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Note to Self: Use Sunscreen and Cover Up

If we were properly mindful, every time we went outside, we’d follow through with the simple steps necessary to minimize our exposure to UV radiation: apply sunscreen and practice sun protective behaviors. But because we’re not, the incidence of skin cancer, especially deadly melanoma, is on the rise.

OK, we need reminders. But, according to a new study, we may have to learn to remind ourselves, because our doctors aren’t doing it nearly as often as they should.

A recent study found that doctors rarely recommend these simple measures during patient visits, even for children (who experience the most sun exposure), and even for patients with a history of skin cancer.

Data reveal that physicians mentioned sunscreen at only 0.07% of patient visits. Physicians did a bit better for patient visits associated with a diagnosis of skin disease, mentioning sunscreen at 0.9% of patient visits. Dermatologists counseled patients the most often, but still not often enough. On visits associated with sunscreen, they mentioned the use of sunscreen to patients at 86.4% of visits. Actinic keratosis was the most common diagnosis associated with sunscreen recommendation. But they didn’t do as well on general dermatology visits, mentioning sunscreen only 1.6% of visits. Even for visits associated with a diagnosis of active or remote history of skin cancer, dermatologists mentioned sunscreen use only 11.2% of the time. Sunscreen was mentioned most frequently to white patients, particularly those in their eighth decade of life, and least frequently to children. The study was based on a survey of 18.3 billion (that’s with a B) US patient visits recorded in the National Ambulatory Medical Care Survey over 21 years, from 1989 through 2010.

“The findings are concerning because children and adolescents get the most sun exposure of any age group, as they tend to spend much of their time playing outdoors. Up to 80 percent of sun damage is thought to occur before age 21 years, and sunburns in childhood greatly increase the risk for future melanoma,” according to Kristie L. Akamine, M.D., Wake Forest School of Medicine, Winston-Salem, NC, one of the authors of the study.

Here’s a reminder: Remember your sunscreen and cover up. You’ll be glad you did.

Need a skin check? Call Zimmet Vein & Dermatology at (512) 485-7700 to schedule or visit www.drzimmet.com to learn about cosmetic treatment options for sun damage.

Shingles Vaccine: Maximizing its Effectiveness

A simple tip to get maximum protection from the shingles vaccine: wait until you are at least 60 to get it. That is the recommendation from the Centers for Disease Control (CDC) after reviewing newly released data from Merck’s Long-Term Persistence Study for shingles.

Though the FDA approved herpes zoster vaccine (HZV) for 50-59 year olds in 2011, research* has shown a gradual decrease in shingles vaccine efficacy by 6-7 years after vaccination. For those vaccinated in their 50s, then, the effectiveness of the vaccine would be waning by the time they reach their 60s, when the risk for a breakout is greater.

“At this time, there is insufficient evidence supporting long-term protection of the vaccine, so if people younger than 60 [years] are vaccinated, they might not be protected when chance of disease is highest,” said Dr. Jeff Duchin, chairman of the CDC’s Advisory Committee on Immunization Practices Herpes Zoster Working Group

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Merck’s Long-Term Persistence Study for shingles.
Shingles Prevention Study
Persistence of the efficacy of zoster vaccine in the shingles prevention study and the short-term persistence substudy.

Concerned you may have shingles or interested in learning more about shingles? To schedule an appointment with Dr. Zimmet, call (512) 485-7700.

It’s Molecular: How Sunscreen Protects

We all know fewer sunburns mean less skin cancer. But how does that work exactly? A study to investigate the effect of sunlight on human skin has revealed that sunscreen protects on a molecular level.

Study

Researchers at Australia’s Queensland University have shown that sunscreen gives protection against all three types of skin cancer (basal cell carcinoma, squamous cell carcinoma and malignant melanoma), and that it also protects against UV-induced damage on a molecular level.

This discovery is important because it proves that sunscreens do more than prevent the redness of sunburn, and gives us insight into how it does so.

Here, an SPF30+ sunscreen, properly applied to exposed skin, prevented damage to a key anti-cancer gene known as p53. If damaged, the p53 gene can mutate in such a way that it no longer does its job of repairing the DNA of skin cells damaged by UV exposure. Once skin cells have DNA damage, there is a higher risk of skin cancer.

“After 24 hours, where the sunscreen had been applied, there were no DNA changes to the skin and no adverse impact on the p53 gene, “said Dr. Elke Hacker, lead researcher.

Published in the journal Pigment Cell & Melanoma Research, this study is saying, in other words, slather it on. Protect your p53.

Remember To Screen Your Skin

Before you go out in the sun, put on an SPF30 or above, broad-spectrum, water-resistant sunscreen. Reapply it every 2 hours. Adults should apply about half a teaspoon of sunscreen to each arm, and to the face, neck and ears area, and just over one teaspoon to each leg, and one teaspoon each to front and back of the torso.

