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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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  • August 19, 2016

    By MedStar Health

    More than half of the 500,000 individuals who die each year from a heart attack are women. Unfortunately, heart conditions are often stereotyped as a primarily male health concern, and symptoms of heart disease in women go unchecked because they differ than those found in men.

    For example, in a 2005 survey cited by the Centers for Disease Control and Prevention (CDC), 92 percent of people were able to recognize chest pain as a sign of a heart attack. But symptoms such as chronic fatigue, anxiety and sleep disturbances can also be warning signs of a heart event for women.

    If you are a woman of any age, it's critical that you know and understand the different women's heart disease symptoms, so you know how to take control of your health and potentially save your life.

    Know the Symptoms

    Heart disease is a leading cause of death in the United States, causing approximately one in every four fatalities each year. Educational programs have made great strides in alerting people to the warning signs of heart disease, as well as heart events such as heart attacks. But only in recent years has the medical community taken greater steps to ensure women and men are aware of the gender-specific signs of heart issues.

    While many women think they are at little risk for heart disease - either due to age, history or lifestyle - the reality is that even young, relatively healthy women may find themselves experiencing a heart incident. That is why it is so important to know symptoms of heart disease in women.

    Signs of Heart Issues in Women

    The term "heart disease" actually refers to a collection of different conditions and coronary events, rather than a singular diagnosis. Each one has distinct symptoms, although they may be closely related in terms of your overall health. Remember these are all possible signs of heart issues, but you may experience only one or a few. For example, some women have a heart attack without experiencing chest pain.

    Coronary heart disease - which can lead to a heart attack - is a condition characterized by reduced blood flow to the heart. Over time, the major blood vessels (coronary arteries) that provide oxygen-rich blood and nutrients to the heart may narrow due to a buildup of cholesterol and other waste deposits.

    You can have coronary heart disease for many years and not know it. Common symptoms of CHD in women include angina (chest pain) and pain in the neck, jaw, upper abdomen, or back.

    With a heart attack, women may experience the following symptoms, in addition to chest pain:

    • Upper back pain
    • Neck pain
    • Indigestion
    • Heartburn
    • Nausea and vomiting
    • Extreme fatigue
    • Shortness of breath

    Symptoms of heart failure include shortness of breath and fatigue, as well as swelling of the abdomen, feet, ankles, and legs.

    Another relatively common condition is arrhythmia, which is characterized by an irregular or abnormal heartbeat. You may experience heart palpitations or a fluttering sensation. This becomes more serious when it leads to other symptoms, including:

    • Fatigue
    • Dizziness
    • Lightheadedness
    • Fainting
    • Rapid heart rate
    • Shortness of breath
    • Chest pain

    Heart events of any kind are a serious medical emergency. So if you or someone you know is experiencing symptoms, contact 9-1-1 services immediately.

    Taking Control of Your Health

    Heart disease is a serious concern for women. But knowing the signs and symptoms of chronic disease or a coronary event can help you to get long-term treatment and life-saving assistance in an emergency.

    Take steps to help yourself and the other women in your community. Discuss the symptoms of heart disease in women with your family members so they know what to look for and be vigilant to protect those around you by spotting the signs in others. Heart disease can affect women of all ages, so make women's heart disease symptoms a family conversation that includes all generations.

    Have questions?

    If you're interested in learning more about symptoms of heart disease in women, or to schedule a consultation, call us at 202-877-3627.

  • August 18, 2016

    By MedStar Health

    For cancer patients, and their loved ones, there is a lot focus placed on the present moment. What courses of treatment make the most sense for them? How will their diagnosis change their life? Will they need to take time off from work? Can they even plan for the future, or is their life now on hold?

    But what about the unknowns that are beyond the scope of treatment administration? How will cancer patients experience potential side effects? Will they be able to resume their daily lives, unimpeded? What will their lives look like after treatment?

    In short, what will their cancer rehabilitation process look like, and when should it start?

    What Is Cancer Rehabilitation?

