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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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  • July 04, 2020

    By MedStar Team

    Since March, organized crime and other threat actors have used the COVID-19 crisis as a basis for increased attacks on computer systems and phishing campaigns designed to obtain sensitive or personal information. 

    Through social engineering, these threat actors attempt to take advantage of the COVID-19 pandemic by prompting associates to provide personal information or passwords, click on or open malicious links or attachments, or transfer money. These attacks can come through phishing emails, texts or voice calls to a workstation, smartphone, or other devices.

    The threat actor may spoof a known source for COVID-19 information, such as the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), MedStar Human Resources, or a local school district. Phishing attempts may also come from vendors purporting to have or sell Personal Protective Equipment (PPE) or other supplies. 

    To avoid these risks, follow these important recommendations: 

    • Take your time when reviewing email or text messages. Be careful before you click!
    • Be alert for phishing messages in your email inbox. Since phishing emails arrive from outside of the network, determine whether the email is legitimate. All external emails include a tag of [EXTERNAL] in the email subject line and a banner:

    ** ATTENTION: This email originated from outside the MedStar network.
    ** DO NOT CLICK links or attachments unless you recognize the sender and know the content is safe.

    • If you don’t know the sender and it looks suspicious, delete the email. Do not click on any attachments or links within the body of the email. 
    • Look for spoofed addresses. For example, if an email appears to come from an associate and the sender’s address is not @medstar.net, it is not a legitimate email.
    • If you receive a text message from a number you do not know, delete the text message. Do not click on any links within the text message. 
    • Report suspicious emails to phish@medstar.net or spam@medstar.net. Call the IS Service Desk at 877-777-8787 with any questions.

    Thank you for your efforts to protect our network, important data, systems, and organization.

  • July 04, 2020

    By MedStar Team

    Congratulations to all MedStar researchers who had articles published in June 2020. The selected articles and link to PubMed provided below represent the body of work completed by MedStar Health investigators, physicians, and associates and published in peer-reviewed journals last month. The list is compiled from PubMed for any author using “MedStar” in the author affiliation. Congratulations to this month’s authors. We look forward to seeing your future research.

    View the full list of publications on PubMed.gov here.

    Selected research:

      1. Sex-Associated Differences in Cardiac Reverse Remodeling in Patients Supported by Contemporary Left Ventricular Assist Devices
        Journal of Cardiac Failure, 2020. DOI: 10.1016/j.cardfail.2020.03.005
        Mehta N, Mazer-Amirshahi M, Schulman C, O'Connell F, Pourmand A.
      2. Differentiated Thyroid Cancer and Hashimoto Thyroiditis: Utility of the Afirma Gene Expression Classifier
        Journal of  Surgical Oncology, 2020.
         DOI: 10.1002/jso.25875
        Papoian V, Rosen JE, Lee W, Wartofsky L, Felger EA.

      3. Varying Rates of Patient Identity Verification When Using Computerized Provider Order Entry
        Journal of the American Medical Informatics Association, 2020. DOI: 10.1093/jamia/ocaa047
        Fortman E, Hettinger AZ, Howe JL, Fong A, Pruitt Z, Miller K, Ratwani RM.

      4. Racial Disparity in Postpartum Readmission Due to Hypertension Among Women With Pregnancy-Associated Hypertension
        American Journal of Perinatology, 2020. DOI: 10.1055/s-0040-1712530
        Chornock R, Iqbal SN, Kawakita T.

  • July 04, 2020

    By MedStar Team

    MedStar Health policies require that all individuals engaged in the conduct of research complete the annual conflict of interest disclosure. The annual research conflicts of interest disclosure process is designed to manage financial and nonfinancial research interests. As you probably know, MedStar Health Research Institute is required to manage conflicts of interests as a condition of receiving federal funding for research.

