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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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  • November 02, 2015

    By MedStar Health

    Ron Waksman, MD, director of Cardiovascular Research and Advanced Education, is leading an international, multicenter study to determine if the presence of Lipid-Rich Plaques (LRP) can predict a future coronary event.

    “We have made good strides in treating cardiac events at the time of the occurrences and understand the characteristics of the vulnerable patient,” Dr. Waksman explains. “Yet events still occur in people we traditionally consider at low or moderate risk.”

    “Our hypothesis is that the detection of LRP is an indicator of a vulnerable plaque with dangerous potential. This study will test this hypothesis and create a natural history cohort, which may ultimately include 9,000 enrollees from across several continents,” he says. “Given the current enrollment and event accrual rates, it’s possible the answer to this important vulnerable plaque hypothesis may be answered by the end of this year, or early 2016.”

    In this study, patients who present with stable angina or acute coronary syndrome with suspected ischemic heart disease will undergo angiograms to identify any lesions with restricted blood flow. These patients also will undergo imaging with a technology that uses combined intravascular ultrasound (IVUS) with near- infrared spectroscopy (NIRS) catheter [Infraredx; Boston, Mass.] This tool assesses the cholesterol content within the artery walls. The resulting NIRS analysis or chemo- gram will provide important information about arterial lipid composition.

    All patients will receive the standard of care treatment with respect to their angiographic and IVUS findings. The chemogram findings will be blinded to the treating physician. The patients with high lipid core burden index (LCBI) or arterial wall lipid composition will be followed closely for two years to determine if a new coronary event has occurred in the areas of high lipid pools.

    A randomly selected half of patients with small or low LCBIs will receive identical follow-up care. Patients who experience a new event will undergo imaging to identify the location of the culprit lesions. These imaging results will be compared to the baseline NIRS chemogram.

    If chemograms derived from NIRS prove effective in identifying vulnerable plaque in vulnerable patients, “we will have another important surveillance tool, and may ultimately be able to develop effective interventions— drug and/or devices—to minimize the risk for these patients,” Dr. Waksman adds. 

    For more information, please call Dr. Ron Waksman at (202)-877-5975 or visit MedStarHeartInstitute.org.

    lipids-cvp

    Lipid core in the coronary artery as seen via the NIRS infrared imaging technology.

  • November 02, 2015

    By MedStar Health

    Stroke Prevention Device Proven Option for Some A-Fib Patients

    On June 16, a team of cardiac specialists at MedStar Heart & Vascular Institute (MHVI) became the first in the metropolitan Washington area to successfully implant WATCHMAN—a potentially life-changing device proven to reduce the risk of stroke in certain patients with non-valvular atrial fibrillation (A-fib). The procedure was performed at MedStar Washington Hospital Center, hub of MHVI, just three months after the breakthrough therapy received FDA-approval.

    The most common cardiac arrhythmia in adults, A-fib currently affects more than five million Americans— a figure that keeps growing as the population ages. A-fib causes about 20 percent of all strokes today, and individu- als with the condition are five times more likely to have a stroke than others. Strokes from A-fib are also particularly severe and twice as likely to cause death or incapacitation compared to strokes not associated with A-fib.

    “Patients with A-fib must take blood thinners to minimize their stroke risk, yet many of them have difficulty with compliance,” says Lowell Satler, MD, director of the Cardiac Catheterization Lab at the Hospital Center. “But one of the biggest issues with blood thinners is bleeding, particularly with warfarin. Even the newer classes of oral anticoagulants can pose problems. As a result, up to 45 percent of the total A-fib population may go untreated and, by extension, unprotected from stroke.”

    The vast majority of A-fib-related strokes originate in the left atrial appendage (LAA), a sub-chamber of the heart where blood can pool and form clots. In turn, those clots may then escape into the circulation and block blood flow to brain tissue.

    WATCHMAN is designed to stop that from happening.

    “By preventing the formation of blood clots within the LAA, WATCHMAN can both reduce the risk of stroke and eliminate the need for long-term anticoagulation therapy in a substantial population of patients with atrial fibrilla- tion,” explains Zayd Eldadah, MD, PhD, director, Cardiac Electrophysiology (EP).

    Available internationally since 2009, WATCHMAN is currently approved in more than 70 countries and has been implanted in 10,000 patients worldwide.

    MedStar Heart & Vascular Institute contributed to the research leading up to the device’s FDA approval. Ron Waksman, MD, interventional cardiologist and director of Cardiovascular Research and Advanced Education at MHVI, initiated participation in the PROTECT AF clinical study, one of several launched by WATCHMAN’s manufacturer.