    Cancer rehabilitation helps patients address many of the challenges they experience beyond the treatment of their cancer. For example, bouts of pain or fatigue when attempting to complete daily tasks, difficulty speaking or swallowing, or mobility and balance issues. And according to Eric Wisotzky, MD, a physical medicine and rehabilitation specialist who directs the MedStar National Rehabilitation Network’s Cancer Rehabilitation Program, early intervention in this regard can be critical.

    “We can identify issues that are likely to cause problems in the healing process and prevent many from occurring,” Dr. Wisotzky says.

    The ultimate goal of cancer rehabilitation is to maximize every opportunity to enhance a patient’s ability to get back to their lives, their job, their family and their priorities. More specifically, cancer rehabilitation can help a patient gain endurance and mobility, in addition to what may feel like their lost sense of independence.

    What Should a Cancer Rehabilitation Program Look Like?

    The most successful cancer rehabilitation outcomes are achieved when it is integrated into both treatment and survivorship plans and include:

    • Comprehensive, interdisciplinary rehabilitation services (physiatry, physical therapy, occupational therapy, speech language pathology)
    • Individualized treatment plans
    • Pretreatment assessments (if indicated) and patient education
    • Post-treatment assessment and follow up
    • Lymphedema (swelling) management services
    • Exercise and fitness programs
    • Pain management
    • Nutrition counseling
    • Prosthetics and orthotics

    At the MedStar National Rehabilitation Network, the rehabilitation program may begin with a pretreatment assessment, which covers the current health status of a patient, as well as their functional needs and goals. A multidisciplinary rehabilitation team then supports patients with actionable insights to help prevent a decline in function.

    After treatment, patients are closely followed for the development of functional deficits. Once identified, patients are again referred for rehabilitation services to minimize side effects of cancer treatment and to help patients continue their work, family and recreational roles.

    Cancer Rehabilitation Empowers Patients

    A cancer diagnosis, even with the most positive outlook, is still both emotionally and physically disruptive. However, a multidisciplinary approach that includes cancer rehabilitation can make all the difference, when it comes to improving quality of life.

    Ideally, patients will come out of their cancer treatment experience with the tools to live an even healthier life than before their diagnosis. Cancer rehabilitation can be a springboard to helping patients improve their general fitness. “We can empower patients to do the things that will keep them as fit and functional as possible throughout the process and beyond,” Dr. Wisotzky says.

    Through these interventions, we hope that our patients can not only survive the cancer treatment process, but thrive into the future.

  • August 16, 2016

    By MedStar Health

    If you're facing the challenges of choosing treatment options for more complicated cases of a non-melanoma skin cancer diagnosis, it can seem like there is an endless amount of information available. This can make it very difficult to know where to start, when seeking the best treatment options available.

    And with an estimated 3 million new cases of non-melanoma skin cancers diagnosed every year in the United States, you're not alone.

    What Is the Difference Between Melanoma and Non-melanoma Skin Cancers?

    Melanoma is a highly aggressive form of skin cancer that often spreads (metastatic) and has a worse prognosis than non-melanoma skin cancers, especially if not discovered early in their development. While surgery (resection of the primary lesion) is generally recommended for both types of skin cancers, treatment approaches for more advanced cases vary.

    Basal cell and squamous cell carcinomas are the most frequently diagnosed skin cancers. In most cases, they are localized and can be treated with surgery or another form of local intervention. They also have a much lower recurrence rate than that of melanomas, especially if caught and treated early. Both of these cancers are less likely to result in death. However, it is important to keep in mind that both basal cell and squamous cell carcinomas can recur locally or spread to distant sites after the primary lesion has been treated.

    Diagnosing and Treating Basal Cell and Squamous Cell Carcinoma

    It's important to have regular skin checks or screenings for potential skin cancer lesions. A dermatologist or primary care provider is well-trained in how to look for these abnormalities and can advise you on the recommended frequency of having these screenings performed. If lesions are found, act quickly and gather as much information as possible on your unique case.

    Both basal cell and squamous cell carcinomas are diagnosed in the same manner. The process starts when a doctor finds a suspicious spot or lesion. A biopsy is performed, and if it comes back positive for cancer cells, surgical excision is usually the first course of action. Topical therapies or cryotherapies are another option, but tend to be limited to specific circumstances.