    If you held a research role at MedStar in fiscal year 2020 (FY20), you may have already entered data into the COISmart system during the fiscal year. If you have completed the questionnaire as a researcher during FY20, a link to the conflict of interest disclosure will be sent to you in July. You will be required to ensure that the disclosure on file for FY20 accurately reflects any external relationships you have for the entire fiscal year. When you receive that email in July, please follow the link in that email to certify your previous disclosure if it already reflects all external relationships you have had during FY20. Use the “revision” links in the questionnaire to update your answers if necessary and resubmit the questionnaire to ensure that it accurately reflects a full fiscal year of reporting (July 1, 2019, through June 30, 2020).  As a researcher, the FY 2021 questionnaire is also available for you to complete between July 1, 2020, and June 30, 2021.

    If you have any questions about the conflict of interest policy or accessing the COISmart system to make disclosures, contact Christine Kyak, Entity Compliance Officer at (202) 510-6876 or Christine.R.Kyak@medstar.net.

  • July 04, 2020

    By MedStar Team

    A collaborative team of researchers from across MedStar Health and partners published their work to assess the effect of race on in-hospital outcomes of takotsubo cardiomyopathy (TC) in a large nationwide sample. The team included investigators from MedStar Washington Hospital Center, MedStar Health Research Institute, MedStar Heart and Vascular Institute, Georgetown University, and National Heart, Lung and Blood Institute.

    “Racial Differences in Takotsubo Cardiomyopathy Outcomes in a Large Nationwide Sample” was published in ESC Heart Failure. Takotsubo Cardiomyopathy or stress-induced cardiomyopathy is characterized by transient ventricular impairment, often preceded by emotional or physical stressors. Gender, racial, and ethnic differences have been reported with respect to incidence and prognosis of cardiovascular diseases including heart failure and acute myocardial infarction, in part due to variability in genetic, biological and socio-economic factors. Studies have reported increased in-hospital complications in African American patients presenting with TC; however, the effect of race on TC remains unknown

    The research included data obtained from the National Inpatient Sample (NIS) database. Of 97, 650 patients included: 83,807 were women; 89, 624 identified as Caucasian; 8,026 identified as African American. Between the two races, demographic characteristics and insurance variables were significantly different.  African American patients were younger, having a higher percentage of men and lower median household income. The rate of TC hospitalizations increased in both races. Mortality rates initially increased from 50 cases (1–2%) to 340 cases (5–6%) and subsequently remained stable around 5–7% with fluctuations but with no overall significant difference between races.  Multivariate regression models were created to adjust for potential confounders.

    In unadjusted analysis, African American patients had more cardiac arrests, invasive mechanical ventilation, tracheostomies, acute kidney injuries, and longer hospital stays compared with Caucasians.  After the adjustment for differences in age, gender, comorbidities, hospital location/teaching status, and socio-economic factors, all differences were significantly reduced or eliminated. The adjusted risk was lower in African Americans compared with Caucasians, for cardiogenic shock, mechanical ventilation and intra-aortic balloon pump insertion.

    The research concluded that African American patients overall have worse outcomes including longer hospitalizations, higher rates of cardiac arrests, invasive mechanical ventilation, tracheostomies, and acute kidney injury compared with Caucasians. Overall, African American patients have more in-hospital complications; however, the differences are driven by racial disparities in demographics, comorbidities, and socio-economic factors.

    The team included Raja Zaghlol,MD; Ana Barac, MD; Amit K. Dey; and Sameer Desale.

    ESC Heart Failure, 2020.  DOI: 10.1002/ehf2.12664

  • July 03, 2020

    By Jasmeet Singh Bhogal, MD, MBA

    The 4th of July holiday weekend is coming up, and many people will be spending their time outside in the sun. Whether you plan on having a backyard barbeque, swimming in the pool, or going out on a boat, taking action to protect your skin, along with practicing proper social distancing, should be a top priority.

