Isotretinoin Safety

Acne Medicine Isotretinoin Appears Not To Adversely Affect Sleep, Executive Function.

MedWire (5/13, Albert) reported that, according to a two studies published online in the Journal of the European Academy of Dermatology and Venereology, "the acne medication isotretinoin does not adversely affect sleep or parameters of executive function." In two separate studies involving 12 and 63 patients with severe acne, respectively, who were treated with isotretinoin and who underwent neuropsychological testing, researchers found "no adverse effects of isotretinoin on mood or executive function."

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Vitamin D and Multiple Sclerosis

Low Levels Of Vitamin D Associated With MS.

WebMD (5/23, Warner) reported that, according to a study published May 24 in Neurology, "77% of African-Americans with" multiple sclerosis "were vitamin D deficient compared with 71% of African-Americans without the disease." The investigators reached these conclusions after studying levels of vitamin D in 342 African-Americans without MS and 339 African-Americans with MS. The study authors theorized that "much of the difference in vitamin D levels may be explained by variations in climate and geography, but the findings add further evidence to the growing link between vitamin D and multiple sclerosis risk."

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Tanning Beds

AAD Survey Finds Young Women Disregard Warnings Linking Tanning To Melanoma Risk.

The Los Angeles Times (5/2, Kaplan) "Booster Shots" blog reported, "When it comes to tanning and health, young women still aren't getting the message," according to a new survey from the American Academy of Dermatology. The Department of Health and Human Services and the World Health Organization have "declared UV a known carcinogen"; and according to the AAD, people who engage in indoor tanning "increase their risk of developing melanoma by 75%." Yet the AAD poll found that "32% of the young women" surveyed had "put themselves in a tanning bed within the past year, with 25% of those tanners saying they had done so on a weekly basis."

        According to Fox News (5/2) the survey, which involved "more than 3,800 white non-Hispanic females ages 14 to 22," also found that 81 percent of the women "said they had tanned outdoors either frequently or occasionally in the past year." WebMD (5/2, Hendrick) noted that the tanning appeal increased with age. The survey showed that "18- to 22-year-olds were almost twice as likely to have used indoor tanning than 14- to 17-year-old girls."

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Sunscreens Not the Answer!

Environmental Working Group: Sunscreens Alone Cannot Prevent Skin Cancer.

The CNN (5/24, Caruso) "The Chart" blog reported that, according to the Environmental Working Group (EWG), "sunscreens alone cannot prevent cancer," a message the group drives home in its latest sunscreen report, encouraging people to stay in the shade, don clothing protective of the sun, avoid being out in the sun from 10 am to 4 pm, in addition to the use of sunscreens. This coming Friday, May 27, has been designated by the National Council on Skin Cancer, one member of which is the American Academy of Dermatology, as "Don't Fry Friday." The council recommends that people who want to prevent sun-related skin damage wear a wide-brimmed hat and sunglasses designed for UVA and UVA protection, and choose sunscreen "products with UVA filters like avobenzone and octocrylene, as well as protection against UVB rays."

        WebMD (5/23, Doheny) focused on the EWG's "annual guide to sunscreen products," noting that "just one in five of more than 600 beach and sport sunscreens made the cut," while 11 products were consigned to the Hall of Shame. The EWG advised consumers to avoid using sunscreen sprays because they might be accidentally inhaled. Report co-author Sonya Lunder, MPH, of EWG, explained that "sunscreens with a form of vitamin A known as retinyl palminate -- in about 30% of sunscreens -- should also be avoided because of concerns about it producing skin lesions." In addition, "oxybenzone, which EWG calls a "hormone disrupter,' is another ingredient to be avoided, she says."

        AAD's Moy Addresses Health Concerns About Sunscreen Ingredients. In a press release (5/23), AAD president Ronald L. Moy, MD, FAAD, stated, "Contrary to recent reports, available scientific literature and decades of public use does not support a link between oxybenzone in sunscreen and hormonal alterations, or other significant health issues in humans." With regard to retinyl palmitate, a form of vitamin A, "there is no evidence to suggest that use of sunscreen with" the chemical poses a risk for skin cancer. Finally, addressing the fear that nanoparticles found in sunscreens also pose a health risk, Dr. Moy said, "Considerable research on the use of nanoparticles on healthy, undamaged skin has shown that the stratum corneum -- the outermost layer of the skin -- is an effective barrier to preventing the entry of nanoparticles into the deeper layers of the skin."

