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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.
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    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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  • April 12, 2019

    By MedStar Health

    Kenneth Fan, MD, recalls when Plastic Surgery’s ability to make a difference in a patient’s life truly hit home. On a medical mission to Haiti, while attending the University of Miami’s Miller School of Medicine, he treated a 35-year-old man who, shamed by a severe cleft lip, had been relegated to life as a recluse. On a subsequent visit to Haiti two years after the procedure, the patient was, figuratively speaking, a new man.

    “From the moment I met him again, he had gone through a complete transformation,” Dr. Fan says. He had gone to college to become an English translator, volunteering time for the program. He had gotten married and was getting ready to start a family. It was evidence of how plastic surgery can bring patients a new sense of wholeness.”

    Advancing Plastic Surgery Research

    Since coming to Washington, D.C., for his residency at MedStar Georgetown University Hospital, the southern California native has pursued an active research agenda, to identify and build upon innovative ways to effect similar transformative results in other patients, particularly those facing post-cancer breast reconstruction procedures.

    “A plastic surgeon is the ‘finisher,’ the last stop on a patient’s sometimes difficult route to recovery,” says Dr. Fan, who now practices at Medstar Washington Hospital Center and MedStar Georgetown University Hospital. He adds that while he was drawn to plastic surgery in part for the high level of technical expertise required, “there’s no one set answer to achieve a solution. And I get to stay engaged with the patient afterward, something I really enjoy.”

    Benefits of Enhanced Recovery After Surgery

    Dr. Fan’s recent work with Enhanced Recovery After Surgery and Anesthesia (ERAS) protocols has focused on minimizing and even eliminating the use of narcotics following breast reconstruction procedures, speeding patients’ recovery and with substantially less post-op “grogginess.” For example, microsurgical breast reconstruction with abdominally-based free flaps typically requires week-long hospital stays, sometimes in the ICU. Using the ERAS multimodal, multidisciplinary approach to pain management, the use of narcotics has been significantly reduced.

    "Patients are walking by post-op day one or two, and going home by post-op day three,” says Dr. Fan, who considers ERAS “a real game-changer,” for improving patients’ recovery from procedures that can be both physically and emotionally challenging.

    “To be able to take the fear out of the postoperative recovery, and to assure patients we are able to manage pain effectively, is by far the most rewarding aspect of this project,” he says. “We are changing the culture of microsurgical breast reconstruction, from a historically challenging recovery, to one of ease and comfort. We hope patients are going to be able to select the right reconstruction for them, without having to consider severe pain and discomfort in their difficult time.”

    Outside of Work

    Given his many other research pursuits—improving health literacy to improve post-op breast reconstruction, reducing barriers to reconstructive surgery among underserved communities, microsurgical correction of lymphedema and other topics that have led to over 140 peer-reviewed articles, book chapters and presentations at scientific meetings —it’s a wonder Dr. Fan finds time for himself.

    “Early mornings in the gym are my favorite time, because it’s usually just me,” he says. Dr. Fan also enjoys reading, traveling, and playing with his German Shepherd, Flora.  He is also a self-described “foodie,” and enjoys trying different cuisines and restaurants.

  • April 12, 2019

    By MedStar Health

    When springtime rolls around, many people are ready to take their exercise-related New Year's resolutions to the next level through new exercises or sports. However, this can cause many individuals to start doing things their bodies aren’t prepared for—think of someone going for a five-mile jog after not running all winter.

    As a result, many people, ranging from high school students to the elderly, visit us with foot and ankle problems, such as:

    • Achilles tendonitis
    • Inflammation of tendons and ligaments in the foot and ankle
    • Plantar fasciitis
    • Severe ankle sprains

    The most common complaints include pain, swelling, and difficulty bearing weight. Read on to learn tips to help you prevent foot problems from developing.

    When springtime comes around, many people jump into physical activity too fast, which leads to #FootPain and #AnklePain. Learn tips to help you prevent these injuries via @MedStarHealth. #LiveWellHealthy

    Click to Tweet

    How to Avoid Foot and Ankle Problems

    1. Wear the Proper Shoes

    It’s important to wear shoes that fit your foot properly—especially for people who put fashion before comfort. Make sure you try shoes on in the store, and walk around for more than just a minute or so to see if you experience any discomfort. Everyone’s foot has its own unique profile, and you should take the time to find the shoes that feel best on your feet. Your ultimate goal should be to match comfort and fit with the fashion you’re looking for.

    Foot orthotics that go into your shoes also can help alleviate foot and ankle pain in some cases. Speak to your doctor to discover whether these devices are right for you.