    If the tumor has grown large or has regrown in the same spot, radiation therapy may be the next step. In rare cases where the cancer has metastasized to the lung or lymph nodes, systemic therapy (such as chemotherapy or targeted therapy) may be necessary.

    Finding Nonsurgical Help for Your Carcinoma

    What happens if you fall into the latter group of individuals who have large tumors that are not eligible for surgical removal, or are metastatic or unresponsive carcinomas?

    Your dermatologist or surgeon will ideally refer you to a clinic that offers specialized multidisciplinary treatment involving a dermatologist, surgical oncologist and medical oncologist who can work together to create the optimal treatment protocol for your individual case. With this approach, you should receive the best care from a wide scope of experience.

    If your basal cell or squamous cell carcinoma is inoperable, it's of utmost importance that you find the best care possible with providers experience in treating your disease type. Multidisciplinary approaches are key in these cases.

  • August 15, 2016

    By MedStar Health

    MedStar Washington Hospital Center has a long tradition of recognizing associates who take that extra step to care for our patients and for one another. We recently recognized several associates for their good work.
  • August 12, 2016

    By MedStar Health

    Leta Brown had a wonderful life, along with her husband, two daughters and her stepson. But when she was diagnosed with widely metastatic melanoma, she felt the rug had been pulled out from under her and her family. “It was a huge jolt,” Leta shared. “I was left with a really grim prognosis. I wasn’t prepared for that kind of news.”

    In April of 2013, a lumpy bruise appeared on the back of her leg. She consulted with her primary care physician, and a leg MRI showed a large metastatic tumor deposit and body CT scans showed additional metastases to her lungs and small intestines.

    “When I got the news, it was really hard to get past the finality of it,” Leta said. “That this was going to take away my daughters' mother."

    Immunotherapy Clinical Trial with Dr. Atkins

    Not long after, while looking for treatment options, she came across an article on immunotherapy. She then found an immunotherapy trial with Dr. Michael Atkins at Georgetown Lombardi Comprehensive Cancer Center, for which she was eligible, due to her diagnosis, as well as her medical and treatment history. He explained to her that cancer cells express proteins that can disable antitumor immune responses; immunotherapy blocks the function of those proteins restoring the function of the immune system so that it can eliminate the tumor cells.

    Following a resection (removal) of a large bowel metastasis, Dr. Atkins and his team were able to safely initiate immunotherapy treatments in August 2013.  Her tumor deposits quickly melted away and she was able to return to her daily activities. After one year of therapy, she was disease-free and able to stop treatment without disease recurrence.

    “This type of result, while at the time being considered exceptional, is fast becoming the rule rather than the exception for patients with advanced melanoma we see at Georgetown-Lombardi,” Dr. Atkins said of Leta’s outcome.

    Reflecting on Her Treatment and Looking Forward

    Of her treatment, Leta recalled, “Choosing an NCI-designated Comprehensive Cancer Center like Georgetown Lombardi [one of 47 in the nation and the only one in Washington, D.C.] to receive my treatment was very beneficial when dealing with the latest therapies and in managing side effects. The various departments were aware of what to expect and knew how to successfully treat the side effects. It also made it easier for me to schedule appointments and avoid traveling to multiple facilities to receive care.”

    And to others who may find themselves in a similar situation, she says to try not to rush into treatment immediately following a diagnosis; seek other opinions and ask lots of questions.

    “Try to let loved ones help you,” she continued. “But allow yourself to handle this experience in a way that works best for you. Well-meaning friends wanted to sit with me through treatments, but that was a time for me to be alone and process my experience without feeling the need to put on a brave face. Say yes to offers that will ease your burden, and say no when you need to.”

    To this day, she still has no evidence of the disease.

    “I can’t believe how fortunate I am,” Leta said. “I’m looking forward to a really long life… it’s an incredible gift.”

