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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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  • December 12, 2017

    By MedStar Health

    Cutting-edge cryoablation therapy helped Eleni beat her esophageal cancer. Since receiving cryotherapy, she has gone nine months cancer-free!
  • December 12, 2017

    By MedStar Health

    Emily and Neil Kishter’s philanthropic partnership with MedStar Georgetown began with a commitment to improving patient care and waiting areas. Just recently, the Kishters became the first $1 million donors to the new medical/surgical pavilion project.
  • December 12, 2017

    By MedStar Health

    MedStar Georgetown will soon offer proton therapy as part of our suite of comprehensive cancer treatments.The new proton therapy system is an innovative, highly precise form of radiation therapy.
  • December 12, 2017

    By MedStar Health

    Dr. Furlong discusses the risks of smoking and how lung cancer is one of the most common types of cancer. However, it is also among the most preventable.
  • December 12, 2017

    By Kenneth D. Burman, MD

    Doctors are seeing more patients with thyroid cancer in the last 30 years, as data from the American Cancer Society show. Thyroid cancer is the fastest-growing cancer diagnosis in the United States. The vast majority of these cases are papillary thyroid cancers, which are more common in adults between the ages of 30 and 50 and more common in women than men.

    For many years, we’ve handled these cases the same way:

    • A growth, or nodule, appears on a patient’s thyroid
    • We perform a biopsy, which involves taking a sample of the nodule’s tissue
    • If the biopsy confirms that the nodule is cancerous, we recommend surgery, which can involve removing either part or all of the thyroid

    But in the last five to 10 years, we’ve found that patients whose thyroid nodules aren’t considered aggressive both clinically and cytologically tend to have a low risk of symptoms or death over long periods of time. As we find more of these small, slow-growing thyroid nodules, researchers have begun to study whether it’s better in these cases to practice active surveillance, also known as watchful waiting.

    As of August 2017, there are several clinical studies measuring outcomes for patients with low-risk thyroid cancer who decide to closely monitor their cancer instead of having surgery. But prospective, controlled trials will take years or decades to show their full results. In the meantime, I recommend surgery for the majority of my patients who have low-risk thyroid cancer.

    LISTEN: Dr. Burman discusses low-risk thyroid cancer further on the Medical Intel podcast.

    The advantages of thyroid surgery

    Surgery is the standard treatment for thyroid nodules that we identify as being cancerous, and surgery has a high chance of successfully treating the patient’s cancer. For small nodules, our surgeons may be able to perform a lobectomy, which involves removing only part of the thyroid. For aggressive, larger cancers, we may need to consider a total thyroidectomy, in which we remove the entire thyroid.

    We have to consider each patient’s health before recommending surgery. Any surgical procedure involves risks, and patients who are younger and healthier tend to recover more quickly after surgery. Thyroid surgery, even in experienced hands, can rarely lead to several possible complications to include:

    • Hoarseness or voice changes
    • Neck pain
    • Trouble breathing or swallowing
    • Low serum calcium

    One of the most important considerations for patients with thyroid nodules is the experience level of their surgeon. Just like any skill, the more you do something, the better you tend to become at doing it. In a February 2017 study, researchers looked at surgical outcomes of patients who had a total thyroidectomy, or a removal of the entire thyroid. Patients whose surgeons didn’t perform many thyroidectomies were more likely to have longer hospital stays and complications after surgery as compared to patients whose surgeons were more experienced.

    When indicated, I can confidently recommend thyroid surgery for my patients in part because of our thyroid surgery team’s vast experience. Our three thyroid surgeons perform around 600 thyroid surgeries each year, which means patients are more likely to have shorter hospital stays and better outcomes after surgery.

    In addition, we discuss our most complicated thyroid cases at a regular team conference, where we can gather input from other specialists and get insights to share with our patients. This helps us make sure we’re giving patients all the options, so we can make informed decisions about their care.

    Why might someone want to wait on thyroid cancer surgery?

    We diagnose more cases of papillary thyroid cancer today in part because of improved imaging technology, such as thyroid ultrasounds. Most thyroid cancer is slow-growing and doesn’t cause pain or difficulty right away for patients.

    Most #thyroidcancer is slow-growing and doesn’t cause pain or difficulty right away for patients. via @MedStarWHC

    Click to Tweet

    Active surveillance involves regular monitoring of thyroid nodules. Patients with small nodules can come back every three to six months for a thyroid ultrasound, and the doctor can track that nodule’s growth over time. If the nodule has grown at least 20 or 30 percent in six months, the surgeon and patient can re-evaluate whether surgery is a good option. A thyroid fine needle aspiration (FNA) is recommended for thyroid nodules at least about 1-1.5 cm or larger.

    A potential reason to wait on surgery is if the patient has other health conditions that could make surgery and recovery more challenging. For example, a patient in their 80s who has heart disease is likely to have more trouble recuperating after thyroid surgery than an otherwise healthy patient in their 30s.

