Caffeine Protects Against Skin Cancer

So how does a dermatologist like me protect against skin cancer? I go to Peet’s Coffee.

There are plenty of reasons to enjoy a cappuccino in the morning (if you can still afford it), and preventing skin cancer might be one of them.

Studies of mice have shown that feeding them caffeine protects them against ultraviolet radiation, which is similar to sun exposure for humans. The protection is most effective when the mice exercise. (So the researchers basically make them drink espresso then hit the exercise wheel.)

While epidemiologic studies and animal studies are helpful, it is nice to have a scientific explanation to support the claim. New studies show how it works.

Researchers exposed skin cells that were growing in culture to caffeine (possibly when one of the graduate students spilled his Red Bull on the petri dish). They then exposed the cells to damaging UVB light. They found that the caffeine-treated, UV-damaged cells underwent programmed cell death. When cells are damaged, but don’t die, they grow into cancerous tumors. When damaged cells die, they are no longer a threat to the body and are safely eliminated.

As sunscreens become more sophisticated, ingredients like caffeine will be added to soak up the damaging oxidants or to protect the skin from developing cancer. Botanicals like ferulic acid, derived from ferns, have proven themselves as powerful additives to sunscreens and are the future of sun protection.

Although there is not enough evidence to advise patients to drink more coffee as a means of sun protection, do you really need another reason to have a nice macchiato in the afternoon?

Photo: Burnt Phrases (flickr)

Caffeine Protects Against Skin Cancer

So how does a dermatologist like me protect against skin cancer? I go to Peet’s Coffee.

There are plenty of reasons to enjoy a cappuccino in the morning (if you can still afford it), and preventing skin cancer might be one of them.

Studies of mice have shown that feeding them caffeine protects them against ultraviolet radiation, which is similar to sun exposure for humans. The protection is most effective when the mice exercise. (So the researchers basically make them drink espresso then hit the exercise wheel.)

While epidemiologic studies and animal studies are helpful, it is nice to have a scientific explanation to support the claim. New studies show how it works.

Researchers exposed skin cells that were growing in culture to caffeine (possibly when one of the graduate students spilled his Red Bull on the petri dish). They then exposed the cells to damaging UVB light. They found that the caffeine-treated, UV-damaged cells underwent programmed cell death. When cells are damaged, but don’t die, they grow into cancerous tumors. When damaged cells die, they are no longer a threat to the body and are safely eliminated.

As sunscreens become more sophisticated, ingredients like caffeine will be added to soak up the damaging oxidants or to protect the skin from developing cancer. Botanicals like ferulic acid, derived from ferns, have proven themselves as powerful additives to sunscreens and are the future of sun protection.

Although there is not enough evidence to advise patients to drink more coffee as a means of sun protection, do you really need another reason to have a nice macchiato in the afternoon?

Photo: Burnt Phrases (flickr)

Fluorescent Light Bulbs and UV Exposure

You might be getting some UV exposure long after the sun goes down — some new fluorescent light bulbs give off UV light.

Fluorescent light bulbs are everywhere now that people are trying to be more green. Most popular are the ice-cream-twist compact fluorescent bulbs called CFBs. CFBs create light by energizing a gas and exciting a phosphorous coating on their glass. The coating prevents most of the ultraviolet light from reaching you, but not entirely; some UV radiation leaks out of any fluorescent bulb. In some CFBs, the emission of UV light is so high that it exceeds the safety limits of the International Commission of Non-Iodizing Radiation.

So, should you be applying sunscreen before turning on your CFB reading light at night? No. Nor should you switch your CFBs back to energy wasting incandescent bulbs. The amount of UV exposure that you get from the light bulb is small compared to the UV exposure you get from just being outside; for most people it is not significant.

However, some people are exquisitely sensitive to ultraviolet light. Auto immune diseases such as lupus, inflammatory disease such as rosacea, and certain drugs such as HCTZ can be triggered by even small amounts of UV light from CFBs.

If you are particularly sensitive to UV, then select CFBs that have a double envelope instead of single, as it will block most of the UV light. And always stay at least one foot away when using fluorescent bulbs of any sort.

