Monday, October 21, 2013

A Cure For The Wondering Eye

The Week

Taking a common antibiotic can help men resist the allure of attractive women, Nature reports. Researchers recruited 100 men and gave half of them a course of minocycline, an antibiotic used to treat acne that also appears to improve decision-making. Then they asked them to play a game of trust, in which the men had to decide how much money to give a women of varying attractiveness, knowing that some women could opt to keep it all while others would give back triple what they got. The men who weren't taking minocycline acted like typical men, giving more money to the women they considered highly attractive; the men on the antibiotic treated all the women the same. That suggests minocycline may disrupt the tendency of men to lavish attention and gifts on pretty women in order to seduce them and "increase the probability of producing attractive offspring," the study authors say. For unexplained reasons, minocycline seems to affect the brain, improving focus and mood.

Friday, October 18, 2013

Sleep deprivation linked to skin aging

Medical New Today

In a first-of-its-kind clinical trial, physician-scientists at University Hospitals (UH) Case Medical Center found that sleep quality impacts skin function and aging. The recently completed study, commissioned by Estee Lauder, demonstrated that poor sleepers had increased signs of skin aging and slower recovery from a variety of environmental stressors, such as disruption of the skin barrier or ultraviolet (UV) radiation. Poor sleepers also had worse assessment of their own skin and facial appearance.
The research team, led by Primary Investigator Elma Baron, MD, presented their data this spring at the International Investigative Dermatology Meeting in Edinburgh, Scotland in an abstract titled "Effects of Sleep Quality on Skin Aging and Function."
"Our study is the first to conclusively demonstrate that inadequate sleep is correlated with reduced skin health and accelerates skin aging. Sleep deprived women show signs of premature skin aging and a decrease in their skin's ability to recover after sun exposure," said Dr. Baron, Director of the Skin Study Center at UH Case Medical Center and Associate Professor of Dermatology at Case Western Reserve University School of Medicine. "Insufficient sleep has become a worldwide epidemic. While chronic sleep deprivation has been linked to medical problems such as obesity, diabetes, cancer and immune deficiency, its effects on skin function have previously been unknown."
Skin functions as an important barrier from external stressors such as environmental toxins and sun-induced DNA damage. The research team set out to determine if skin function and appearance is also impacted by sleep quality, which is vital to the growth and renewal of the body's immune and physiological systems.
The study involved 60 pre-menopausal women between the ages of 30 and 49, with half of participants falling into the poor quality sleep category. The classification was made on the basis of average duration of sleep and the Pittsburgh Sleep Quality Index, a standard questionnaire-based assessment of sleep quality. The study involved a visual skin evaluation and participation in several non-invasive skin challenge tests including UV light exposure and skin barrier disruption. Additionally, participants filled out a sleep log for one week to quantify sleep duration.
The researchers found statistically significant differences between good and poor quality sleepers. Using the SCINEXA skin aging scoring system, poor quality sleepers showed increased signs of intrinsic skin aging including fine lines, uneven pigmentation and slackening of skin and reduced elasticity. In this system, a higher score means a more aged appearance. The average score in the good quality sleepers was 2.2 versus 4.4 in poor quality sleepers. They found no significant difference between the groups in signs of extrinsic aging, which are attributed primarily to sun exposure, such as coarse wrinkles and sunburn freckles.
The researchers found that good quality sleepers recovered more efficiently from stressors to the skin. Recovery from sunburn was more sluggish in poor quality sleepers, with erythema (redness) remaining higher over 72 hours, indicating that inflammation is less efficiently resolved. A Transepidermal Water Loss (TEWL) test was used at various time points to determine the ability of the skin to serve as an effective barrier against moisture loss. In measurements 72 hours after a skin barrier stressor (tape-stripping), the recovery of good quality sleepers was 30% higher than poor quality sleepers (14% vs. -6%) demonstrating that they repair the damage more quickly.
Additionally, poor quality sleepers were significantly more likely to have a higher Body Mass Index (BMI). For example, 23% of good quality sleepers were obese compared to 44% of poor quality sleepers. Not surprisingly, self perception of attractiveness was significantly better in good quality sleepers (mean score of 21 on self evaluation) vs. poor quality sleepers (mean score of 18).
"This research shows for the first time, that poor sleep quality can accelerate signs of skin aging and weaken the skin's ability to repair itself at night," said Dr. Daniel Yarosh, Senior Vice President, Basic Science Research, R&D, at The Estée Lauder Companies. "These connections between sleep and skin aging, now supported with solid scientific data, will have a profound effect on how we study skin and its functions. We see these findings as yet another way we can direct our scientific research toward the real needs of our customers who want to look and feel their best."

The Children and Suncreen Study

Archives of Dermatology

Childhood sun exposure is thought to be a key risk factor for future skin cancer development. Often used as a stand-alone primary prevention method, sunscreen is the most common form of sun protection used by children. Because there is a linear relationship between the thickness of sunscreen application and the sun protection factor (SPF), sunscreens may have an effectively lower SPF if applied in inadequate amounts. In this crossover study of children's use of 3 sunscreen dispenser types, Diaz et al demonstrate that children applied significantly more sunscreen when using a pump and a squeeze bottle compared with a roll-on. All sunscreens were applied at substantially less than the recommended thickness.

