The Use of Topical Corticosteroids During Pregnancy

If you are planning a pregnancy or are currently pregnant, it is important to check the safety of your medications. Topical corticosteroids are effective anti-inflammatory agents often prescribed for the treatment of rash and eczema. A recent study* suggests that pregnant women can use topical corticosteroids for short periods of time at normal doses without posing a risk to their child. A group of 2,658 pregnant women ages 15-44 were given one or more prescriptions for topical corticosteroids. Compared to a control group of 7,246 pregnant women who were not exposed, the study revealed no associations between topical corticosteroids and orofacial cleft, low birth weight, preterm delivery, fetal death, low Apgar score nor mode of delivery. It is important to note, however, that further analysis suggests that the use of potent or very potent doses (≥300 g) of corticosteroids during the entire pregnancy may increase the risk for low birth weight.

From Dermatology Times, *original study published online in JAMA Dermatology

Attention Tylenol Users!

Acetaminophen, brand name Tylenol (amongst others), is a common household drug used to relieve aches, pains and fevers. However, if you develop a rash, blister or any other kind of skin reaction while taking acetaminophen you should stop taking the drug and seek medical attention immediately. This past August the FDA issued a safety announcement stating that acetaminophen poses a risk for three rare but potentially fatal skin disorders; Toxic epidermal necrolysis (where the top layer of skin detaches from the lower layers of skin), Stevens-Johnson syndrome (a minor form of toxic epidermal necrolysis), and Acute generalized exanthematous pustulosis (pustules on the skin). Typical symptoms include a burning rash, skin pain, dryness of the eyes, blistering of the lips, a cough with mucus, a headache or joint paint. If you or your child display any of these symptoms while taking acetaminophen it is important to STOP taking the medication and go to the nearest ER.

Before You Get Your Next Mani Pedi...

Manicure and pedicure safety is extremely important if you get your nails professionally done on a weekly basis. Here are a few Dermatologist-recommend tips before you make your next trip to the salon:

1. Apply a cream to moisturize your nails, especially after removing nail polish since most removers contain chemicals that dry the nails.
2. To prevent infection, never cut or forcefully push back your cuticles. If you must push them back, only do so gently after a shower or bath.
3. While most nail salons follow strict cleanliness and disinfection guidelines, look for the following when visiting a salon:

1. Does your nail technician have the necessary experience and/or license, if required?
2. Are the stations clean?
3. Does the nail technician wash her hands between clients?
4. Are there dirty tools lying around?
5. In addition, do not hesitate to ask how they clean their tools.

4. Shave your lower legs after getting a pedicure, not before. That means not shaving your lower legs for at least 24 hours before you get a pedicure. If you nick yourself while shaving, a pedicure could put you at risk for an infection.
5. If you get frequent manicures and pedicures, consider purchasing your own tools to be used at the salon.
6. In addition, check that the pedicure footbaths and filters are thoroughly disinfected before you use them. If they are improperly cleaned, they can harbor bacteria and fungus. If the salon does not appear clean, then move on.
7. If you want to wear a bright red or orange polish, prevent discoloration by applying an extra layer of base coat. If your nails become yellowed and discolored from the polish, your nails should return to normal color over several weeks if the same color is not reapplied.
8. While some people beg to differ, there is no scientific evidence that immersing nails in gelatin makes them stronger. Polishes that contain strengthening ingredients increase nail stiffness, which may make nails break more frequently.
9. Do not wear artificial nails to cover up nail problems as they may make them worse. Artificial nails are not recommended for people who are prone to fungal infections or have brittle nails. For people with healthy nails, artificial nails can be fine as long as they are not worn continuously.

1. Know what products are used in your artificial nails as the substances used can cause an allergic reaction in some people. If you develop a rash or other reaction, tell your doctor what products you used.

If you have any nail care questions, be sure to call and schedule an appointment with Dr. Talakoub. 

http://www.aad.org/skin-conditions/skin-health-tips/manicure-and-pedicure-safety/manicure-and-pedicure-safety#.UWmoqu2zK-I

Rethink the Ink

Within the past ten years the American Academy of Dermatology (AAD) constructed a survey of five hundred individuals between the ages of 18-50, 24% reported having a tattoo.  Of these individuals, 16% had gotten their first tattoo by the age of eighteen.  Today, however, 17% of them have considered getting their tattoo removed, but none have actually gone through with it. 

