Risky Combo: Tanning Beds, Meds

Bloomington, Ind. — A new study suggests that self-treating skin eruptions by using a tanning bed may cause more problems than it solves, ScienceDaily.com reports. 

Researchers at Indiana University School of Medicine’s department of dermatology randomly surveyed 1,200 people and found that nearly 10 percent of those who frequented tanning salons did so in response to treatment of skin disease — and that only 5 percent did so on the advice of a physician. 

“There is an increasing trend for patients to seek tanning bed radiation exposure as a means of self-treatment because, among much of the general public, the perceived benefits of tanning bed radiation include its ability to treat rashes,” the study notes. 

The study reports on an individual who went to a tanning bed to self-treat a mild skin rash caused by an allergy to ibuprofen. Following exposure, the patient’s skin developed toxic epidermal necrolysis with severe blistering. Her blood pressure dropped significantly and her rash spread. High levels of a protein responsible for inflammation were found in the patient’s skin. 

The researchers used laboratory studies to show that normal skin cells, when exposed to UV radiation of the type found in tanning beds, produced very large amounts of protein responsible for inflammation and cell death. According to the researchers, these studies demonstrate that patients with rashes caused by allergic reactions to nonsteroidal anti-inflammatory or prescription drugs can experience severe reactions following exposure to tanning bed radiation. 

ScienceDaily.com quotes study author Jeffrey B. Travers, M.D., as saying, “There are many reasons to be cautious of tanning bed radiation, but some people use tanning beds to self-treat skin eruptions. If the skin eruption is eczema or even psoriasis, a tanning bed might help. However, if the eruption is caused by a drug reaction, then (use of a tanning bed) can be dangerous.” 

Mar 23, 2011
By: Bill Gillette
Dermatology Times E-News

Did You Know? Finasteride May Impair Sex Drive

Washington — Results of a new study suggest that men who take the drug finasteride to halt male pattern hair loss may experience an ongoing reduction in sex drive and, in some cases, prolonged periods of erectile dysfunction even after they stop using the drug, Medical News Today reports.

 Researchers at George Washington University School of Medicine and Health Sciences looked at the reported types and duration of persistent sexual side effects in otherwise healthy men who took finasteride — commonly marketed by Merck under the names Propecia and Proscar — for male pattern hair loss. Michael Irwig, M.D., assistant professor of medicine, conducted standardized interviews with 71 men ages 21 to 46 who reported they were in otherwise good health and claimed they experienced the onset of sexual side effects after they began finasteride.

Of the men studied, 94 percent said they developed low sexual desire, 92 percent said they developed erectile dysfunction, 92 percent said they developed decreased arousal and 69 percent said they developed problems with orgasm.

The men reported using finasteride for an average of 28 months and stated that from the time of stopping finasteride to the interview date, the average duration of persistent sexual side effects was 40 months.
Medical News Today quotes Dr. Irwig as saying, “While finasteride has been associated with reversible adverse sexual side effects in multiple randomized, placebo-controlled trials, this is the first series to find that symptoms persisted for at least three months despite stopping finasteride.”

He said the study underscores the importance of physicians discussing the potential risk of persistent sexual side effects with their patients.

Mar 23, 2011
By: Bill Gillette

Fibrin Matrix Yields Good Results

New York — A new study suggests that the use of autologous platelet-rich fibrin matrix (PRFM) yields good results in facial plastic surgery procedures, Reuters Health reports. 

Study author Anthony Sclafani, M.D., director of facial plastic surgery at the New York Eye and Ear Infirmary, conducted a chart review of 50 patients who had undergone aesthetic facial procedures with autologous PRFM. The most common indications for treatment were nasolabial folds, facial volumization, superficial wrinkles and acne scars. 

According to Dr. Sclafani, most patients were satisfied with the treatments and noted improvement within seven days. Five of the patients were dissatisfied with their results and underwent a second PRFM treatment. One of these patients remained dissatisfied with results following the second PRFM procedure. 

In his study, published online Feb. 21 in Archives of Facial Plastic Surgery, Dr. Sclafani writes, “Autologous tissue would be the ideal material choice for soft-tissue augmentation in the face if it could be provided in a simple process with good predictability.” 

Publish date: Mar 10, 2011
By:  Bill Gillette

When Should Aesthetic Interventions be Initiated?

Question:

At what point in the aging process should aesthetic interventions be initiated?