    2. Stretch Regularly

    As we age, we become less flexible. A lack of flexibility can lead to a number of foot and ankle problems such as Achilles tears, ankle sprains, and plantar fasciitis. It’s important to maintain flexibility by working out and taking the time to stretch every day. A simple 10-minute stretching exercise each day could help you avoid foot and ankle problems related to flexibility. Some common exercises we recommend include:

    • Gastroc towel stretch: Sit down with your legs straight in front of you and loop a towel around your feet. While holding the two ends of the towel, gently pull on the towel, lifting your foot toward you. Hold the position for 30 seconds and do three repetitions.
    • Gastroc uni standing stretch: Stand facing the wall and place your hands on the wall. Step forward with your uninvolved foot, leaning hips towards the wall. Keep rear leg straight with your heel on the floor. Hold the position for 30 seconds and do three repetitions.
    • Soleus standing stretch: Stand facing the wall and place your hands on the wall for support. Place your left foot in front of the right. Slowly bend your knees while keeping your heels on the floor, until you feel the stretch. Repeat with your right leg in front. Hold the position for 30 seconds and do three repetitions.

    3. Listen to Your Body

    It’s important to listen to your body as you exercise. I often see patients who have picked up a new activity, such as running, martial arts, or basketball, and within a few weeks, they develop a foot or ankle problem they’ve never experienced before. It’s important to gradually ease yourself into new activities to avoid setbacks. If you constantly feel foot or ankle pain after a new activity, work on improving your flexibility or consider switching to a different activity. If you have discomfort that goes away within a day or two, that’s normal. But if you’re limping after a couple of days, you may be exceeding what your body can handle for that particular activity.

    4. Work on Your Balance

    Similar to flexibility, balance declines as we age—especially for those over the age of 70. Poor balance increases your risk of falling and developing foot and ankle problems. One common exercise to improve balance is a one-legged balance—this is when you take turns picking up one foot with your knee facing forward or to the side and hold the position for 10 to 20 seconds. Try doing four reps on each foot. Speak to your doctor to learn more activities that can improve your balance.

    It’s common to develop foot and ankle problems, especially as you age. Make sure you use these tips to help you prevent any avoidable issues down the road.

    Are you suffering from a foot or ankle injury? Don’t ignore it – click below to learn how our orthopedic experts can help you at the Foot and Ankle Clinic at MedStar Health at Lafayette Centre.

    Learn More

  • April 09, 2019

    By Krishnan Venkatesan, MD

    Getting circumcised often is associated with baby boys. However, many people are surprised to learn that adults can request the procedure. In fact, at MedStar Washington Hospital Center, we perform somewhere between 50 and 100 adult circumcisions each year.

    Adult circumcision is a reconstructive procedure that removes excess foreskin from the shaft of the penis. Because most American men are circumcised, those who aren’t can feel self-conscious, as they worry whether their partners find it unusual. Furthermore, some skin conditions can lead to an adult circumcision, including:

    • Genital warts: When large or multiple warts develop on the foreskin, circumcision is the preferred approach.
    • Lichen sclerosus: An immune-mediated skin condition, this can cause scarring of the foreskin and cause the skin to become tight around the shaft and head of the penis, which can result in infections.
    • Phimosis: When foreskin tightens and traps urine underneath the skin, it can lead to inflammation or an infection on the head of the penis or skin, or in the urinary tract.

    We saw one man who was in his 50s and experiencing tight penis foreskin, frequent infections, and phimosis. He received a circumcision and shortly after was infection- and symptom-free—just a month after surgery.

    LISTEN: Dr. Venkatesan discusses adult circumcision in the Medical Intel podcast.

    How are Adult Circumcisions Performed?

    During a circumcision, two parallel incisions are made around the penis—one upstream from the skin that’s set to be removed and one downstream. Then, we unwrap the excess skin from the penis and sew the two remaining edges back together.

    Most often, we see men in their late teens or early 20s who are first moving out on their own or becoming sexually active. After the minimally invasive surgery, recovery is very manageable. Men considering a circumcision should consult with their urologist to fully understand the procedure and what to expect during recovery.

    What Can I Expect During Recovery?

    Following surgery, patients can immediately urinate on their own. Recovery usually involves some activity restrictions, however. For example, patients must refrain from sexual activities for about four weeks while the stitches and incisions heal. They also should avoid any heavy exercise for the first two weeks to avoid sweating and putting strain on the incision to ensure it heals properly.

    Basic pain medication and antibiotics are given to patients after surgery, but they usually only need them for one week. After that, they’re usually back to work and doing most of their everyday activities.

    After an adult #circumcision, men usually are off of basic pain medication and antibiotics and back to work within a week, says Dr. Venkatesan. https://bit.ly/2OYl4pG via @MedStarWHC

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    Are There Any More Risks if I Don’t Get Circumcised?

    Not being circumcised thankfully doesn’t have any other concrete risks, outside of increasing the likelihood of skin conditions. However, evidence does suggest that circumcisions before puberty might decrease the risk of penile cancer (although it is very rare to begin with).

    Furthermore, circumcisions sometimes are used outside of the U.S. to prevent HIV or other sexually transmitted diseases. But there’s no compelling evidence that they reduce the risk.

    At MedStar Washington Hospital Center, we’re experts in caring for men who seek a circumcision, because we’re a referral center that routinely sees patients with complex skin conditions. Due to the number of patients we treat with adult circumcisions, we truly offer advanced, results-tested care.

