OTC Vitamin Lowers Non-Melanoma Skin Cancer Risk

Can a simple vitamin taken in conjunction with sensible sun protection significantly lower the risk of common, non-melanoma skin cancer in high-risk patients?

A recent study completed at the University of Sydney and Royal Prince Alfred Hospital in Australia supports this claim. Senior author and professor of dermatology Dr. Diona Damian found evidence that skin cancers may be reduced with a year of treatment of nicotinamide.

A type of vitamin B3, nicotinamide is considered to be safe and affordable and is available in most countries as an over-the-counter drug. The study showed that nicotinamide was very well tolerated with no difference in adverse events, blood results, or blood pressure.

Nicotinamide differs from nicotinic acid and niacin, two other forms of vitamin B3. Nicotonic acid commonly causes headaches, flushing, and low blood pressure, but these side effects are not seen with nicotinamide.

Previous studies suggest that nicotinamide enhances the repair of DNA in skin cells damaged by sunlight. Additionally, nicotinamide appears to protect the skin's immune system from UV radiation by providing skin cells an extra energy boost when they are in repair-mode after sun exposure.

Skin cancer is known to be the most common form of cancer in fair-skinned populations in the world and it is considered to be four times as common as all other cancers combined. More than half of the population of Australia is affected by non-melanoma skin cancer.

Non-melanoma skin cancer is caused by sun exposure. The 386 participants involved in Dr. Damian’s study had a history of skin cancer, increasing their risk for additional skin cancers.

The patients were asked to take the pill twice-daily pill for a period of 12 months. Nicotinamide reduced the incidence of new non-melanoma skin cancers by 23%, relative to placebo controls, and cut the incidence of pre-cancerous sun spots by around 15%.

The average number of actinic keratoses (pre-cancerous sun spots) in the nicotinamide group was consistently lower during treatment, ranging from an 11% reduction at three months, to a 20% reduction at nine months.

Dr. Damian hopes that these findings can be immediately translated into clinical practice. However, she adds that people who are at high risk of skin cancer still need to practice sun safe behavior, use sunscreens, and have regular check-ups with their doctors.

More about this on: http://www.sciencedaily.com/releases/2015/10/151021185104.htm

Motivations for Cosmetic Procedure in Numbers

Great news for Med Spa practitioners! American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) studies reveal that nearly 75% of adult men and women in Texas are considering or have had a cosmetic procedure on the face or neck. The other 25% of the 160 Texans surveyed are undecided, which suggests most people in Dallas have a never-say-never attitude about having nips and tucks.

Here are the survey results about the motivations why Texans are interested in aesthetic surgery:

  •  22% say that they were frustrated because of their pictures on social media
  •  31% of the men, compared to 19% of the women were more concerned about looking better in their selfies
  • 13% were motivated because of upcoming major life events, such as a wedding celebration, 
  • 15% were motivated to go under the knife, laser, needle and more in order to remain professionally competitive
  • nearly 33% of the men said they considered facial plastic surgery to stay competitive in the workforce, compared to 10% of women
  • 40% said they’re most bothered by their necks
  • 39% are bothered by their eyes
  • 33% are bothered by their lips, followed by noses and foreheads

According to AFPRS President Stephen S. Park, M.D., 

Over the last five years, the selfie craze has exploded across all age groups. Photographs on social media can deliver a distorted image of reality, holding up a magnifying glass to flaws, real or perceived. This is causing plastic surgery requests to skyrocket in both teens as well as adults.

More on:http://cosmeticsurgerytimes.modernmedicine.com/cosmetic-surgery-times/news/nip-tuck-survey-why-texans-want-treatment

Tanning Industry Calls Warnings A "Sun Scare" Conspiracy By Doctors

If you're a dermatologist or physician who has warned patients about the dangers of tanning, you've been been labled part of "the Sun Scare people" who are "just like Big Tobacco, lying for money and killing people".

