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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 13, 2016

    By MedStar Health

    When one of our patients is considering or about to undergo a surgical procedure at MedStar Washington Hospital Center, we are usually asked two questions: “How invasive or painful will it be, and how long will it take for me to recover?”

    Both are understandable questions, since many types of surgeries can take an emotional and physical toll on someone. But thanks to advancements in technology, we’ve seen procedures that were historically much more invasive, with protracted periods of recovery, become less painful, with patients getting back on their feet much more quickly.

    Specifically here at MedStar Washington Hospital Center, our doctors have seen more positive outcomes with the da Vinci Xi. A minimally invasive robotic surgery technology from Intuitive Surgical. But what does the da Vinci Xi robot mean for our patients?

    One of the most important things to understand about this surgical robot is that is not used to perform surgeries on automation. Rather, it is a surgical robot that is controlled by a person. Though remote use is possible, typically a surgeon will be in the same room with the da Vinci Xi, as well as the patient, as the procedure is performed.

    What Our Doctors Have to Say About the da Vinci Xi and Patient Care

    What makes the da Vinci Xi so powerful is its precise use of much smaller surgical tools, and thus smaller incisions for the patient. It’s also a step above previous iterations of the surgical robot technology, says Medstar Washington Hospital Center colorectal surgeon Jennifer M. Ayscue, MD.

    “The older robot was less user-friendly and very static, so as a colorectal surgeon, I was only able to operate on one part of the abdomen. This limited the type of colon resections we could do,” Dr. Ayscue says. “The Xi robot allows us to operate in several areas of the abdomen in one procedure, so we can do almost any colon surgery using this very advanced tool.”

    Cheryl Iglesia, MD, director of the section of Female Pelvic Medicine and Reconstructive Surgery (FPMRS) at MedStar Washington Hospital Center and a leader in her field, shares Dr. Ayscue’s sentiments.

    “Having the ability to do a single-port surgery is the next frontier,” Dr. Iglesia points out. “You can perform surgery through just one incision at the belly button.”

    An Investment in Our Patients and Their Recovery

    Most of all, many of our patients recover more quickly, thanks to the da Vinci Xi empowering surgeons to perform more minimally invasive robotic surgeries for certain procedures.

    Of this, Dr. Ayscue says, “My patients have minimal, if any, pain postoperatively. That means they are able to move on with the next part of their therapy sooner, or get back to their lives or work quicker!”

    “While this new robot is very advanced technology, it is very expensive,” she continues. “However, MedStar [Washington Hospital Center] is committed to having the most advanced and best options for our patients, whatever the cost for the institution.”

    As heard from Lambros Stamatakis, MD, on WTOP Radio:

    Have any questions?

    We are here to help! If you have any problems, or would like to schedule a consultation, call us at 202-877-3627.

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  • October 11, 2016

    By MedStar Health

    Since your diagnosis of breast cancer, you probably have many questions about your disease and treatment. Once you enter the world of doctors, specialists, nurses and paperwork, you may not have the time or ability to touch base with your physician about every concern.

    When you head to internet search engines to find out more, remember that the results will include massive amounts of information from a wide range of sources. Unfortunately, much information you will find is not based on high-quality scientific research and not all of the sources are reputable. There are a lot of cancer myths out there, and you may find distinguishing fact from fiction to be a challenge.

    Soy and Breast Cancer: What’s the Connection?

    If you search the internet using the keyword phrase “soy and,” you will find that the number one auto-complete is “breast cancer.” Search engines create auto-complete suggestions based on a prediction of what their readers are looking for as indicated by popularity of terms and search activity. The auto-complete phrase “soy and breast cancer” is an indication of just how many people are looking for answers about the link between the two.

    As you research the connections and implications of soy and breast cancer, you will also find a lot of conflicting information.

    So what’s the truth about soy and is there a connection to breast cancer?

    Soy contains what is called phytoestrogens known as isoflavones. Just like the words phyto and estrogen imply, they are a form of hormone derived from plants. Phytoestrogen is similar to human estrogen; but only the human form of estrogen is linked to breast cancer. Scientific research has shown that natural exposure to the human hormones estrogen and progesterone are common causes of breast cancer and that women who are sensitive exposure to these hormones are at higher risk for breast cancer.