Answer:

As we learn more about the long, slow process that is aging, perhaps the most sophisticated way to treat the aging face would be to initiate treatment when only the professional eye of the physician can see aging-associated changes. The face loses a little volume across the entire face as aging progresses, so why not replace a little volume as soon as possible after it is lost rather than waiting until all the changes associated with aging have taken their toll? Doesn't a stitch in time save nine? In addition, because loss of integrity in one tissue influences loss of integrity in another tissue, it is possible that fixing a few small things early might slow down the aging process to some degree. I think there is a lot to be gained by starting interventions earlier.

-Response from Rebecca Fitzgerald, MD; Clinical Instructor, University of California Los Angeles

Real Results with the PureGraft Fat Transfer!

Dr. Zimmerman is the first doctor in the state of Nevada to complete a PureGraft Fat Transfer! PureGraft is redesigning natural beauty!

Here are some real Before and After photos of patients that have had the PureGraft FatTransfer:

 These photos are actual patients and surgeries performed by Dr. Zimmerman at Las Vegas Laser and Lipo.

An Informative Article on Skin Care, Sun Exposure, and Vitamin D

The Importance of Skin Care at ALL Ages

March 3, 2011 — The American Academy of Pediatrics (AAP) has issued guidelines on limiting sun exposure in children and supporting legislation to prohibit salon tanning by minors, according to a policy statement entitled "Ultraviolet Radiation: A Hazard to Children and Adolescents."

The new recommendations and an accompanying technical document are reported online February 28 and published in the March issue of Pediatrics.

"Ultraviolet radiation (UVR) causes the 3 major forms of skin cancer: basal cell carcinoma; squamous cell carcinoma; and cutaneous malignant melanoma," write Sophie J. Balk, MD, former chairperson, AAP Committee on Environmental Health, and colleagues.

"Public awareness of the risk is not optimal, overall compliance with sun protection is inconsistent, and melanoma rates continue to rise. The risk of skin cancer increases when people overexpose themselves to sun and intentionally expose themselves to artificial sources of UVR."

Despite these risks, sunburn continues to be prevalent, and teenagers as well as adults continue to make frequent visits to tanning parlors. Therefore, the policy statement suggests that pediatricians offer advice about UVR exposure during health supervision visits and at other appropriate times.

Recommendations
Specific recommendations for pediatricians include the following:

• Health-supervision practices should include advice about UVR exposure, such as avoiding sunburn and suntan, wearing clothing and hats with brims, using sunglasses, and applying sunscreen. If possible, outdoor activities should be scheduled to limit exposure to peak-intensity midday sun (10 AM to 4 PM).
• When a child or adolescent might sunburn, he or she should use sunscreen to reduce the known risks for sun exposure and sunburn, including the increased risk for skin cancer. Sunscreen with a sun-protection factor (SPF) of at least 15 should be applied every 2 hours and after swimming, sweating, or drying off with a towel. People may prefer avoiding sunscreens containing oxybenzone, as these may have weak estrogenic effects when absorbed through the skin.
• Although all children need counseling about UVR exposure, this is particularly true for children at high risk for the development of skin cancer, including those with light skin, nevi, and/or freckling; and/or a family history of melanoma.
• Skin cancer prevention is a lifelong effort, and beginning in infancy, at least 1 health maintenance visit per year should include advice about UVR exposure. All children are at risk for adverse effects of UVR exposure on the eyes and immune system, although not all children sunburn. Especially appropriate times for counseling about UVR exposure include during the spring and summer in northern states, before anticipated sunny vacations, and during visits for sunburns.
• Because outdoor physical activity should be strongly encouraged, this should be promoted in a sun-safe manner.
• Sun-protection practices tend to wane in early childhood. Beginning at age 9 or 10 years, it may be helpful for pediatricians to discuss sun protection with children, together with parents, to encourage joint responsibility for the child's sun protection.
• Infants younger than 6 months should be kept out of direct sunlight and covered with protective clothing and hats. When sun avoidance is impossible, parents may apply sunscreen only on exposed areas. Absorption of sunscreen ingredients may be higher in preterm infants.
• Pediatricians should become familiar with chemical photosensitizing agents. People using these oral or topical agents should limit sun exposure and avoid all UVA from artificial sources. When sun exposure is inevitable, they should wear fully protective clothing and high SPF sunscreen that also blocks UVA wavelengths.
• Breast-fed and formula-fed infants and other children should receive vitamin D supplementation in accordance with guidelines, for a total intake of at least 400 IU of vitamin D daily. Children at risk for hypovitaminosis D may need laboratory testing of 25-hydroxyvitamin D concentration.
• Deliberate UVR exposure to artificial sources and overexposure to sun with the goal of increasing vitamin D concentrations or for other reasons should be avoided.
• Pediatricians should advocate for adoption of sun-protective policies (eg, shaded playgrounds, outdoor time before 10 AM, and allowing hats at schools and child care facilities).
• Pediatricians should support and advocate for legislation banning use of tanning parlors by children younger than 18 years.