Wet Wipes Linked to contact dermatitis in children

Skin & Allergy News
MILWAUKEE – Despite extensive testing, seemingly innocuous wet wipes have been linked to allergic contact dermatitis in children.
The first reported case occurred in a healthy 8-year-old girl who presented with chronic, recalcitrant erythematous, eczematous patches and plaques with crusting and fissuring around the mouth and perianal area. She had been using wipes containing methylisothiazolinone (MI), without methylchloroisothiazolinone (MCI).
Within 22 months, an additional five children had been diagnosed with allergic contact dermatitis to MI in wet wipes, Dr. Mary Wu Chang and Ms. Radhika Nakrani reported at the annual meeting of the Society for Pediatric Dermatology.
All cases were confirmed on patch testing, and all patients had rapid, complete resolution within about 2 days after discontinuing use of the wipes. Ms. Nakrani also interviewed the parents to determine the type of wipes used, identified as Cottonelle and Huggies brands (both manufactured by Kimberly-Clark). The preservative MI was identified in these brands.
"This is going to explode," Dr. Chang, a pediatric dermatologist at the University of Connecticut, West Hartford, said in an interview. "There’s more marketing [of wipes] now for non–diaper wearing children, and older people use wipes out of convenience."
The case series was described as the first report of pediatric allergic contact dermatitis to MI in wet wipes in the United States.
Although the MCI/MI patch test (T.R.U.E. Test) detected contact allergy to MI in the six children, identifying MI contact sensitization may require specialized MI patch tests with higher concentrations of MI or the use of small squares of the wipes themselves, Dr. Chang observed. Patch testing containing 100 ppm of MCI/MI mixture consists of only 25 ppm of MI and may be inadequate to detect MI alone, missing 33%-60% of cases.
Acute contact dermatitis was suspected in the index case, when the 8-year-old girl presented to pediatric dermatology after suffering for 11 months. She was initially misdiagnosed with impetiginized eczema and had received numerous oral and topical corticosteroids and antibiotics, said Dr. Chang. Questioning revealed that the patient used wet wipes for toileting and facial cleansing, and the rash resolved after the wipes were discontinued. MI sensitivity was confirmed on patch testing. Ms. Nakrani also interviewed the parents to determine the type of wipes used, and the preservative MI was identified in these brands.
"Remember to ask about wet wipe use, even in individuals who do not wear diapers and even if the rash in on the face," Dr. Chang said.
In the five other cases, allergic reactions to MI in the wet wipes were misdiagnosed as impetigo, psoriasis, diaper dermatitis, or atopic dermatitis, and unsuccessfully treated with a multitude of medications including steroids, antifungals, and topical tacrolimus (Protopic). The children, aged 3-8 years, had experienced symptoms for 1-12 months, according to the authors, who earned top honors for their poster presentation at the meeting.
The index patient also suffered from chronic retroauricular dermatitis, which resolved after discontinuing a shampoo containing MI.
MI was named the 2013 contact allergen of the year by the American Contact Dermatitis Society. In another recent study, Australian researchers reported 23 reactions to MI from a variety of personal care products, including 7 cases of hand dermatitis in parents of young children that was caused by an allergic reaction to MI in baby wipes (Australas. J. Dermatol. 2013 May 29 [doi: 0.1111/ajd.12062]).
The preservative MI was previously used only in a 3:1 MCI/MI combination (Kathon CG) that is widely known to cause allergic contact dermatitis. In an attempt to minimize such reactions, MI has been used alone, explained Ms. Nakrani, a medical student at the University of Connecticut.
However, its permitted concentration has increased by more than 25 times – from 3.7 ppm to 100 ppm – because it was thought to be a weaker sensitizer than MCI, she said.
"Once we found out the culprit was MI in the wet wipes and instructed parents to read labels and avoid MI, parents became more vigilant about the other products they were using like shampoos and soaps, and it really turned things right around once they stopped using these products," Ms. Nakrani said. "One mom, very grateful that the rashes finally cleared, said her child was going to school and everyone thought it was contagious."
The investigators have not contacted Kimberly-Clark regarding their findings. Bob Brand, director of external communications for Kimberly-Clark, would not specifically say whether they had received complaints of allergic contact dermatitis to MI in their wet wipes, but said all of their products undergo a thorough safety review prior to commercialization.
"While we understand there might be concern regarding a potential reaction to one of our products, consumers can use our wipes with confidence and know that the concentration levels of MI in our products are considered safe and well within the recommended levels as established by scientific and regulatory bodies such as the Cosmetic Ingredient Review Expert Panel in the U.S.A. and the European Commission Scientific Committee on Consumer Safety," he told Skin & Allergy News.
The formulation of the wipes appears to vary by product. Ms. Dianna Kenneally, principal scientist, baby care scientific communication, for Procter & Gamble, said in a separate interview that Proctor & Gamble baby wipe brands do not contain MI.

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Communications About Family Members' Risk of Melanoma

Archives Of Dermatology

As many as 5% to 12% of patients with melanoma have a family history of the disease, and patients with a positive family history of melanoma should be observed closely because of their elevated risk. When the initial diagnosis of melanoma is made, dermatologists play a crucial role in communicating risk assessment to their patients and recommending that family members be screened.