    The connection between estrogens and breast cancer and the early faulty assumption that this also pertains to phytoestrogens in soy, resulted in a number of publications investigating the link between the breast cancer and soy.

    The Truth About Soy and Breast Cancer

    While early studies did indeed suggest that increased soy consumption could lead to breast cancer, later studies have disproved this claim and emerging research suggest that they may in fact reduce the risk.

    In fact, recent studies on the subject indicate that while phytoestrogens do exist in soybeans and other soy products, the estrogen is not a hormone recognized in humans; therefore, it doesn’t have a causal link with breast cancer. Advanced studies of plant and human hormones reveal that different types of estrogen can’t cross over to be used by other species.

    The upshot? Evidence suggests that women with a history of hormone positive breast cancer who consume the most soy phytoestrogens have the lowest risk of breast cancer recurrence. The recommendation is: enjoy phytoestrogen-rich foods if you like them. Avoid them if you don't. The choice is yours.

    The Benefits of Soy

    Even more surprising, the latest research suggests that soy can protect women from breast cancer. Keep in mind that the interaction between the compounds in soy and your body depends significantly on what types of soy products you choose. Unprocessed soy like soybeans, edamame, tofu, tempeh and soymilk are healthy choices and may offer a level of protection for breast tissue.

    Highly processed soy products like protein powders, soy burgers and soy bacon, on the other hand, are not as healthy. The reason is probably because they contain less fiber, more fat, especially saturated, and more salt. Highly processed foods of any sort should be avoided. If you want to include soy in your diet, make sure you choose the unprocessed versions.

    To Find Out More

    When you’re looking for more information about your breast cancer and trying to separate fact from fiction, it helps to turn to trusted sources. You can rely on the highly researched scientific data and advice about breast cancer available from:

    Your oncology nutritionists are also an excellent source of information. By relying on valid sources, you can rest assured knowing you are getting the most up-to-date information about your breast cancer diagnosis and treatment.

  • October 10, 2016

    By MedStar Health

    Cardiac arrest can happen to anyone at any time. Take the time to learn CPR (cardiopulmonary resuscitation), and you could save someone's life.
  • October 10, 2016

    By MedStar Health

    Did you know that up to 20 percent of people have pituitary tumors, but many of them cause no problems, if they are ever even diagnosed? While this may be considered good news for many people, pituitary tumors are not always benign.

    If you develop a pituitary tumor that interferes with your hormones or presses on the surrounding nerves, you could experience a broad range of health issues that should be addressed. Read on to learn about pituitary tumors so you can spot the signs and seek the treatment you need.

    First, What Is the Pituitary Gland?

    Before you can understand the symptoms, you first need to understand the purpose of the pituitary gland. It is a tiny gland located at the base of the brain, which makes several important hormones, including:

    • TSH (thyroid stimulating hormone), which controls the thyroid gland;
    • ACTH (adrenocorticotropic hormone), which affects the production of cortisol (the body’s stress hormone) from the adrenal gland;
    • FSH (follicle stimulating hormone) and LH (Luteinizing hormone) that regulate male and female sex organs and fertility;
    • Growth hormone, which regulates growth, particularly in children; and
    • Prolactin, which controls breast growth and lactation.

    You can think of the pituitary gland as the conductor of the endocrine orchestra. It regulates the production of hormones by other glands in the body, just like a conductor controls the production of sound by individual musicians.

    Symptoms of Pituitary Tumors

    Pituitary tumors can be functional (overproduction of one or more hormones by the tumor cells) or non-functional.  Symptoms of pituitary tumors therefore fall into two categories: those related to hormonal excess and those related to mass effect of the tumor on surrounding structures.

    Tumors that do not increase hormone production can press on important structures around them, such as the nerves connecting the eyes to the brain. These tumors can cause headaches and vision problems. On the other hand, tumors that raise hormone levels can create health issues tied to the hormone they produce.