    In the U.S., more people are diagnosed with skin cancer than any other kind of cancer, according to the American Cancer Society. Since most skin cancers develop as a result of exposure to harmful ultraviolet (UV) rays, taking steps to protect your skin in the sun can help you reduce your risk of skin cancer.

    July is #UVSafetyMonth. You can minimize your risk of #SkinCancer this holiday weekend by protecting your skin with these tips from family medicine physician Dr. Bhogal on the #LiveWellHealthy blog: https://bit.ly/2ZtrxPf.

    Click to Tweet

     

    It’s important to use sun protection while enjoying the benefits of getting outside.

    Our skin makes vitamin D naturally when it’s exposed to the sun, which can positively impact our body’s mental and physical function. In fact, Vitamin D can help to boost your immune system and improve your mood by increasing serotonin levels in the body. Still, there are many dangers to the sun, which is why most doctors recommend getting vitamin D from what you eat or supplements.

    While there are many benefits to getting outside, the sun’s UV rays can be harmful if we don’t take precautions to protect our skin in the sun. The sun gives off two different types of UV rays, both of which can be dangerous:

    • UVA rays are responsible for sunburn, hyperpigmentation, and skin cancer.
    • UVB rays can contribute to skin aging and skin cancer.

    While both types of UV rays can negatively affect the skin, UVB rays are more likely to cause skin cancer, including melanoma.

    Factors affecting UV exposure.

    It’s important to protect your skin from both types of UV rays because neither one is safe. And, your environment can impact how strong they are. The following factors can impact how much your skin is exposed to UV rays:

    • The time of day: 10 am to 4 pm is when UV rays are strongest.
    • Distance from equator: The closer you are to the equator, the stronger the UV rays are.
    • Elevation: Higher elevation means more exposure.
    • Reflection off surfaces: Sand, snow, and water may reflect sunlight, increasing UV ray exposure.
    • Length of time: The longer your skin is exposed, the greater your risk.

    By taking the right steps to protect your skin in the sun, you can reduce your risk of getting skin cancer—and prevent premature skin aging, like wrinkles, dark spots, and leathery skin.

    How to protect your skin in the sun.

    Even if it’s not sunny, your skin is still exposed to harmful UV rays any time you’re outside. Here are seven simple ways you can limit your UV exposure and protect yourself in the sun.

    1. Choose the right type of sunscreen.

    Sunscreen is an effective way to minimize your risk of skin cancer and signs of early skin aging caused by the sun. Except for babies under the age of six months, everyone should wear sunscreen anytime they’re outdoors. When picking a sunscreen, it’s important to choose the right kind. The American Academy of Dermatology also recommends selecting a sunscreen that is:

    • A broad-spectrum option, offering protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays.
    • Sun protection factor (SPF) of 30 or higher.
    • “Water-resistant”.

    Keep in mind that while sunscreen can be “water-resistant”, it is not waterproof or sweatproof. As a result, it’s important to reapply frequently, especially if you are swimming or sweating.

    2. Apply and reapply sunscreen regularly.

    The way you apply sunscreen impacts how effectively it protects your skin. The best way to apply sunscreen is to lather it on 15 to 30 minutes before you expose your skin to the sun. That’s about how much time it takes for your skin to absorb it. After you apply, wait 10 to 20 minutes to avoid accidentally rubbing off the sunscreen. You can reduce your risk of sunburn by reapplying every two hours—or sooner if you’re swimming.

    How much sunscreen do I need to apply?

    Following the “teaspoon” rule is a great way to ensure you’ve used enough sunscreen to protect uncovered skin. The “teaspoon rule” suggests applying a teaspoon-sized amount of sunscreen according to these guidelines:

    • One teaspoon on your face and neck.
    • One teaspoon on each arm.
    • Two teaspoons on your front torso.
    • Two teaspoons on your back.
    • Two teaspoons on each leg.