Also, remember to sit back from your TV (which my mother taught me to do when I was a kid). Of course, now with HDTVs, you get the best picture when you’re sitting a distance of 3 times the diameter of your TV. If you just bought a 60 inch HDTV, you might need to be in your neighbor’s living room to watch it. This, fortunately, should be safely away from any radiation.

Photo: Steven Fernandez (flickr)

Poison Ivy and Poison Oak Treatment

There are some lucky people who don’t get poison ivy or oak. If you’re like me, you do. Here are some poison plant pointers:

Ivy block cream prevents poison ivy or oak, but only if it is applied 15 minutes before exposure. It doesn’t work after you’ve been exposed.

The intensely itchy, sometimes frighteningly-bubbly rash is an allergic reaction to oil, urishiol, found on poison ivy, oak and sumac plants.

You can wash off the oil with soap and water. Do not use laundry detergent, alcohol, or expensive poison ivy soap — any ordinary bar of soap will wash off the oil. However, the oil is quickly absorbed into your skin, like olive oil into nice piece of Italian bread, so time is of the essence. Once the oil is absorbed in your skin, you cannot get it out no matter what you use.

• You can wash off 50% of the oil within 10 minutes
• You can wash off 10% of the oil within in 30 minutes
• After 1 hour, no amount of washing will make any difference. Nothing will prevent the soon to be rash.

Whatever you do, don’t touch your groin in the first hour or so. You could end up in the hospital; I’ve seen it.

After one hour, you cannot spread poison ivy to someone else. Scratching or breaking the water blisters does not spread the poison ivy or the rash.

The rash lasts for 2 weeks, sometimes less if it is not severe. No cream or treatment, however expensive, can shorten the duration. The rash must run its course.

Once your arms and face turn into wet tapioca pudding, use a drying astringent like Domboro soaks to dry it out.

Once the blistering dries up, apply a topical steroid like hydrocortisone 1% cream or anti-itching lotions like topical Calamine or Benadryl. Cool baths with collodial oatmeal will also help. Super hot showers will relieve the itching, but only temporarily, and in the end, only makes it worse.

If you have a severe case of poison ivy, defined by your mother doesn’t recognize you or you are unable to sit, stand, or lie down, then see a dermatologist for prescription drugs to help.

Photo: Jim Frazier (flickr)

Post by Dr. Benabio, copyright The Derm Blog 2009.

Eczema and Asthma Link

Eczema or atopic dermatitis is a common skin disorder seen mostly in children. It is characterized by a red, scaly, itchy rash that can occur on the face, neck, arms, legs, and sometimes the trunk.

We have known for some time now that eczema, also called atopic dermatitis, is also associated with asthma and allergic rhinitis (hay fever). At least 50% of children with severe eczema also develop asthma. Research from the Washington University School of Medicine might shed light on why these diseases go together.

The research, published in the journal PLoS, found that in mice, eczema-damaged skin produced a substance called thymic stromal lymphopoietin (TSLP). TSLP is a signal to the body that the skin has been damaged. When TSLP circulates through the blood, it elicits a powerful immune response. As such, TSLP is your skin’s way of warning you that its protective barrier has been breached and that backup defenses are needed to keep you protected.

Similar to your skin, your lungs are in direct contact with your environment as well, although we don’t often think of it that way. Like skin, lungs are exposed to the air with all its potential pathogens such as bacteria and viruses. It is not hard to see how an inflammatory disease that affects the skin might also affect the lungs. This is exactly what researchers found — when TSLP from the damaged skin traveled in the bloodstream to the mice’s lungs, it triggered inflammation in the lungs (similar to an asthma attack in humans). The researchers believe that TSLP is the link between eczema and asthma.

Ideally, if a drug was developed that blocked the production of TSLP, this might be a way to prevent people with eczema from developing asthma later in life. It also suggests that minimizing damage to the skin can help limit production of TSLP and improve both eczema and asthma.

Photo: Penreyes (flickr)

UV Light for Acrylic Nails Might Cause Skin Cancer

“It’s like a mini tanning bed for your fingers. ”

Artifical nails are a $6.3 billion dollar industry. There are nearly 60,000 nail salons in the US — 5 times as many Starbucks! Many of these nail salons use UV light, which might increase the risk of skin cancer on your fingers.