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Anti-Wrinkle Products

Efficacy Of OTC Anti-Wrinkle Products Questionable.

The Boston Globe (5/2, Lazar) noted that a primary ingredient in many over-the-counter anti-aging face care products is "retinol, a vitamin A compound that is less potent than another vitamin A derivative, tretinoin, which has been approved by the FDA for the treatment of wrinkles" but is available "only by a prescription." Dermatologists say some OTC creams with "retinol may lessen the appearance of fine lines." But it is hard to determine whether the OTC "products live up to their promises." Although most OTC anti-aging products "are not scrutinized by regulators for effectiveness," approximately "eight dozen companies" are listed on the Food and Drug Administration's "most recent 'Yellow List'" for imported skin care products that "may have 'exaggerated anti aging claims,'" including some "well-known names" such as "Chanel, Elizabeth Arden, Estee Lauder, and Revlon."

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Carcinogenic Hair Straightener

US Lawmakers Call On FDA To Issue Voluntary Recall Of "Brazilian Blowout" Hair-Straightening Treatments.

The Wall Street Journal (5/17, D3, Athavaley) reports that members of the US Congress, including Jan Schakowsky (D-IL) and Ed Markey (D-MA), earlier this month sent a letter to Food and Drug Administration Commissioner Margaret Hamburg calling for a voluntary recall of two hair-straightening treatments sold in salons under the brand name Brazilian Blowout. The missive cites a 2010 study by the Oregon Occupational Safety and Health Division that found formaldehyde in the Brazilian Blowout Solution and Brazilian Blowout Acai Professional Smoothing Solution. The lawmakers want the agency to test chemical hair straighteners and recall those with high levels of the carcinogen.

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Botox Under 18 Ban

New Jersey Bill Would Ban Physicians From Giving Botulinum Toxin To Patients Under 18 For Cosmetic Reasons.

The AP (Lederman) reports that the New Jersey Legislature's "Assembly Health and Senior Services Committee approved legislation Thursday to clamp down on doctors injecting people under 18 with botulinum toxin for cosmetic purposes." The AP reports, "Federal and state regulations already restrict the use of Botox on patients under 18. The new legislation would require doctors to document in a patient's chart the non-cosmetic medical reason for performing the procedure on a minor."

        The Star-Ledger (Friedman) reports, "Use of Botox on minors for medical reasons would still be allowed, since it is used to treat facial spasms and certain eye conditions. The bill would leave it up to the State Board of Medical Examiners and the commissioner of Health and Senior Services to develop the regulations and set penalties." The Gloucester County Times (Beym) also covers the story.

Seems sad that this legislation is even necessary...BB

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Tan Ban for Minors

New York Legislators Considering First Indoor Tanning Ban For All Minors.

The AP (5/5) reports that New York state is trying to "become the first to ban indoor tanning for all minors." Russell Sciandra, of the American Cancer Society in New York, "said the current effort is bolstered by a February report by the American Academy of Pediatrics. 'Rates of skin cancer -- including melanoma, the most serious form of skin cancer -- continue to rise, even in young people,' the academy found." Therefore, "along with the World Health Organization, the American Medical Association, and the American Academy of Dermatology, the AAP supports legislation prohibiting access to tanning salons or use of artificial tanning devices by children under the age of 18."

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Routine Use Of Antibiotics On Animal Farms Leading To Antibiotic Resistance In Humans.

Routine Use Of Antibiotics On Animal Farms Leading To Antibiotic Resistance In Humans.