    Adult circumcisions occur quite often in the U.S. Whether it’s because of appearance concerns or the result of a medical condition, expert treatment is available for you and your family.

    Call 202-877-3627 or click below to make an appointment with a urologist.

    Request an Appointment

  • April 05, 2019

    By MedStar Health

    Applications are now being accepted for the Pilot Awards for Clinical Translational Studies (PTCS) through GHUCCTS.  Applications Submissions are online at PTCS Applications. The completed application and signed forms (institutional support forms) are due by Monday, April 15th, 2019 at 11:59 pm.

    Funding Priorities

    • Investigations of environmental determinants of health, particularly those involving clinical and or public health data bases and geospatial mapping, and have potential to point toward solutions through surveillance or policy;
    • Innovative community engagement methods and technologies including research aimed at engaging minority, vulnerable, or other understudied populations;
    • Research that brings together a new type of team;
    • Research that expands a translational research focus across the lifespan including to pediatric and/or geriatric populations;
    • Innovative approaches to the implementation of precision medicine;
    • Engaging individuals with Opioid Use Disorders in research and clinical care while developing effective models of care delivered within medical settings of interest;
    • Research to address health disparities and the significant burden of conditions that disproportionately affect rural, minority, and other underserved populations.

    Eligibility

    Applicants must have a full-time faculty appointment at one of the GHUCCTS institutions (Howard, Georgetown, DCVA, MedStar, ORNL). Each application should identify a Contact PI that will be responsible for coordinating and submitting the application. Research teams can include collaborators who are not GHUCCTS affiliated.

    Funding Opportunity Details

    • Award Amount: up to $40,000 (includes Institutional cost share)
    • Duration: Funds must be spent by March 31st, 2020.
    • A 50% cost-share with the applicant institution is required. (In most cases this has previously been negotiated with the participating institutions.)

    Applications Submissions are online at PTCS Applications. The completed application and signed forms (institutional support forms) are due by Monday, April 15th, 2019 at 11:59 pm.

    About GHUCCTS

    The missions of Georgetown-Howard University Center for Clinical and Translational Science (GHUCCTS) and the national Clinical Translational Science Award (CTSA) programs highlight promotion of interdisciplinary research that translates basic research findings into clinical applications and clinical research into community practice, and improving the process of research. It is also our goal to implement research that will benefit underserved populations, including minorities, people with disabilities, and older adults. Additional priorities recently indicated by the agency that administers CTSAs, the National Center for Advancing Translational Science (NCATS) (see https://ncats.nih.gov/ctsa), further emphasize interaction and collaboration of the 62 CTSA hubs spread throughout the United States (see https//ctsacentral.org).  

  • April 05, 2019

    By MedStar Health

    At MedStar Health, we are committed to creating an academic healthcare system that fosters and supports research. To support this effort, we are pleased to announce two (2) intramural grant funding opportunities that are now open.

    These research funding announcements have been developed to increase collaboration, support new investigators, and enhance the quality of care to our communities. Please refer to the attached requests for proposals (RFPs) for specific submission instructions. Questions about the application process should be directed to research@medstar.net.

    2019 Early Stage Investigator – Associate Giving Grant

    This grant opportunity is made possible by our annual associate giving campaign. Every dollar given by MedStar associates who select “Research” is directed to this fund and used to support early stage investigators. This funding opportunity prioritizes early stage investigators at MedStar Health to help launch impactful research careers in any discipline or specialty that will advance health and create new knowledge.

    We all know the first years as an investigator are important and this grant will provide support to initiate research and conduct pilot studies that can lead to building a robust research activity that will be competitive for external funding. The successful candidate will demonstrate how this seed funding will lead to external grant funding. The proposed budget must not exceed $25,000 in direct costs. There are no indirect costs associated with this grant opportunity. The proposed budget can be used for any study-related expenses necessary to complete the proposed investigation (e.g., salary, supplies, equipment, etc.).

    The RFP is available here. The application should be sent to Research@medstar.net as a single PDF file by 11:59 pm on May 13, 2019.

    2019 MedStar Diabetes Research Grant

    This grant is an opportunity for Investigators interested in diabetes research and is made possible by a generous donation to advance the health of patients living with diabetes through research at MedStar Health. This donation will allow us to support investigators in the field of diabetes research who are interested in developing pilot data that can lead to additional, externally funded studies. These awards are intended to support particularly innovative and transformational ideas that have the potential to have an exceptional impact on diabetes. The successful candidate will demonstrate how this seed funding will lead to external grant funding.

    The proposed budget must not exceed $25,000 in direct costs. There are no indirect costs associated with this grant opportunity. The proposed budget can be used for any study-related expenses necessary to complete the proposed investigation (e.g., salary, supplies, equipment, etc.).

    The RFP is available here.  The application should be sent to Research@medstar.net as a single PDF file by 11:59 pm on May 13, 2019.