    “Overall, the experience with the device during the investigational phase and now post-approval has been excellent,” he says.

    Since WATCHMAN’s commercial debut, the MHVI team—composed of interventional cardiologists Drs. Satler, Waksman and Robert Lager, MD, and cardiac electrophysiologists Sarfraz Durrani, MD, and Manish Shah, MD—has implanted the device in eight patients to date. The first six procedures were performed by Drs. Durrani and Shah on longstanding A-fib patients already under their care for arrhythmia.

    “MHVI’s early adoption of WATCHMAN reflects our complete commitment to offering patients the most advanced, evidence-based arrhythmia care available,” says Dr. Eldadah, who leads the region’s largest and most experienced EP group with nine board-certified arrhythmia specialists on board and more to come. “As a key component of our comprehensive atrial fibrillation management program, WATCHMAN gives us yet another advanced tool to manage patients’ risk and improve their quality of life.”

    In a minimally invasive, one-time proce- dure, WATCHMAN is threaded through a catheter in the groin and then implanted in the heart at the LAA’s opening. Essentially a mesh filter, the jellyfish-looking device

    is available in five different sizes to accom- modate varying anatomies. The procedure generally takes less than an hour, is performed under general anesthesia, and requires a one-day post-operative hospital stay. Eventually, heart tissue forms over the device, permanently sealing off the LAA from the circulation.

    Just 45 days after the procedure, 92 percent of patients can stop anticoagulation therapy altogether. That figure jumps to 99 percent at 12 months.

    Ten years in the making, WATCHMAN consistently demonstrated comparable stroke-risk reduction— and statistically superior reduction in hemorrhagic stroke, disabling stroke and cardiovascular death—compared to warfarin. Despite this impressive performance, however, MHVI specialists caution that WATCHMAN is neither a cure for A-fib nor a replacement for other proven stroke- reduction therapies.

    “Deciding who is appropriate for WATCHMAN and who isn’t is critical,” concludes Dr. Shah, director, Clinical Cardiac Electrophysiology Fellowship Training Program. “All patients with atrial fibrillation should be evaluated by experienced providers to ensure therapy is tailored appropriately for each individual. It’s a delicate balancing act between risk and benefit.”

     

    First WATCHMAN Procedure a Success

    WATCHMAN_physicianHand[1] copyConstance Wiley is a prime example of how WATCHMAN can change lives. First diagnosed with A-fib in 2002, Wiley subsequently had a full-blown ischemic stroke, followed by multiple TIAs. Warfarin was not a long-term solution for the 63-year-old who developed a major GI bleed. “Without anticoagulants, Constance faced a 5 to 10 percent increased risk of another stroke each passing year,” says cardiac electrophysiolo-gist Sarfraz Durrani, MD. “Her medical history made her an ideal candidate for WATCHMAN.” In June, Wiley became the first in the area to undergo a WATCHMAN implant. Dr. Durrani was able to stop Wiley’s warfarin at her 45-day follow-up. “I was out watering my garden the first day after the procedure,” she says.

    For information or appointments,
    please call 888-354-3422.

  • November 02, 2015

    By MedStar Health

    The first three phases of construction of the new Heart Hospital at MedStar Washington Hospital Center are complete, and the final phase is underway.

    Slated for completion in July 2016, the Heart Hospital has been “designed to provide the very best of heart care in the best possible facility,” says Bradley Kappalman, former vice president, MedStar Heart & Vascular Institute (MHVI).

    “We’re making sense of space in innovative ways to create an efficient, vertically integrated center for cardiovascular care. It’s truly a hospital within a hospital,” he explains. “Now cardiovascular services at the Hospital Center have a unique identity and cohesive, self-contained geographic space.”

    Highlights of the renovations to date:

    First floor: A separate entrance and lobby, with special admissions office and ambulatory care offices for cardiologists and surgeons; an expanded first floor Echo Lab and waiting area.

    Third floor: Renovation and build-out of cardiac and vascular surgery units; includes rooms for LVAD and heart failure patients and inpatient Echo Lab.

    Fourth floor: Renovated cardiology nursing units, with all private rooms; inpatient Echo Lab.

    Sixth floor: Administrative offices

    Phase IV: Cutting Edge ICU's

    The second floor ICU, the final phase of renovation, is the most complex portion of the project.

    “This area has required a complete gut of the existing structure,” says Peri DeOrio, MS, RT(R), senior transition manager. She and IT Transition Manager Denise Figueroa are coordinating the massive effort. The second floor will house 34 ICU beds and 10 intermediate care beds.