    3. Wear protective clothing.

    Covering up in clothing is a great way to minimize your exposure to UV rays, but different types of clothing offer varying levels of protection. The following types of clothing offer the most protection:

    • Thicker fabrics (e.g. denim) compared to thin fabrics (e.g. cotton)
    • Darker colors
    • Dry fabrics

    4. Cover your head with a wide-brimmed hat.

    Hats with brims at least three inches in diameter are an effective way to limit your face’s exposure to UV rays. Baseball caps or other hats with a narrower brim may not protect all of the areas on your face that may be exposed to the sun, like your ears, nose, and neck.

    5. Protect your eyes with sunglasses.

    Sunglasses are important for protecting your eyes and the skin around your eyes from the sun. It’s hard to judge how well a pair of sunglasses can protect you from the sun just by looking at the color of the lenses. Instead, look for sunglasses that say they block 99% or 100% of UVA and UVB rays.

    6. Avoid the sun during peak hours.

    The sun’s UV rays are strongest between the hours of 10 am and 4 pm. Try to stay in the shade if you must be outside during that time of day—or avoid it altogether, if you can. Friday July 3 is also National Stay Out of the Sun Day, a day when staying indoors is encouraged to give your skin a break from the sun. But you don’t have to just lay around and watch Netflix all day to participate. You can relax in the shade, do an in-home workout, play a board game with family, anything that doesn’t involve being in the sun.

    7. Seek shade wherever you can.

    Staying under shade can be a great way to get outside while limiting your UV exposure. Whether you seek shelter under a tree or set up a tent on the beach, it’s important to find shade, especially during the sun’s strongest hours. This is especially true for babies who should avoid any unnecessary sun exposure. Babies younger than six months should always be protected from the sun with strollers, hats, and umbrellas.

    What to do if you get a bad sunburn.

    Most cases of sunburn are mild to moderate, which can be uncomfortable. Ibuprofen, aloe vera gel, or cold compresses can help to minimize swelling and pain while it heals. If you have any blisters, avoid picking them open. If they do rupture, clean them with soap and water and cover with a wet dressing to avoid any infection.

    In more severe cases that result in vomiting, fever, or disorientation, you may need to seek medical attention from an urgent care center.

    You don’t have to stay indoors altogether, but being cautious can help you protect your skin and minimize your risk of skin cancer. Limit unnecessary sun exposure by correctly applying sunscreen, covering up with clothes, hats, and sunglasses, and staying in the shade.

    Get the care you need, now.

    It’s important that you don’t delay your medical needs or ignore symptoms that would typically make you seek care. Early detection and treatment improve our ability to provide the most comprehensive and effective care.

    Since the COVID-19 pandemic reached our region, MedStar Health has made innovations to ensure we are still the best and safest place to receive care.

    We have worked hard to make sure we can provide the care you need in the most appropriate and safe setting. MedStar Health Video Visits are still options for a variety of appointment needs, but in some cases, an in-person visit may be best. We’re here to help you get the right care that reflects your needs and comfort level.

    We’re open and prepared to safely offer the same high-quality care you expect from MedStar Health, when you are ready to see us.

    This is an updated version of an article previously posted on May 20, 2020.

    Find care now. 
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  • July 02, 2020

    By Min Deng, MD

    Skin cancer is the most common form of cancer, with 9,500 people in the U.S. diagnosed each day. Fortunately, it’s also the most preventable.

    Here are some things you can do to reduce your risk of developing skin cancer.

    Skin Cancer: What Is It? What Causes It?

    Skin cancer is a cancerous growth of skin cells. The three most common types are basal cell carcinoma, squamous cell carcinoma, and melanoma.

    Ultraviolet (UV) damage, whether due to sun exposure or tanning beds, is a major contributing factor for skin cancer. Tanning beds are now also classified by the WHO as a class 1 carcinogen.

