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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 29, 2015

    By MedStar Health

    New ACL repair surgery allows athletes to return to comeptition better and faster.
  • 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.”

  • October 29, 2015

    By MedStar Health

    Instrumental music teacher Marilyn Beeson had just finished teaching her lively class of fourth and fifth graders who were preparing for their spring concert. 

    She was taking a drink when she felt a tickling sensation in her throat, “and then it closed up completely,“ Mrs. Beeson recalls. “I thought I was going to die in front of the kids.”

    A student ran to the school nurse, who summoned paramedics. “I asked the EMTs not to use sirens so the children wouldn’t be upset,” Mrs. Beeson recalls.

    A CT scan at Calvert Memorial Hospital revealed a blood vessel pressing on her esophagus, effectively blocking her throat. Mrs. Beeson was diagnosed with a serious swallowing disorder known as dysphagia lusoria. She was transferred to MedStar Washington Hospital Center, where vascular surgeon Rajesh Malik, MD, and cardiac surgeon Christian Shults, MD, both with MedStar Heart & Vascular Institute, at MedStar Washington Hospital Center, took over her care.

    “This is an unusual condition that requires a multidisciplinary approach,” says Dr. Shults. “And being at the Hospital Center means being able to collaborate with colleagues from different disciplines to come up with a solution."

    After consulting with each other and with Mrs. Beeson and her family, the physicians performed two surgical procedures a few days apart to redirect and reposition the artery. “This approach eliminates the pressure on Mrs. Beeson’s esophagus so it won’t cause problems for her in the future,” explains Dr. Malik.

    Both surgeries went well, and Mrs. Beeson felt the difference immediately. “From the time I awakened from surgery, I no longer felt any kind of rubbing sensation in my throat,” she says.

    “Mrs. Beeson is recovering well, and the problem with her artery is completely resolved,” Dr. Shults says. Dr. Malik adds, “It’s great to be able to help her feel more comfortable and allow her to eat and drink without worry or fear.”

    “This was a frightening thing to go through, but I trusted Dr. Shults’ and Dr. Malik’s opinions and expertise,” Mrs. Beeson says. “I feel so much gratitude to them for performing this complicated procedure so successfully.”

  • October 29, 2015

    By MedStar Health

    Mammograms and Pap Screenings

    The federally sanctioned U.S. Preventive Services Task Force recently issued new findings about women’s health. The panel of experts recommended that women begin routine screening mammograms at age 50. This differs from long-established guidelines advising women at low risk for breast cancer to begin screening at 40, and continue them annually. That’s still the recommendation of the American Congress of Obstetricians and Gynecologists. And, more recently, the American Cancer Society changed its recommendation to age 45.

    Mary Melancon, MD, an obstetrician/gynecologist, says patients often ask what they should do. “We are happy they are reaching out,” Dr. Melancon said. “Every woman’s situation is different, and your health provider is your best resource.”

    Dr. Melancon notes that the major advisory groups, including the American Cancer Society, agree that women with low risk factors for cervical cancer need a Pap screening every three years from ages 21-29, and every five years for ages 30-65, including a screening for human papillomavirus, or HPV. Women are at high risk for cervical cancer if they have a weakened immune system, are HIV positive, or have a previous history of cervical cancer or pre-cancer.

    However, Dr. Melancon emphasizes, even if testing isn’t recommended yearly, it’s still important for women to receive regular gynecological checkups. “We urge women to maintain a relationship with their providers, even after menopause,” she says. “It’s vital to check in, remain current with health screenings and discuss any changes or concerns.”

    Blood Sugar Targets for Diabetes Patients

    Sharma_6603FinalIn April, the American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) released new guidelines for patients with diabetes, including a lower target for HbA1c test results. (The HbA1c reflects a person’s average blood sugar reading over three months.) The AACE and ACE guidelines recommend an HbA1c of 6.5 or lower. The American Diabetes Association’s target remains 7.0.

    “People might have been confused by these different target numbers, but overall, the recommendations have more commonalities than differences,” says endocrinologist Meeta Sharma, MD. The difference between the two recommendations “is actually very small,” Dr. Sharma says. “And all of the organizations stress the need to control glucose levels safely.”

    “Glycemic target is affected by a number of factors—how long someone has had diabetes, their age and other health conditions,” Dr. Sharma says. An elderly person with cardiovascular issues may be at greater risk for hypoglycemia (dangerously low blood sugar), and the consequences of keeping tighter control may outweigh the benefits.

    “There is never one recommendation or solution that works for all,” says Dr. Sharma.

     

    Confusing Prescriptions

    LowellSatler_0060FinalTaking prescribed medications correctly is vital. When those with cardiovascular conditions, for instance, don’t follow their medication regimes, the consequences can be catastrophic, says Lowell Satler, MD, an interventional cardiologist and medical director of the Cardiac Catheterization Lab.

    “Taking drugs incorrectly is a major cause of hospital admission and re-admission,” Dr. Satler says.

    Patients with new diagnoses may feel overwhelmed and unaware of medication’s importance in their treatment, he says. One recent study found that more than 25 percent of cardiac patients had not filled their prescriptions a week after their hospital discharge.

