Consuming alcohol increases risk of Skin Cancer: maybe

A recent study has shown a positive association of increased alcohol consumption with the risk of non-melanoma skin cancer. The study was small, so larger studies are needed to confirm these preliminary results.

Here is yet another possible reason to limit or eliminate alcohol consumption. Red wine has some other health benefits that, according to some, might outweigh the negative effects when taken in moderation–no more than one glass per day, but even that is somewhat controversial.

Erectile dysfunction treatments lead to increased risk of melanoma and basal cell carcinoma.

The use of PDE5 inhibitors such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) are common for those with erectile dysfunction. More and more research has shown an increased risk of some types of skin cancer for those taking these medications. Interestingly, there have been no studies showing an increased risk of squamous cell carcinoma.

For this reason, those with a history of melanoma should take this into consideration when considering taking one of these medications. Those with a personal history of multiple dysplastic moles or family history of melanoma should also take this into consideration. For patients whom have had multiple basal cell carcinomas should also weigh the risks of taking these medications.

iPhone case causes skin burns and irritation

MixBin Electronics sparkly, glitter iPhone cases, sold by Amazon and others, “are giving consumers skin irritation and burns as a result of liquid and glitter seeping from the cases, according to the Consumer Product Safety Commission.” Over 250,000 cases have since been recalled. These cases contain liquid and glitter that moves around in the liquid. For more information, go to: https://www.cpsc.gov/Recalls/2017/mixbin-electronics-recalls-iphone-cases

 

How to store pain medications

Now I know that this post has nothing to do with skin care, but it is in the best interest of public safety.

It is not uncommon for one to receive a prescription for narcotic pain medication after having a procedure. In fact, often, one does not finish all of the medication. But, what does one do with them?

Prescription narcotics is one of the biggest when it comes to drug abuse, especially among teens. It is essential to keep narcotics in a secure, locked location. Often one does not finish them and leaves the bottle in an unsecured location for many months or years. This is not recommended.

Even if your kids are all grown and out of the house, do you have grandchildren or other teenagers or young adults visiting?

Be safe.

Diet & Acne: What to avoid

For decades, we have told patients that there were no studies to support that drinking soda made acne worse, although if that was their experience then they should not consume soda. Over the recent years, more and more evidence has emerged showing that diet can affect acne. The first study showed that drinking non-organic milk may exacerbate acne. Recently a study published in the The Journal of Academic Nurtition (J Acad Nutr Diet. 2017 Jun 9. doi: 10.1016/j.jand.2017.03.024 ) showed that consuming high-glycemic index carbohydrates is correlated with worsening of acne. 

In short, the recommendations have not changed–for all persons, eating a good healthy diet is recommended. What has changed is the evidence showing that poor eating habits is connected with worsening of acne. For all of my patients, acne or not, I recommend avoiding white rice, white potatoes, white flour, and sugar in their diet. Unfortunately, most of my patients, with or without acne, consume a large amount of these high-glycemic index foods, which contributes to obesity, fatigue, and the development of type II diabetes.

Choose the BEST Mohs’ Surgeon

According to a recent study, there is great variation from one Mohs’ surgeon to another when having Mohs’ surgery. In this study, they found that the mean number of stages per case was 1.47 (range, 1.09-4.11). The variation in range is huge!!! Thirty-five percent of surgeons were persistent outliers (performed more stages than the mean) in all three years of this study. Physicians in solo practice had a 2.35-times likelihood of a persistent high outlier status (OR = 2.35; 95% CI, 1.25-4.35). Now this does not make sense! Think about it, often the most difficult cases are referred to tertiary care centers (academic institutions), yet they were more likely to clear a patient in fewer stages.

Why the great variation? In an academic center, there are residents and fellows assisting on cases. What does that mean for patients? There is less risk for “funny business”–surgeons intentionally taking smaller pieces so that they they will require more stages (in a fee-for-service model, the surgeon is paid for each stage taken).

In my practice, approximately 80% of patients are cleared within the first stage. This falls well within the mean average of 1.47 average stages per patient. Unfortunately, many surgeons fall outside of this mean. This increases cost, may adversely affect cosmetic outcome, increases surgical time for patients, and may lead to increased patient discomfort as additional anesthetic may be needed.

How do you choose a Mohs’ surgeon? That is a difficult question. According to this study, a Mohs’ surgeon in Private Practice is more likely to perform more layers than is necessary than a surgeon who is a full-time academic surgeon. That being said, I know of great surgeons who are in private practice and many who rarely clear a patient in one stage. In fact, some of the best surgeons are in private practice.

What do I recommend? When choosing a Mohs’ Surgeon, one must be more cautious when choosing one who is in Private Practice. In my over 2 decades of performing Mohs’, I can count on one hand how many patients during the initial consultation have asked me what the likelihood of clearing them on the first stage is.

Approximately one third of sunscreens provide less than half of the SPF claimed

Medscape (5/19, Doheny) reported, “About a third of sunscreens tested by experts…provide less than half the SPF protection claimed on the label,” according to Consumer Reports’ annual sunscreen report. According to the article, the Food and Drug Administration does not routinely test sunscreen products’ SPF.

Dr. Bader recommends sunscreens that have a high concentration of zinc oxide and/or titanium dioxide as the active ingredient(s). These are physical blockers, that reflect all of the suns rays (UVB and UVA).

Chemical blockers only work for specific wavelengths and break down, often within a few hours of sun exposure.