-3627 or click below.

    Request an Appointment

    Things to remember during diabetic ulcer treatment

    Treatment discussions are never one-size-fits-all. Everyone heals differently, and the location of a wound affects how easily and quickly it can heal. During treatment, we constantly evaluate and tweak the therapy to improve healing. Your doctor will ask you a lot of questions and may recommend lifestyle changes during recovery. It’s important to speak up if you are concerned or if you have questions about your condition or treatment.

    One thing that often surprises patients is that negative-pressure wound therapy devices make noise. The devices are made with sophisticated sensors, and these noises are from the device adjusting as it cleans and closes the wound. The devices are relatively quiet, but the noises can change as the wound changes or as the patient moves around. New sounds don’t mean that something isn’t working. The devices also have alarms, so if something does go wrong, you’ll know!

    Another important aspect of recovery is self-care. People who have well-controlled diabetes tend to have better outcomes with VAC therapy. These are patients who carefully monitor their blood sugar and routinely examine their feet to look for cuts or wounds so we can prevent them from getting infected.

    Related reading: Prevent diabetic foot problems with these easy care practices

    With diabetes, nutrition is a delicate balance. We have to be careful with calorie intake, and we have to manage needs related to heart and kidney health. Many of our patients have trouble with all three, so we work as a team with a nutritionist and the patient’s endocrinologist. Regaining limb strength and mobility also is very important for long-term outcomes and quality of life, and our patients see a physical therapist and/or occupational therapist for rehabilitation.

    I view my job as being able to provide the patient with the ability to be mobile for as long and as independently as possible. Sometimes that means amputation. But my job also is to prevent amputations, and negative-pressure wound therapy is an effective treatment that helps me do just that for my patients.

    If you have been told your diabetic foot ulcer requires amputation or if your wound won’t heal, make an appointment with a wound care expert today.

    Request an Appointment

  • March 30, 2018

    By MedStar Health

    Vadim Morozov, MD, FACOG, FACS, considers reading a good science fiction novel ideal for unwinding from his duties as an attending physician at the National Center for Advanced Pelvic Surgery at MedStar Washington Hospital Center. “It allows me to turn my mind off for a bit,” he explains, adding that the books may well be providing some clues about treatment tools he may be using in the future. After all, he says, “Many everyday technologies were first mentioned in science fiction stories. Medicine is no different.”

    Indeed, the minimally invasive laparoscopic and robotic procedures that Dr. Morozov and his colleagues routinely perform today are not that far removed from the realm of experimentation. He also marvels at how once relatively large instruments have been miniaturized, while also gaining extra degrees of precision.

    We’re not that far away from giving patients pills, in lieu of certain other treatments,” Dr. Morozov says. “Injectable microparticles are already being used for blood purification, so there’s no reason why they can’t fix other parts of the body.”

    A Family of Doctors

    Medicine would seem to be in Dr. Morozov’s blood as well. Both his parents and a grandmother were physicians in his native Belarus. Having begun his medical education before coming to the U.S. at age 23, he received his medical degree at the State University of New York (SUNY) in Syracuse. It was then on to a residency in obstetrics and gynecology at the Long Island Jewish Medical Center, an affiliate of Yeshiva University’s Albert Einstein College of Medicine.

    Dr. Morozov then completed an American Association of Gynecologic Laparoscopists (AAGL) fellowship in gynecologic endoscopy and minimally invasive gynecology at the Nezhat Medical Center, at the Atlanta Center for Special Pelvic Surgery & Reproductive Medicine. He joined the Hospital Center after nine years at the University of Maryland Medical Center.

    Medical Inventions and Contributions

    Along the way, Dr. Morozov has made his own contributions to the field of gynecologic treatment technology. His inventions include the uterine excision device (UED), an electrosurgical element to the uterine manipulator for total laparoscopic hysterectomy. He also developed hybrid surgical mesh for the treatment of pelvic organ prolapse, and a pelvic device for control of hemorrhage during pelvic surgery.

    But Dr. Morozov insists that a technology’s true value is realized when it makes a positive difference in the lives of patients with chronic pelvic pain, endometriosis and other conditions.

    “It’s great to see the positive change we can bring to their lives,” he says.

    The Future of Medicine

    There may well be another medical Morozov on the way. The older of Dr. Morozov’s two sons is currently a sophomore, in the pre-med curriculum at the University of Maryland at College Park. What kind of clinical world will he inherit?

    “I don’t think physicians will ever be replaced totally, but many more things will be done semi-autonomously,” Dr. Morozov speculates. “What is certain is that our methods will continue to evolve. And being here at the Hospital Center helps me stay on top of everything that’s happening.”

  • March 29, 2018

    By MedStar Health Research Institute

    The 2018 NIH Regional Seminar on Program Funding and Grants Administration is a 2-day event on Thursday & Friday, May 3-4. Multiple sessions are offered across 3 tracks for administrators, investigators, and all interests.

    The NIH Regional Seminar serves the NIH mission of providing education and training for the next generation of biomedical and behavioral scientists. This seminar is intended to:

    • Demystify the application and review process
    • Clarify federal regulations and policies
    • Highlight current areas of special interest or concern

    The seminar and optional workshops are appropriate for those who are new to working with the NIH grants process – administrators, early-stage investigators, researchers, graduate students, etc. For those with more experience, the seminar offers a few more advanced sessions, updates on policies and processes direct from NIH staff, as well as valuable presentation resources to share with your institution.

    When registering, you will not be signing up for specific sessions. Instead, you are free to move between the tracks and choose on-site. Register today here.

    The 2-day seminar has a track just for investigators that is designed to provide step-by-step guidance on mapping your career, an understanding of the funding process and what can be expected up to the time of award. General registration is open and the agenda has been posted here.

    May 3-4, 2018
    Hyatt Regency Washington on Capitol Hill
    400 New Jersey Ave NW
    Washington, D.C., 20001

  • March 29, 2018

    By MedStar Health Research Institute

    The MedStar Health Research Institute (MHRI) is offering a one-day orientation session on Tuesday, May 15 focused on conducting research at Medstar. 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.

    The MHRI Investigator Orientation is an interactive session that covers the following topics:

    • 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, May 15
    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.

  • March 29, 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.

    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.

    Novel Therapy for Nonalcoholic Steatohepatitis (NASH)
    Jill Smith, MD
    Professor of Medicine, Georgetown University

    Professor Smith has been a creative and prolific translational investigator, with decades of NIH support for her research, including several projects that she has taken from discovery to bench to bedside to therapeutics.  She has made important discoveries elucidating roles for gastrointestinal peptides and receptors, genetic variants, and novel opioid growth factors in pancreatic cancers, as well as basic, translational, and early clinical studies of opioid receptor mechanisms regulating inflammation and immunity in the gastrointestinal tract, the latter including clinical trials of naltrexone in Crohn's disease.  As well, she has mentored dozens of trainees in their research, including GHUCCTS TL1 scholars. 

    Dr. Smith’s will share some of her most recent research, focused on a disorder with inadequate therapies and exploding public health impact.

    April 6, 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

    For those located at remote sites and unable to attend in-person, log on to  http://georgetownu.adobeconnect.com/mhri/ on April 6, 2018, at 12:00 Noon to hear Dr. Smith’s presentation.

    For more information on this and other Research Grand Rounds, please contact Research@medstar.net. The webcast of the Research Grand Rounds is archived on the GHUCCTS website. Presentations are uploaded approximately 30 days from the event. View past presentations here.