The Los Angeles Times (4/25, Adams) reports that, according to a study published in the journal Clinical Infectious Diseases, Staphylococcus aureus bacteria was found "on 47% of 136 samples of beef, chicken, pork and turkey from 26 grocery stores in five US cities" and that "of those bacteria, 96% were resistant to at least one type of antibiotic and more than half were resistant to at least three." Lance Price at the Translational Genomics Research Institute in Arizona, and colleagues, "concluded that the resistant staph on meat was probably coming from the animals - and not, say, a worker's unclean hands. This seems to point the finger at antibiotic use in agriculture." The Los Angeles Times notes, "calls for restrictions, particularly on antibiotics used to combat human infectious disease, have come from a slew of organizations, including the World Health Organization, the Centers for Disease Control and Prevention, the American Medical Assn and the Union of Concerned Scientists. Yet the practice remains."

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Mysterious Morgellons Disease

Researchers Find No Physical Explanation For Delusional Infestation.

CNN /Health.com reported that, according to a study published online May 16 in the Archives of Dermatology, physicians now have "firm proof that...infestations -- known as delusional parasitosis or delusional infestation -- are not real." Patients who suffer from the problem "feel a constant creepy-crawly sensation beneath their skin, which they believe is due to bugs, worms, or eggs below the surface." The article also noted, "The CDC recently completed its own study of the condition, which the agency refers to as unexplained dermopathy, but the results have not yet been published."

        For the study, investigators performed skin biopsies and examinations on 108 "patients convinced that bugs, worms, or germs had invaded their skin," HealthDay reported. Notably, "the majority of the skin samples showed signs of dermatitis and other skin conditions, such as ulceration or inflammation. Only one skin sample revealed an insect with infestation potential -- a pubic louse."

        WebMD (5/16, Mann) reported that dermatologist Donald S. Waldorf, MD, "has developed his own approach to treating these patients," many of whom simply do not want to believe they are suffering from a psychiatric disorder. "Waldorf will often prescribe topical agents to prevent infections from scratching and may suggest steroids to reduce inflammation." If necessary, he may even prescribe an antipsychotic. In the case of many of these patients, he explained that if he told them to consult a psychiatrist, "I will have lost them, so I basically give them support and prevent infection."

        Reuters (5/17, Pittman) notes that delusional infestation is also referred to as Morgellons Disease. MedPage Today (5/16, Walsh) also covered the story.

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8 Year-Old Botox Abomination

San Francisco Agency Investigating Report Of Botox Shots For Eight-Year-Old Girl.

In follow-up coverage of the story of a San Francisco mother who is giving her eight-year-old daughter Botox (onabotulinumtoxin A) shots, the AP (5/14) reported that "an investigation was under way." The AP said "Trent Rhorer, executive director of the San Francisco Human Services Agency, told KGO-TV on Thursday that officials want to talk with Kerry Campbell and her daughter Britney," after the agency "received numerous calls from people concerned about Britney's well-being." The AP notes that the FDA does not recommend Botox injections for people younger than 18.

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Fear Of Skin Atrophy From Topical Corticosteroids Unfounded.

Fear Of Skin Atrophy From Topical Corticosteroids Unfounded.

WebMD (4/21, Goodman) reported, "Proper use of corticosteroid ointments to treat childhood eczema does not appear to damage or thin skin over time," according to a study in Pediatric Dermatology.

        MedPage Today (4/21, Smith) reported that investigators "studied 70 children with atopic dermatitis or eczema-psoriasis overlap who had used topical corticosteroids for at least three months and whose condition was under 'excellent control.'" In the dermatitis group, investigators rated skin atrophy at three sites treated with topical corticosteroids and an untreated self-control site. The control group was made up of 20 children who had never used corticosteroid ointments but had been referred to the dermatology facility for noninflammatory conditions. The investigators looked at same sites in the control group as in the dermatitis group. "The researchers found: neither investigator observed any atrophy in any of 280 sites from the dermatitis group or 88 sites from the control group; Grade 1 telangiectasia was observed in several patients, all located on the inside of the elbows; but there was no significant difference between the groups;" and "no patient had evidence of striae, atrophic scars, or purpura."