Benefits of Limiting Exposure to UVR
The AAP, the World Health Organization, the American Medical Association, and the American Academy of Dermatology all support legislation prohibiting access to tanning salons or use of artificial tanning devices by children younger than 18 years.

"Skin cancer is a major public health problem; more than 2 million new cases are diagnosed in the United States each year," write Dr. Balk and coauthors of the accompanying technical report. "Approximately 25% of sun exposure occurs before 18 years of age. The risk of skin cancer is increased when people overexpose themselves to sun and intentionally expose themselves to artificial sources of UVR."

In addition to describing new evidence on the association of exposure to sun and artificial sources of UVR with skin cancer and other health risks, the report also highlights sun-protection methods, vitamin D, community skin cancer–prevention efforts, and the pediatrician's role in preventing skin cancer.

This report describes the interrelationship between sun exposure and vitamin D status, and the requirement of adequate vitamin D for bone health and for various other health conditions. Sunlight exposure is needed for cutaneous vitamin D production, but the efficiency of this production is complicated by many factors.

"Ensuring vitamin D adequacy while promoting sun-protection strategies, therefore, requires renewed attention to evaluating the adequacy of dietary and supplemental vitamin D," the report authors write. "Daily intake of 400 IU of vitamin D will prevent vitamin D deficiency rickets in infants. The vitamin D supplementation amounts necessary to support optimal health in older children and adolescents are less clear."

Brought to you by:

Pediatrics. Published online February 28, 2011.

Dr. Z and CoolSculpting!

CoolSculptVegas has just launched today and Dr. Zimmerman of Las Vegas Laser and Lipo will feature this new state-of-the-art treatment beginning on Friday, March 18th!

SO WHAT IS COOL SCULPTING?

CoolSculpting™ by Zeltiq™
Lose unwanted fat quickly and painlessly!

Non-invasive CoolSculpting™ by Zeltiq™ reduces fat cells with no needles, surgery or downtime. This is great news for men and women dealing with exercise and diet-resistant persistent fat areas such as the tummy, love handles and back rolls!

The unique Zeltiq™ Procedure (pronounced Zel ′teek) is an effective way to reduce fat without the pain, risk, and recovery time of surgical procedures. Results are natural-looking fat reduction in treated areas involving the stomach, love handles, thighs, hips, arms, chin and the lower and upper back. The Zeltiq™ procedure utilizes a patented method called Cryolipolysis™ (the use of precisely controlled cooling to remove fat) that is designed to target only fat cells without causing damage or trauma to the skin.

How the Zeltiq™ Procedure is performed.

The applicator is applied to the skin surface targeting folds of fat that can be grasped by gentle suction; drawing a roll of skin and fat into the applicator. The fat is then chilled under precise temperature control, until it is firm but not to the point of freezing. There is no pain during treatment and no anesthesia is needed although you may experience a strong pulling sensation. Most patients find CoolSculpting™ by Zeltiq™ comfortable and are able to read, listen to music or just relax during the procedure. Typically patients resume their routine activities, including returning to work and exercise regimens on the same day as the procedure.


Several days after the procedure, the cooled fat cells begin to shrink. These damaged fat cells are slowly eliminated through the body's normal metabolic processes. Fat cells that have been treated fail to regenerate themselves and are eliminated slowly over several months. The result is a reduction in bulging fat for natural contouring in about two to four months.

Are there side effects after the Zeltiq™ Procedure?

The Zeltiq™ Procedure is non-invasive, allowing return to normal activities on the same day as the procedure although redness may appear in the treated area, and may last from a few minutes to a few hours. Some localized bruising may occur, which clears within a few weeks. Many patients experience a temporary dulling sensation in the treated area which can last for several weeks.

How long does the CoolSculpting™ Procedure take?

Procedure time can be two hours or more depending on the size of the area to be treated.

Am I a candidate for the Zeltiq™ Procedure?

Zeltiq™ is ideal for those seeking a more natural contoured physique. Ideal candidates for the Zeltiq™ Procedure are at or near their ideal weight, but have some excess fat areas that are resilient through diet and exercise. CoolScuplting™ by Zeltiq™ is not intended as a weight-reduction program for overweight individuals. Even though Zeltiq™ CoolSculpting™ technology delivers permanent results, patients must maintain a healthy weight to maintain the results. A consultation with will determine whether the Zeltiq™ Procedure is right for you. -www.coolsculptvegas.com