    For example, a tumor that secretes too much ACTH which then stimulates the adrenal glands to make cortisol can cause Cushing's disease, a state of cortisol excess associated with  weight gain, muscle weakness, depression, high blood pressure, diabetes, and an increased risk of heart disease, osteoporosis, fractures and blood clots in the blood vessels of legs and lungs. A tumor that produces too much prolactin can cause menstrual problems (in women) and decreased sex drive, problems with fertility and low bone mineral density with increased risk for fractures in both men and women.

     Call today to make an appointment at the Pituitary Center.

     

    301-608-9078

    Diagnosis and Risk Factors

    For nonfunctional tumors, you may only find out that you have this kind of tumor when it shows up on an unrelated MRI or when the tumor has grown large enough to compress the surrounding structures causing headaches, visions problems and symptoms of hormonal deficiency (due to compression of the normal pituitary cells). Functional tumors can present with symptoms of hormonal excess, as described above, but they can still be difficult to diagnose, as many of these symptoms can have other possible causes with overlap between various disorders and the diagnosis is often best made at a tertiary referral center.

    Unfortunately, experts don’t know exactly what causes pituitary tumors. Some very rare genetic disorders can make them more likely, but these are associated with symptoms of other components of the syndrome as well. Most tumors have no apparent cause and therefore at present there is no known way to prevent them.

    How Pituitary Tumors Are Treated

    Some pituitary tumors require surgical resection. If this is needed, the doctors treating you will first need to correct your hormone levels to ensure you are safe during the operation. Following the procedure, you may need to have radiation therapy or take medication to treat any residual tumor and regulate your hormone levels.

    That said, not all pituitary tumors need surgery. Asymptomatic small tumors can simply be observed. Also, there are medical treatments available for some tumors, such as those that produce prolactin.

    Final Thought

    If you have symptoms such as headaches, vision problems, sudden weight gain or menstrual problems, you need to reach out to a center that has experience with handling pituitary tumors. Experienced teams can formulate a treatment plan using different approaches that is optimal for you.

    Finally, if your pituitary tumor requires surgical intervention, it is imperative to engage a surgeon who has experience with pituitary tumors. When in doubt, talk to your physician. They can help you with answers to your questions, guidance or a referral.

    Click below to request a Pituitary Center appointment.

    Request an Appointment

  • October 06, 2016

    By MedStar Health

    When men are diagnosed with prostate cancer, their first question is usually, “Can it be cured?” Often, their second question is, “What are my treatment options?”

    Fortunately, research, diagnosis and treatment of prostate cancer has advanced significantly. Many treatments for prostate cancer are considered safe and effective; even so, it’s important to discuss your treatment options with your doctor or specialist(s), so you can understand the process and side effects.

    Discussing Treatments

    When you begin your exploration of prostate cancer treatments, you should think of your urologist as your team leader. Ask him or her for the names of two or three other prostate cancer experts you can speak to, including a medical oncologist, a radiation oncologist and another urologist.

    Ask your doctor the following questions:

    • Whom would you depend on for your own diagnosis and treatment?
    • Whom would you want a family member to visit if they were diagnosed with prostate cancer?

    When you discuss your cancer with a professional, it helps to bring along a significant other or friend who might be willing to raise topics that you feel uncomfortable bringing up; and may absorb information from the conversation that you don’t yet understand.

    Seeking a Specialist

    After you've gathered diagnosis and treatment advice from more than one source, it's time to find a provider. Keep in mind that it's best to prioritize your search by looking for a recommended expert or well-established practice rather than for a specific therapy. 

    For instance, it's not a good idea to focus your search based on the procedure such as transoral robotic surgery (TORS) for prostatectomy and then hoping the surgeon will meet your needs.  Instead, search for an outstanding specialist and allow that person to help you decide which form of therapy is best for you. Also consider a multidisciplinary medical team with proven expertise in prostate cancer care. Experience is crucial to successful remission of the disease.

    Traditional vs. Cutting-Edge Therapies

    The vast majority of prostate cancer cells present as localized areas of disease. Standard treatments for localized cancers are radiation and surgery. For metastatic or recurrent prostate cancers, hormone therapy has become a common treatment option. 