Whether the reason for garnishing your skin with ink is impulsiveness or personal expression, tattoos over time can become regretful.  Those with unwanted ink can testify that the meanings behind their tattoos may become no longer significant. Not to mention the price and pain associated with getting a tattoo removed. That once vibrant tulip located on your hip, the initials of your high school boyfriend on your wrist, or the tattoo of your favorite quote from spring break that takes up your entire rib cage are all constant reminders of how permanent tattoos really are.

 For it being such a popular fad, many of us know very little about tattoos.  The risks associated with getting one are both dangerous and painful.  If you have never gone under the needle before here are a few threats linked to getting inked:

Allergic Reactions – Tattoo dyes, especially blue, red, green, and yellow, can cause allergic skin reactions resulting in an itchy rash around the area of the tattoo.

Bloodborne Diseases – The equipment used to create your tattoo can be contaminated with infected blood from the previous client, making you susceptible to disease.  These diseases include tetanus, hepatitis B, and hepatitis C.

Skin Infection – Small bumps called granulomas sometimes form around the ink of the tattoo that can develop into keloids, or raised areas of overgrown scar tissue.  Tattoos have also been known to cause redness, swelling, and even pus-like drainage of the site.

Cancer Risk - Several chemists have identified low levels of carcinogens in tattoo ink. In the tattoo removal process the pigment is scorched with heat, triggering chemical reactions to generate carcinogenic products absorbed by the body.

A new FDA warning was just released warning people not to be tricked into getting the “safe” and temporary alternative, a henna tattoo.  Permanent tattoo ink is injected into the skin, whereas henna tattoo ink is applied to the skin’s surface. The most popular henna “black ink” often contains a coal-tar hair dye containing p-phenylenediamine (PPD). This ingredient can cause dangerous skin reactions.  By law the ingredient PPD, because of the severity of it’s harmful factors, is not even permitted in cosmetics.   Serious and long-term reactions have been reported which include redness, blistering of the site, raised lesions, loss of pigmentation, sensitivity to sunlight, and permanent scarring. Reactions can appear immediately or take weeks to show.

So if you feel the risks aren’t enough to deter you, think about how unattractive tattoos look on more “mature” skin. It’s not always pretty!

Is Your Bowel Linked to Your Skin?

Ever wonder if your skin rash or pimples could be related to your diet? More specifically could the gluten in your diet be triggering your symptoms?  Everyday more and more benefits of gluten-free diets are being discovered.   

Gluten-free diets are most commonly used to manage celiac disease, which causes the immune system to trigger a reaction in the gut to gluten, a protein which is found in wheat, barley, rye, malts and triticale.  But what if you have never been diagnosed with celiac disease?  In a recent study published in Journal Watch General Medicine, patients without celiac disease but symptoms of celiac sensitivity, experienced relief from their symptoms after adopting a wheat-free diet.  

Therefore, whether you have celiac disease, a gluten sensitivity, or neither, experimenting with a gluten-free diet has several potential benefits. Patients in our clinic with eczema, acne, and peri-oral dermatitis have seen benefits with glow gluten or gluten free diets! Luckily, with the growing popularity, many grocery stores have now made these products more accessible to consumers by adding gluten-free aisles. 

As with any diet change, it is important that you maintain a balanced diet, especially when you are excluding foods you are used to eating. It is also important to continue eating a balance of proteins, carbs, healthy fats, and other nutrients. 

If you have itchy skin, acne, or rashes that do not improve with standard regimens, call Dr. Lily to discuss your diet.   

Steps to Insure a Smooth Shave

Shaving can be rough on your skin particularly in the winter months. Shaving bumps can best be avoided with the following technique:

1. Before you shave, wet your skin and hair to soften it.

2.             Next, apply a shaving cream or if you have dry skin, hair conditioner works best.

3.             Shave in the direction that the hair grows. Never shave against the grain!

4.             Change blades or throw away disposable razors after 5 to 7 shaves to help minimize irritation. Do not leave razors in the shower. Mold and bacteria grow on the blades in moist environments.

5. Men/Women who have acne should take special care while shaving. Shaving can irritate your skin, making acne worse.

If you have acne on your face, try experimenting with electric or disposable blade razors to see which work best for you.

Use a razor with a sharp blade.

Shave lightly to prevent nicks and never try to shave off the acne as both can make acne worse.

6.   Always apply a moisturizer after shaving.

If you have questions or concerns about caring for your skin or irritating shaving bumps, you should make an appointment to see Dr. Lily.