    Leta's full story can be viewed here:

  • August 12, 2016

    By MedStar Health

    Have you been diagnosed with melanoma? If so, there is some good news. Since 2011, melanoma went from being one of the most lethal cancers to one of the most curable cancers in the United States.

    What’s more, even for patients with advanced disease, achievement of long-term, cancer-free survival is now more the rule than the exception. The choices you make for your own melanoma treatment can profoundly affect your health for the better, and it starts with a second opinion.

    The Importance of an Accurate Diagnosis

    Astonishingly, one-third of early-stage melanoma patients who come to the Georgetown-Lombardi Comprehensive Cancer Center in Washington, D.C., for a second opinion are found to have been diagnosed with either the wrong stage of melanoma or the wrong type of melanoma – both of which often involve completely different risks and subsequent treatment.

    Changes in cancer diagnoses may influence things like patient management plans; the size of surgical incisions; the need for additional biopsies; and eligibility for clinical trials with emerging new treatments. All can impact your quality of life in addition to your chances of being cured of your cancer.

    Take Your Time with Treatment

    When it comes to the treatment of cancer, It is much more important to do the right thing than the expedient thing. Waiting a week or two to make sure that you understand the biology of your melanoma and your treatment options can make a big difference in your care, and this small delay should not impact your health negatively. Some health insurance companies may require patients to get a second opinion.

    Seek the Care of a Multidisciplinary Team

    In textbooks, we don’t teach how to manage cancers when suboptimal treatment is done first, so using a multidisciplinary team from the start is crucial to developing a treatment plan that considers all options and their impact on subsequent treatment choices.

    Additionally, not all physicians possess the same level of experience in all areas – and through interaction with different specialties they are able to learn from each and come to a consensus on your care. For some patients diagnosed with early-stage melanoma, a careful review of the pathology slides by a multidisciplinary team while taking into consideration the clinical presentation might determine that lesion is not a melanoma but a benign mole.

    While your medical oncologist will drive your melanoma management, a full team of professionals should be coordinating every aspect of your care to optimize your experience. Depending on the stage and location of your melanoma, you could expect your management to include a:

    • Medical oncologist
    • Surgical oncologist
    • Dermatologist
    • Dermatopathologist
    • Radiologist
    • Radiation Oncologist
    • Pharmacist
    • Plastic surgeon
    • Dietician
    • Genetic counselor
    • Social worker

    Second Opinions Really Do Matter

    Second opinions can prevent you from undergoing unnecessary treatment, avoiding additional medical expenses, wasted time, associated health risks, and the psychological burden of prolonged treatment.

    For example, we saw one young man who was diagnosed with stage three melanoma, which warrants aggressive postsurgical therapy, due to its likelihood of spreading throughout the body. But a closer look identified his cancer as spitzoid melanoma, a form of skin cancer commonly found in young people that never spreads beyond lymph nodes. This change in his melanoma diagnosis meant he did not need to continue with any treatment or medical follow-up.

    Another patient came to us after his thin melanoma (less than 1-millimeter-thick) was surgically removed, along with a draining lymph node. The lymph node biopsy was interpreted as containing melanoma cells, which dictated the subsequent removal of all the lymph nodes in that basin.

    When he first came to us to talk about further therapy, our team took the extra step to compare the lymph node involvement with the original melanoma and determined that lymph node lesion was actually a benign subcapsular nevus. Thus his melanoma was down staged from stage 3 to stage 1A. Although he had already undergone unnecessary removal of all his lymph nodes, the changing of his stage meant that his prognosis for remaining free of disease recurrence had increased from around 70 percent to about 95 percent, preventing the need for additional treatment.

    Research Institutions Can Provide Cutting-Edge Care

    All the progress in melanoma treatment over the last 10 years has been based on research. And patients who receive care from research institutions get a chance to benefit today from the therapies of tomorrow. That’s because melanoma teams at research-based facilities often have access to medical developments and treatment options that may not yet be available to oncologists or surgeons or dermatologists in the traditional community setting. So research institutions are more likely to be active in enrolling patients in clinical trials for cutting-edge new therapies.

    We are here to help.

    If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513.