    Most people are familiar with the short-term effects of a sunburn, such as pain, redness, blistering, and peeling. What many people don’t realize is that ultraviolet light also damages DNA. While the redness and peeling can heal, the underlying DNA damage remains. Repeated damage accumulates and this cumulative effect can lead to skin cancer.

    #Sunburns are painful and inconvenient, but did you know they also damage your #DNA? Dr. Min Deng discusses how wearing #sunscreen helps protect you from #skincancer. https://bit.ly/2BoWVGx via @MedStarWHC
    Click to Tweet

    Some people are more naturally susceptible to skin cancer than others. Intrinsic risk factors for skin cancer include having fair skin, blue eyes, and/or red hair. Individuals with lighter complexions are more vulnerable to the damaging effects of the sun. A person whose parent, sibling, or child has a history of skin cancer is also at greater risk of developing the condition.

    How Can You Protect Your Skin?

    The good news is that there are many steps you can take to protect your skin from harmful UV radiation.

    • Wear Sunscreen
    If you spend time outside, protect your skin by wearing a broad-spectrum sunscreen.

    There are two main types of sunscreen: chemical and mineral. Chemical sunscreens contain many different active ingredients, with each chemical working to absorb a different wavelength of light. Mineral sunscreens, sometimes called “sunblocks,” can include zinc oxide and/or titanium dioxide. Rather than absorbing the sun’s rays, mineral sunscreens sit on the skin and reflect UV rays.

    If possible, I recommend choosing a mineral sunblock over a chemical sunscreen. The ingredients in chemical sunscreens can irritate sensitive skin, and there is also evidence that these chemicals are harmful for corals and other marine life. However, any sunscreen is better than none at all!

    To get the full SPF value that’s listed, it should be applied in quantities of 2 mg/cm2. I recommend applying it every two hours, or every hour if you are swimming or perspiring a lot, since these products can degrade. Cream products are best for your first application to ensure full and adequate coverage. I generally recommend spray products more for touch-ups throughout the day.

    • Wear Protective Clothing
    If you spend time outdoors, whether for work or play, wear protective clothing whenever possible. Long-sleeved shirts, hats, and sunglasses can provide good protection, particularly against the afternoon sun.

    If you spend a lot of time in the sun, have your skin checked by a board-certified dermatologist once a year. Having regular checkups is important for establishing your baseline risk and keeping track of changes as they occur.

    • Avoid Tanning Beds
    Many people believe that tanning beds are a healthier way to get a tan, but this is not true. Tanning beds emit UV rays, often delivered in potent doses. Their use is associated with a significantly increased risk of developing skin cancer, including melanoma, which is why the World Health Organization’s International Agency for Research on Cancer classifies the UV rays emitted by tanning beds as carcinogenic to humans.

    LISTEN: Dr. Deng discusses skin cancer on the Medical Intel podcast.

    Can Skin Damage Be Reversed?

    Damage caused by UV exposure accumulates over time, and unfortunately this damage can’t be reversed. However, there are options for treating precancerous skin lesions, also known as actinic keratoses.

    If you have this type of lesion, a dermatologist may suggest field therapy with a topical cream, photodynamic therapy, or a combination to decrease the burden of disease and slow the rate of progression to cancerous growths. I usually recommend that patients with 10 or more such precancerous lesions on any single body site receive field therapy. Your dermatologist will determine the treatment course based on your unique needs.

    Though UV skin damage is irreversible, it’s never too late to start taking steps to protect yourself from the sun. Each sunburn increases your risk of developing skin cancer, which means that each avoided sunburn reduces this risk. No matter how much sun exposure you’ve had throughout the years, you still have the power to protect yourself from further damage!

    If you’re concerned about changes to your skin, our team of board-certified dermatologists at MedStar Washington Hospital Center can help. We’re here to provide individualized care and assure that you’re informed to make healthy choices regarding your skin.

    Too much sun exposure?

    Our dermatology team is here to help.

    Request an appointment with a dermatologist
    or call 202-644-9526.