    As research advances, new and promising forms of prostate cancer treatments are becoming available. One of the most exciting innovations is molecular analysis of DNA abnormalities; in particular, researchers are investigating DNA repair genes, mutated androgen receptors and ways to tailor hormone and chemotherapies to address specific molecular defects. 

    Molecular analysis can help doctors and specialists decide which specific cancer therapies will be ideal for individual patients. Additionally, these tests can indicate the best time to initiate or end a treatment based on the reaction of genes found on cancerous tumors.  Ideally, scientists will use molecular analysis to develop inhibitors that prevent the cellular abnormalities that can lead to prostate cancer. Other innovations include turning to chemotherapy early in the treatment schedule as well as utilizing vaccines to combat the growth of tumors.

    When the Best Treatment Is No Treatment

    New urine and blood tests may be able to calculate a prostate cancer patient's risk of spreading. If your prostate cancer is not aggressive and unlikely to spread, you and your doctor might want to discuss simply monitor your health over time - a course of action called "active surveillance."  Active surveillance might include regular biopsies and other tests, but not necessarily treatment. When your best treatment is no treatment, you can avoid unnecessary, expensive therapies and possible side effects.

    Final Thought

    If you face a prostate cancer diagnosis, know that you have a variety of treatment options available to you and that innovative options are possible. With the guidance of experienced medical professionals and your loved ones at your side, you can find a treatment that is right for you to help you continue living an active, healthy life.

  • October 04, 2016

    By MedStar Health

    Whether or not to continue employment while undergoing treatment for cancer is a difficult question. The answer needs to include consideration of your unique situation and needs. You may feel strongly about continuing to work during treatment, or you may need to take time off in order to allow for healing.

    Either decision may be workable, but it’s important to think about your particular situation, and to know some of the basic protections offered to people undergoing treatment for cancer.

    What’s the Right Choice for You?

    The decision of whether to work during cancer treatment is a very personal one, so the variables that contribute to it are unique to an individual’s situation. If work provides a sense of meaning or relief for you, then continuing to do so may be wise.

    On the other hand, if you find your workload or workplace to be emotionally or physically taxing, you may want to take some time off, reduce your work hours or simply stop working. Before making any decision, it’s important to talk to your medical provider about your treatment plan, as well as what the side effects might be. It’s also a good idea to let them know what type of work you do, so he/she can help you decide whether you will be able to continue working.

    Then, it’s time to do a little research about your workplace benefits.

    Do you have short-term disability benefits? What would it take to access those benefits, and how will they help you? Does your workplace offer a leave bank? Are you eligible to take leave through the federal Family and Medical Leave Act? Or does it make more sense for you to apply for Social Security Disability Insurance or Supplemental Security Income? (For more information about these programs, visit the Social Security Administration's website.)

    If your company has an established Employee Assistance Program, you may want to speak to a specialist in that department. Some questions can be answered by talking to your human resources officer or supervisor. You may also want to meet with an oncology social worker to help you sort through some of the possibilities and then determine what would be a good choice for you.

    There Are Laws on Your Side

    Many patients who are undergoing treatment for cancer are protected by federal laws. The Americans with Disabilities Act, The Family and Medical Leave Act, and The Consolidated Omnibus Reconciliation Act (COBRA) are just a few of the laws that offer protection for cancer patients and those experiencing chronic, life-limiting illness. Become familiar with these laws, and the protections they provide.

    For more information about the federal laws that can help cancer patients and their families, two resources that offer additional information are the Cancer Legal Resource Center and Cancer and Careers.

    An Oncology Social Worker Can Help

    Again, the decision to continue or discontinue your work as a result of a cancer diagnosis is a personal one. Regardless of the circumstances, however, consider contacting an experienced oncology social worker. An oncology social worker can be your ally in navigating the emotional and practical complexities that surround this issue.

    Within the MedStar Georgetown Cancer Institute, we have social workers, doctors and specialists who can provide you with support, information and resources. Yes, a cancer diagnosis is disruptive, difficult and confusing – but you don't need to go through it alone. As a team, we work to make your treatment and its impact on your personal life as functional as possible.