Researchers from the M.D. Anderson Cancer Center at the University of Texas noticed that some of their patients with skin cancer on their fingers (an uncommon place to get skin cancer) reported having had UV light for artificial nails. Such UV light has been shown to damage cells’ DNA (the genetic code in all cells) and to cause mutations that lead to skin cancer.

There are several types of nails. The most popular is acrylic, a two part process where a liquid monomer is combined with a powder polymer. It hardens in seconds, but takes an hour for the final hardness to set. Ultraviolet light is used to speed up the hardening.

A second type of artificial nail is the UV-gel. These are more flexible and have a high-gloss finish than acrylics. As their name suggests, ultraviolet light is used to harden the nails.

UV light is also used for a topcoat sealant. Because artificial nails yellow from UV light (especially tanning booths), a top coat can be used to protect the nail. This topcoat is cured (or set) using UV light.

The amount of radiation that your fingers get from the nail treatment is comparable to what you would get in a tanning booth. Because nails are done every 2-4 weeks (one would hope), that can add up to a significant amount of UV exposure over years.

No large scale studies have been done to examine the danger of using UV light for nails, but these patients suggest that there is likely a risk, especially if you have fair skin or have a history of skin cancer.

Photo: Monibela (flickr)

Is Your Physician Board Certified?

Is the milk you drink rBST-free? Is your physician board certified?

Many people take the time to buy hormone free milk, but they don’t make an effort to choose a physician who is board certified. That’s a shame.

Asking a friend or family member might be a good way to choose a hairdresser, but it is not a good way to choose a physician. Medicine is difficult. The same way that you want the pilot of your next flight to be maintaining his or her skills and knowledge of flying, you also want your physician to maintain his or her skills in medicine. The truth is, you are much more likely to die from your doctor’s mistake than from a pilot’s mistake.

Being board certified is no guarantee that your physician is good (or nice!), but it does assure you that your physician is committed to continuing education and is learning advances in medicine. It also assures you that your physician has completed the necessary training and passed a certification exam for the field of medicine he or she is practicing. Having a license means only that they completed the minimal requirement to practice medicine. Maintaining active board certification means that your physician has undergone yearly continuing education and has passed a re-certification exam every few years.

Certainly there is more to being a good physician than completing residency and passing written and oral examinations. But studies show that high exam scores do correlate with practicing better medicine.

There are 24 board specialties. You can check to see if your physician is board certified by going to the American Board of Medical Specialties site at ABMS.org, registering, and putting in your physician’s name. It is a free and confidential service. You can have a nice glass of rBST-free milk in the meantime.

Post written by Dr. Jeffrey Benabio, Copyright The Derm Blog 2009.

Photo: Ingrid Taylar (flickr)

Facials Don’t Treat Wrinkles

Last week one of my patients complained that she gets facials every month for her wrinkles, but that she still has prominent wrinkles around her eyes and mouth. “What,” she asked, “is she doing wrong?”

Facials are the third most popular treatment in spas after nails and massage. They come in many flavors like: mineral masks, steam treatments, microdermabrasions, LED light treatments, blu-light, and even oxygen facials.

Facials can be beneficial; they extract clogged pores, exfoliate dull, scaly skin, and give you a deep, invigorating cleansing, leaving your face smooth and silky. But facials cannot treat wrinkles, broken blood vessles, or brown spots.

Facials are done by aestheticians who are not licensed to practice medicine. Aestheticians cannot administer treatments that penetrate the skin or have  biologic effects (by definition, this would be considered medicine and must be administered by a licensed practitioner such as a physician or registered nurse).  Deeper problems such as wrinkles require invasive treatments which cross the line from cosmetics to medicine.

Facial massages or electrostimulations, which are supposed to tone your skin, don’t. Toning or building muscle requires intense and repeated activity. Just like building biceps, firming musles on your face would require working out. The problem is that wrinkles on your face are caused by contracting muscles — crow’s feet are caused by contracting muscles around your eyes; frown lines are caused by furrowing your brow; lip lines are caused by contracting the muscles around your mouth. Any treatment then that firms facial muscles would only make wrinkles worse.

Other treatments such as oxygen facials and mineral treatments have no evidence to support them, (unless you count “Madonna said so” as evidence). Save your money and have your daughter apply a mud mask the next time you go to the beach.