    These are valid considerations, and doctors should discuss them with their patients. Though I tend to recommend surgery for my patients with low-risk thyroid cancer (e.g., thyroid nodules larger than 1-1.5 cm and/or that have an FNA suspicious or diagnostic of thyroid cancer it’s a decision both the patient and their doctor should weigh carefully. Make sure to discuss the advantages and disadvantages of surgery, as well as your risks if you decide to wait. Ask about the surgeon’s experience performing this kind of procedure. And don’t be afraid to ask for a second opinion.

    Request an appointment with one of our endocrinologists if you think you may have a thyroid nodule or if you need a second opinion.

    Request an Appointment

  • December 11, 2017

    By Pavle Doroslovacki, MD

    When you see the words “plastic surgery,” your first thought probably doesn’t involve the eyes. Or you may think about cosmetic procedures to remove wrinkles or bags under the eyes.

    I’m an oculoplastic surgeon, and I specialize in surgery of the area around the eyes. And while there is value to cosmetic procedures in the eye area, that’s not my area of focus, though many oculoplastic surgeons do perform cosmetic procedures.

    I’ve encountered a lot of confusion from patients who are curious about how an oculoplastic surgeon could help them. Let’s go through what an oculoplastic surgeon does, what conditions we treat and answers to some of the most common questions patients ask.

    What does an oculoplastic surgeon do?

    An oculoplastic surgeon is an ophthalmologist, or eye doctor, with specialized training in plastic surgery around the eyes. Oculoplastic surgeons work exclusively with the eyes and the structures in the eye area, including the:

    • Eye sockets
    • Eyelids
    • Tear ducts

    Contrast this with a general plastic surgeon, whose experience is much broader because they work with many other parts of the body. Some plastic surgeons have experience with eye-related issues, and are indeed very good at working around the eye, but that may not be enough. Plastic surgeons’ overall training is less eye-focused, and they see fewer patients with eye-related problems.

    It’s similar to the difference between a general car mechanic and one who specializes in transmissions. For many jobs, the general mechanic is the better choice. But for difficult jobs involving a transmission, the specialist may be the better option.

    When you see an oculoplastic surgeon, you get the advantage of our narrower focus, as well as our greater familiarity with the anatomy and how everything works together in the eye area.

    What conditions do oculoplastic surgeons treat?

    My practice, like that of many other oculoplastic surgeons, deals with functional surgeries. Functional surgeries of the eye are procedures that improve either a patient’s vision or some other symptom related to a medical condition that affects the eye. Because these are medically necessary procedures, patients’ insurance plans usually cover some or all of the cost.

    I personally don’t do many cosmetic procedures, which are primarily related to improving a patient’s appearance.

    Some of the many procedures I perform include:

    • Blepharoplasty, removal of eyelid lesions, drooping eyelid repair (ptosis repair), malpositioned eyelid repair (entropion or ectropion repair)
    • Removal of blind, painful, disfigured eyes and insertion of orbital implants, so that people can obtain a natural-appearing prosthetic “glass eye”
    • Surgery to treat lesions/tumors or disorders of the eye socket, such as thyroid eye disease, which can cause bulging of the eye
    • Tear duct surgery, such as correcting a blocked tear duct

    I also evaluate and treat patients for neurological conditions that affect their vision. This field of medicine is called neuro-ophthalmology. Some of the conditions that affect vision include:

    • Bell’s palsy, a weakening or paralysis of one side of the face
    • Blepharospasm, an involuntary blinking or twitching of the eyelid
    • Cranial nerve disorders, which affect eye movements and can cause double vision
    • Optic neuropathies, or diseases of the optic nerve

    Related reading: What your eyes can tell you about your health beyond how well you see

    Questions and concerns about oculoplastic surgery

    The main question patients should ask before any surgery—eye surgery included—is whether the surgeon has experience with the procedure and condition. Ask your surgeon if they’ve treated other patients with your condition before, and if so, what the outcomes were.

    There’s also benefit to asking how many of the particular procedure your surgeon has done. The more often a surgeon does a procedure, the more likely they are to be better at it. Your surgeon should be able to share the number of surgeries like yours they’ve done previously and how many of those had good results for their patients.

    Pay attention to the surgeon’s responses to your questions. Don’t be afraid to ask for a second opinion if the surgeon doesn’t have experience with your condition, if you don’t feel confident that you’re getting the best possible answers to your questions or if you just think you could benefit from another perspective.

    My patients often ask me what they can expect during their surgeries. Most people are nervous about any type of surgery, and surgery around the eyes can be even more intimidating. I perform many of my procedures in the office on an outpatient basis. Patients usually are awake during these procedures, but I give them local anesthesia so they don’t feel pain. After surgery, patients can go home, and their recovery is quick in most cases.

    Your eyes are too important to trust to just anyone. An oculoplastic surgeon understands the eye’s intricate details and is specially trained to treat conditions that affect the tissues around this delicate organ.

    Request an appointment with one of our oculoplastic surgeons if you have an eye condition that may need surgery or if you need a second opinion.

    Request an Appointment