        HealthDay (4/21, Preidt) reported the Pediatric Dermatology study shows "long-term use of topical corticosteroids to treat children with the skin condition known as eczema doesn't cause any major negative side effects." During the study, "all of the children were assessed for signs of corticosteroid-related side effects" and the researchers found that "there were no differences between the children receiving the medication and those in the control group."

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Thyroid Link to Acne

Women With Acne May Be More Likely To Have Thyroid Autoimmunity Than Healthy Controls.

MedWire (5/6, Albert) reported that, according to a study published online in the Journal of the European Academy of Dermatology, "women with acne may be more likely to have thyroid autoimmunity than healthy controls." In a study of 107 adult women with acne, "following measurement of C-reactive protein (CRP) and various thyroid hormones and antibodies, the team found that significantly more of the women with acne had raised (>40 U/ml) antithyroglobulin antibodies (anti-TG) than the controls, at 25.2% versus 8.3%." Notably, "this translated to a significant 3.89-fold increase in risk for having high levels of anti-TG in acne patients versus healthy controls independent of age."

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More Americans Move Toward High Deductible Plans

Analysis Finds High-Deductible Plans Do Not Deter People From Medical Care.

Modern Healthcare (4/18, Vesely, Subscription Publication) reported that the RAND group and Towers Watson concluded from examining the first year of high-deductible health plans used by 59 big companies that low-income or chronically ill people are no more likely to skip getting medical treatments than wealthier and healthier patients in such plans. The study focused on claims data from some 360,000 families nationally between 2003 and 2007. The study appeared in the online journal Forum for Health Economics & Policy.

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Baldness Cure?

Some Men Experimenting With Eyelash-Enhancement Drug As Baldness Treatment.

The New York Times (5/5, E3, Quenqua, Subscription Publication) reports in "Skin Deep" that "a growing number of men [are] experimenting with Latisse [bimatoprost ophthalmic solution] as an antidote to encroaching baldness." Manufactured by Allergan, "the drug has already won a following among women for helping them grow long, fluttery eyelashes." Therefore, "it was only a matter of time before it made the leap to denuded pates." The drug is not approved for such a use by the Food and Drug Administration, but some dermatologists are now prescribing it off-label.

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New Drug for Eczema

Apremilast May Benefit Patients With Moderate Or Severe Atopic Dermatitis.

MedPage Today (5/8, Bankhead) reported that, according to research presented at an investigative dermatology meeting, "half of patients with moderate or severe atopic dermatitis had at least 50% improvement in disease status when treated with an oral phosphodiesterase inhibitor" called apremilast. In fact, "overall, the mean Eczema Activity and Severity Index (EASI) score declined from 24.8 at baseline to 16.2 at the end of the study (P=0.002)" that involved 16 patients. What's more, "pruritus and disease-related quality of life also improved significantly."

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High Priced Branded Meds

Physician: Americans Should Stop Purchasing High-Priced Drugs.

In a letter to editor in USA Today (4/14), Dr. Nick Benton of Corvallis, Oregon, writes that if Americans "still spent only 10% of our gross domestic product on healthcare, the price would be sustainable long term. The problem is that our healthcare spending is now up to about 17% of GDP." Dr. Benton writes, "Here is a simple solution. Let's just say no to the ridiculous price of new drugs and technology. If we do, companies will lower the price."

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Scraped Knees Should be Kept Hydrated!

Keeping Wound Covered, Moist May Help Prevent Scarring.

The Los Angeles Times (4/17, Delude) discussed the efficacy of various creams sold over the counter to reduce the appearance of scars. Unfortunately, "there's little evidence that they work any better than inexpensive petroleum jelly." In fact, "a 2009 study in the Journal of the American Academy of Dermatology...found a huge gap between the advertised benefits of over-the-counter scar products and the clinical evidence that they actually work." What's more, "several articles in a March supplement of the Journal of the American Academy of Dermatology show that antibiotic ointments do not aid in healing or reduce the risk of infection -- but they do raise the risk of antibiotic resistance." Dermatologists recommend that a good way to minimize scars from forming is to keep a wound covered and moist, the article explained.

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