Also, don’t forget the benefits of sun-protective clothing, a broad-brimmed hat. Get in the shade when you can, and choose wraparound sunglasses for best protection.

If you are only just starting to regularly protect your skin and would like to know what can be done to address existing sun damage, contact Zimmet Vein & Dermatology to schedule a free consultation.

Out Damn Spot! The Scourge of Granny Arms

It happens. One day, it hits you that you appear to be on track to have arms not unlike your grandmother’s. Those pesky aberrations she called “liver spots” appear to have commenced their creeping conquest on your once pristine flesh. Do not fear, my dear. There are tools in the dermatologist’s arsenal to keep them at bay and lifestyle choices you can make to manage them.

What are “liver spots”?

Liver spots, age spots, lentigo (plural: lentigines) – they are all the same thing. And just to be clear, liver spots have nothing to do with the liver! Usually occurring in those over 40, age spots commonly appear on the shoulders, chest, forearms, hands and face and are a damage response, in the form of pigmentation, to UV light exposure.

Are they dangerous?

Although age spots are generally considered harmless, they should be checked by your dermatologist if they change or their color or border become irregular. They also are a marker for sun damage meaning they could indicate a higher risk for skin cancer.

How are they prevented?

The best way to prevent the eventual development of age spots is to have a consistent and ongoing practice of sun protection from an early age. Application of a good quality sunscreen whenever venturing outside and being mindful to avoid the sun during peak UVB hours between 10am and 2pm is critical.

Be aware that elevation, ozone, and latitude are factors in the intensity of the rays. Also keep in mind that UVA rays, present at about the same intensity as UVB rays during daylight hours, can penetrate clouds and glass. So, sitting in the car on a cloudy day does not mean you are not being exposed.

What is the best way to get rid of them?

Some people don’t develop age spots, and some people who have them don’t mind them. But for others, age spots are an unsightly distraction and a harbinger of doom! There are a variety of techniques used to remove age spots. Topical treatments such as hydroquinone and tretinoin can help lighten them to some degree. Freezing with liquid nitrogen can be effective, but may leave white spots. By far, the most effective way to treat is with Q-Switched lasers.

Q-Switched Lasers deliver ultra short pulses (nanoseconds) of light to the affected area to gently remove the extra melanin. The skin generally returns to its original complexion, free of age spots. The risk of white spots is lower than with freezing. Q-switched lasers are also used in tattoo removal as well as for non-invasive skin rejuvenation using laser genesis techniques and via carbon peels.

Interested in learning more? Contact Zimmet Vein & Dermatology in Austin, Texas at (512) 485-7700 today or visit us at www.drzimmet.com.

Simple Urine Test Being Developed at MIT to Detect Blood Clots

At one time or another we’ve all sat on a long plane ride, been confined to bed for several days, or been immobile after surgery. These situations can put us at increased risk for life-threatening blood clots.

There is currently no quick or easy way to detect clots. Often, they are diagnosed only after causing a stroke or heart attack. But now, a simple, noninvasive urine test for clot detection is being developed.

A team of MIT engineers has designed the test, described in a recent issue of the journal ACS Nano, using nanoparticles to detect the presence of thrombin, a key blood-clotting factor. Such a system could be useful to monitor patients who are at high risk for blood clots.

“Some patients are at more risk for clotting, but existing blood tests are not consistently able to detect the formation of new clots,” says Sangeeta Bhatia, senior scientist on the project and the John and Dorothy Wilson Professor of Health Sciences and Technology and Electrical Engineering and Computer Science, also a senior associate member of the Broad Institute and a member of MIT’s Koch Institute for Integrative Cancer Research and Institute for Medical Engineering and Science (IMES).

Bhatia envisions two applications for this test. One is to screen patients who come to the emergency complaining of symptoms that might indicate a blood clot. This new diagnostic test would allow doctors to rapidly triage such patients.

“Right now they just don’t know how to efficiently define who to do the more extensive workup on. It’s one of those things that you can’t afford to miss, so patients can get an unnecessarily expensive workup,” Bhatia says.

A second application would monitor patients at high risk for a clot. Bhatia and her team are working on a urine dipstick test, similar to a pregnancy test, that doctors could have patients take home after surgery. “If a patient is at risk, you could send them home with a 10-pack of these sticks and say, ‘Pee on this every other day and call me if it turns blue,’” she says.

Henri Spronk, an assistant professor of biochemistry at Maastricht University in the Netherlands, sees an additional application for this technology: predicting the recurrence of clots. “Through application of the nanoparticles, if proven well-tolerated and nontoxic, alterations in the normal low levels of physiological thrombin generation might be easily detected,” says Spronk, who was not part of the research team.

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