    “The rooms will be large enough for the latest technology and monitoring equipment, as well as space for overnight stays by loved ones,” says Kappalman. “Large windows allow natural light to brighten the space,” he says. “It produces a healing, soothing environment.”

    Keeping the Dominos Standing

    “A project this comprehensive requires the work of hundreds,” says Catherine Monge, chief administrative officer, MHVI, “to move dozens of patients and staff, and sophisticated equipment, without disrupting services.”

    “We’ve made it work with careful strategic planning upfront, and commu- nication and coordination on a grand scale,” Monge says. “So many people have made this possible, especially the commitment of Project Lead Chris Poad, whose oversight is a major reason for our success.”

    Stuart F. Seides, MD, physician executive director of MHVI, says, “This is the result of the team’s hard work. Cathie, Peri, Brad, Chris and Denise deserve much credit and gratitude. We’ve had some growing pains, but the end is in sight, and I am confident our patients will reap the benefits.”

  • October 29, 2015

    By MedStar Health

    New ACL repair surgery allows athletes to return to comeptition better and faster.
  • October 29, 2015

    By MedStar Health

    Pacemakers have long been used to regulate heart function. Now, a similar approach called vBloc® may help patients with obesity and weight control problems regulate their appetites.

    The therapy, recently approved by the FDA, uses a small device to help patients better regulate their appetites, allowing them to eat more appropriate portion sizes and avoid snacking between meals.

    Unlike more complex bariatric surgery procedures such as gastric bypass, sleeve gastrectomy and adjustable gastric banding, the vBloc device can be implanted on an outpatient basis, and adjusted as needed using wireless communication technology. vBloc therapy patients may also have fewer meal and lifestyle restrictions.

    While vBloc is a promising alternative therapy for weight loss, it’s not for everyone. “vBloc opens up possibilities for weight loss surgery patients who have a lower body mass index,” says Timothy Shope, MD, a bariatric surgeon at MedStar Washington Hospital Center. “Patients still need to first come through our weight loss program and be evaluated to see if they are eligible for the therapy.”

    For more information about bariatric surgery and vBloc, call 202-877-DOCS (3627).

  • October 29, 2015

    By MedStar Health

    Hundreds of people with chronic artery blockages could benefit from a new technique to clear those old blockages.

    Take Dick Talley, for instance. He likes to sail, race go-karts, and work out. Since a coronary artery bypass in 1991, the St. Leonard, Md., resident had felt just momentarily slowed by a minor stroke four years ago.

    Then, early in 2014, a heart attack trimmed his sails. Deepening fatigue meant he had to rest more than garden, and skip out on sailing and racing. “I hated to admit having no energy,” says Talley, 70.

    Talley’s cardiologist performed an angiogram and diagnosed chronic total occlusion (CTO), the complete blockage of a coronary artery. In addition to the original blockage, his bypass had closed. CTO occurs in 15 to 20 percent of patients with significant coronary artery disease.
    The cardiologist sent Talley to MedStar Heart & Vascular Institute’s interventional cardiologist Robert Gallino, MD, at MedStar Washington Hospital Center.

    Dr. Gallino favored a procedure called CTO percutaneous coronary intervention (PCI). He would open Talley’s original blockage that occurred 24 years earlier.

    American physicians had used a similar method on CTOs in the leg with excellent results, “and the Japanese started doing it with the heart in the early 2000s,” says Dr. Gallino. The procedure is tricky, especially this one, since Talley’s blockage was 24 years old and had grown and hardened over time. Part of the procedure involved reaching the blockage by advancing special guide wires from the right side of the heart, all the way through to the left side, where he could then open the blockage with angioplasty, a procedure to restore blood flow through the artery.

    Gallino_Bernardo_0011Final2.jpgDr. Gallino and Nelson Bernardo, MD, started performing hybrid CTO PCIs about 18 months ago. Only eight U.S. hospitals do more than 50 such procedures a year. Drs. Gallino and Bernardo do two each week.

    Traditional surgery opens the chest and means a week in the hospital and six weeks’ recovery. If this procedure occurs on a Monday or Tuesday, Dr. Gallino says, the patient can be playing golf that weekend.

    Talley’s procedure was clear sailing—an amazing result given the blockage was 24 years old. Such procedures used to be considered impossible.

    “We’re treating blockages many people thought weren’t treatable,” Dr. Gallino says. “That’s tremendously gratifying.” As for Talley, “I went from just taking an afternoon sail around the Chesapeake Bay to feeling like I can sail around the world!” And no, that’s not a metaphor. Starting next fall, the veteran boater plans to spend three years sailing the globe. “This heart’s going to outlive me,” he says. “I’m lovin’ life.”