    Fortunately, MedStar has systems to help patients, including texts and e-newsletters as reminders. Also, Dr. Satler says, “we have the Med-to-Bed program, where a pharmacist sends patients home from the hospital with a 30-day supply of their prescriptions, and our nurses do check-in calls to answer patients’ questions and make sure they understand how to take their medications correctly.”

    Dr. Satler is also helping develop an educational video on medication adherence that features a cardiac patient who didn’t comply, and suffered a heart attack.

    New Blood Pressure Recommendations

    Taylor_8025FinalWith studies producing different results, “this can be a confusing time for patients,” says Allen J. Taylor, MD, chief of Cardiology at MedStar Washington Hospital Center and MedStar Georgetown University Hospital.

    He noted findings from the study of Systolic Blood Pressure Intervention Trial (SPRINT), sponsored by the National Institutes of Health and the National Heart, Lung and Blood Institute. Preliminary SPRINT results indicate that maintaining a systolic blood pressure
    of 120 mm Hg — versus a higher target of 140 mm Hg — greatly reduces the chances of cardiovascular complications, such as stroke and heart attack, in adults 50 and older.

    (The systolic, or top, number measures pressure when the heart contracts. The current recommended ceiling is 140 mm Hg for most adults, and 150 mm Hg for ages 60 and older.)

    Although this new information sounds initially compelling, Dr. Taylor cautions, it’s difficult to determine how much it may change patient care.

    “First, we don’t have complete study results,” he says. “When we know the extent of benefits, medications used and any risks of the more intensive treatment, we can better determine how to apply the findings to patient care.”

    “Your particular circumstances are always the most important thing to consider in setting healthcare goals,” Dr. Taylor says.

    In some ways, it’s never been easier to live a healthy, vibrant life. We have 24/7 access to the latest health recommendations about wellness, preventive testing and treatments for challenging conditions. But sometimes it’s overwhelming to have so much new, and sometimes contradictory, information from healthcare organizations. Which recommendations should you and your loved ones follow?

    Fortunately, our MedStar physicians can help. Here, they share their expertise on recent findings about diabetes, hypertension, gynecological health and medication adherence. The common thread: while recommendations are important, no two people are the same, and it’s best to seek advice from your provider before making major healthcare decisions.

    If you have concerns that you would like to discuss with one of our doctors, please call
    202-877-3627.

  • October 07, 2015

    By MedStar Health

     

    Washingtonian Names More Than 95 MedStar Georgetown
    Doctors as “Top Doctors”

    Washingtonian recently announced its “Tops Doctors” for 2015, and 96 physicians from MedStar Georgetown were honored! 

    To determine the area’s “Top Doctors,” Washingtonian surveyed local physicians and asked them to name the doctors they would send a family member to in each of 40 medical specialties. More than 1,300 physicians replied.

    Congratulations to the following MedStar Georgetown physicians who are “Top Doctors” in their specialty:

    Breast Cancer Surgery

    Dermatology

    Endocrinology

    Family Practice

    Gastroenterology

    General Surgery

    Gynecological Oncology

    Hand Surgery

    Infectious Diseases

    Internal Medicine

    Nephrology

    Neurology

    Obstetrics/Gynecology

    Oncology/Hematology

    Ophthalmology

    Orthopaedic Surgery

    Otolaryngology

    Pediatrics

    Plastic Surgery

    Psychiatry

    Pulmonology

    Radiation Oncology

     Radiology, Interventional

    Rehabilitation

    Rheumatology

    Spinal Surgery

    Thoracic Surgery

    Urology

  • September 02, 2015

    By MedStar Health

    Registry to Clarify Optimal Type B Aortic Dissection Treatment

    The perfect storm of high prevalence, large volume and advanced technology make MedStar Heart & Vascular Institute (MHVI) an ideal setting to help define the optimal treatment for aortic dissection.

    As a tertiary referral hub, MHVI at MedStar Washington Hospital Center treats between six to eight patients with aortic dissection every month. While ascending dissection (Type A) requires lifesaving surgical intervention, treatment for descending aortic dissection (Type B) is less clear.

    Medical management has long been the treatment choice unless there is leaking or rupture. But endovascular procedures now are more frequently used. Still, questions remain: Who is at greater risk for future rupture? Which patients would benefit from the endovascular repair of the aortic tear—and when?

    To help clarify the issue, cardiac surgeon Christian Shults, MD, and vascular surgeon Tareq M. Massimi, MD, RPVI, are collecting extensive data to develop a registry of patients from across the MedStar Health network—information about treatment, outcomes and follow-up care that may help inform future clinical trials.

    “We see more aortic dissection cases than any other hospital in the region,” says Dr. Shults. “And area physicians are referring an increasing number of complex cases to us. In many instances, open surgical intervention is clearly the right choice. But in less complicated cases, we have to weigh the risks and benefits of endovascular surgery with drug management. We want to know when and how to intervene before a catastrophic event occurs.”

    “Nationwide there is a paradigm shift in treatment toward endovascular repair for patients with Type B dissection,” Dr. Massimi says.

    No matter the treatment option, all of these patients are followed very closely, and that care provides a great opportunity to collect data and compare results.

    The registry will begin retrospectively with patients treated from January 2014 and move forward. “We think the information will help us develop a new treatment algorithm for these patients, and help to reduce mortality and morbidity,” Dr. Massimi adds.