Photo: Arkansas Shutterbug (flickr)

Related posts:

1. Oxygen Facials: A Lot of Hot Air? Oxygen facials and products touting oxygen as a skin enhancer...
2. 10 Ways to Prevent and Treat Crow’s Feet Crow’s feet are the wrinkles that form on your...
3. What Causes Crow’s Feet? Crow’s feet — the fine lines that radiate from...

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Facials Don’t Treat Wrinkles

Last week one of my patients complained that she gets facials every month for her wrinkles, but that she still has prominent wrinkles around her eyes and mouth. “What,” she asked, “is she doing wrong?”

Facials are the third most popular treatment in spas after nails and massage. They come in many flavors like: mineral masks, steam treatments, microdermabrasions, LED light treatments, blu-light, and even oxygen facials.

Facials can be beneficial; they extract clogged pores, exfoliate dull, scaly skin, and give you a deep, invigorating cleansing, leaving your face smooth and silky. But facials cannot treat wrinkles, broken blood vessles, or brown spots.

Facials are done by aestheticians who are not licensed to practice medicine. Aestheticians cannot administer treatments that penetrate the skin or have  biologic effects (by definition, this would be considered medicine and must be administered by a licensed practitioner such as a physician or registered nurse).  Deeper problems such as wrinkles require invasive treatments which cross the line from cosmetics to medicine.

Facial massages or electrostimulations, which are supposed to tone your skin, don’t. Toning or building muscle requires intense and repeated activity. Just like building biceps, firming musles on your face would require working out. The problem is that wrinkles on your face are caused by contracting muscles — crow’s feet are caused by contracting muscles around your eyes; frown lines are caused by furrowing your brow; lip lines are caused by contracting the muscles around your mouth. Any treatment then that firms facial muscles would only make wrinkles worse.

Other treatments such as oxygen facials and mineral treatments have no evidence to support them, (unless you count “Madonna said so” as evidence). Save your money and have your daughter apply a mud mask the next time you go to the beach.

Photo: Arkansas Shutterbug (flickr)

Related posts:

1. Oxygen Facials: A Lot of Hot Air? Oxygen facials and products touting oxygen as a skin enhancer...
2. 10 Ways to Prevent and Treat Crow’s Feet Crow’s feet are the wrinkles that form on your...
3. What Causes Crow’s Feet? Crow’s feet — the fine lines that radiate from...

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A New Drug, Latisse, Makes Eyelashes Grow Longer, Thicker

It is a medical breakthrough. No, not a cure for cancer, but for the short lashed. The FDA has approved a prescription medication that makes your eyelashes grow.

We have known for years that prostaglandin medications used to treat glaucoma have an interesting side effect –they make patients’ eyelashes grow. Now a prescription drug is available that is specifically for treatment of hypotrichosis of the eyelashes, (which means sparse lashes).

Eyelashes are hair, just like the hairs on your head and legs. Not all hairs are created equal though; eyelashes are designed to grow a certain (short) length, then stop. The number and thickness of your lashes is determined by your genetics.

Latisse (bimatoprost opthamlic solution 0.03%) is a prescription drug made by Allergan, the makers of Botox. It’s a prostaglandin, an active biologic compound named after the prostate gland, the first place they were found. Latisse has been shown to increase the number, thickness, and darkness of lashes.

Latisse can be applied to the upper eyelashes only and should not be applied directly into the eye. It takes about eight weeks to notice results, and it can take 16 weeks to see the full effects of the drug. Unfortunately, you have to continue using Latisse to maintain the results; if you stop using it, then your eyelashes will go back to the way they were before you started treating them.

Side effects of using Latisse include disoloration of your eyelid. Fortunately this appears to be reversible; the color fades when affected people stop using it. Latisse can also cause darkening of the iris in your eye. Your eye color is genetically determined, but medications can change the color. Latisse might cause increased brown pigmentation of your iris. This side effect, unlike the darkening of your eyelid however, is permanent.

Latisse costs about $120 dollars a month and, of course, is not covered by health insurance. It is apparently already popular among the celebrity crowd: reports say Jenny McCarthy has been using it.  The question is how long will it be before someone starts applying it to their eyebrows? I could be the poster boy.

Photo: Nicholas Kenrick (flickr)

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