The tanning indusrty is changing the debate, moving the discussion from tanning's risks to a "deadly epidemic of vitamin D deficiendy and positioning itself as the more trustworthy source of information on tannings health effects.

Evidently the tanning indusrty is taking a page out of the big tabacco's book and now targeting physicians as part of a conspiracty out to protect their own financial interests, as well as using a few willing doctors to tout their own position.

Fairwarning.or has posted an article that you can read here: Burned By Health Warnings, Defiant Tanning Industry Assails Doctors, 'Sun Scare' Conspiracy

In the video, Levy is explicit about what salon employees are allowed to say at work and what they should say on their own time. He encourages the D-Angels to follow what he calls the “Clark Kent/Superman” model. Inside the salon, employees should be Clark Kents who refrain from making health claims about vitamin D and direct clients to industry websites that make pro-tanning claims that are carefully calibrated to stay inside legal bounds. Beyond salon walls, however, employees can spread their wings, becoming superheroes who expose the lies of sunscreen manufacturers and dermatologists and share the vitamin D gospel. “Outside the salon, you can be a D-Angel,” Levy says in the video. “You can promote a message to your friends and neighbors that the Sun Scare people are just like Big Tobacco, lying for money and killing people.”

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I Want To Be A Fibroblast!

medical spa md fibroblastWhat criteria is most important when choosing a treatment or technology to stimulate fibroblasts for skin rejuvenation?

Being a dermatologist focused on aesthetic treatment options for improving skin's condition  it's quality and overall appearance I clinically and scientifically overlook tons of different approaches.

Basically, and I think we can agree on this, many treatments try to target the fibroblast. Its about the stimulation of this branched tissue cell who's function is to maintain the structural integrity of connective tissues by continously secreting precursors of the extracellular matrix such as ground substance, a variety of fibers notably the reticular and elastic ones and cytokines.

The goal in many skin rejuvenation treatments is to activate and stimulate the fibroblasts... and there are countless strategies to do this: You might choose chemical peels, energy based devices such as non-fractionated or fractionated resurfacing lasers, intense pulsed light (IPL), infrared light or radiofrequency. One might think of dermal filler substances such as hyaluronic acid or – better – calciumhydroxylapatite (there are even publications on a stimulating effect botulinum toxin type a...). Further one might consider microneedling, dermabrasion, etc..

Or think about "newer" technologies such as platelet rich plasma, carboxytherapy, nitrogen plasma energy, kinetic HA (kinetic Hyaluronic Acid). And last but not least cosmeceuticals (this list is not exhaustive!!).

Which strategy to choose? It's actually very difficult to find way through this jungle!

I would like to encourage and activate the discussion here and ask for your opinion: What are the most important criteria for you when you do your choice? Is it about mangeability, about downtime, about scientific proof, about safety, about treatment protocols (such as e.g. multiple treatments), about clinical experience of other physicians, about availability, about the learning curve, about the deligability, about the costs?

What's your decision maker here?

Laser/IPL Procedures For Patients With Skin Cancer History

There was a recent posted question on the American Board of Laser Surgery's website about treating a patient who has had basal cell carcinoma (BCC) in the past with a treatment like IPL.

This is obviously a controversial topic for sure!

My protocol (remembering that I am a surgeon) is that anyone with a history of skin cancer must have a full body skin cancer screening in the last six months by their dermatologist prior to me treating them. I must have a letter from that dermatologist stating that there is no active cancer anywhere on the skin and no suspicious lesions that need to be followed. Obviously, if there was a h/o skin cancer on an area I am NOT treating with IPL or laser, I just want a full body check and then we're good. If there is a previous lesion IN the area I am treating, then after dermatology clearance, I have a strong talk with the patient discussing the fact that treatmetns that potentially depigment lesions can mask the warning signs of a potential or growing cancer. They sign separately in consent their understanding and acceptance of risk and wish to proceed with the cosmetic treatment.

This particular question was regarding a simple IPL treatment for a cosmetic concern in a patient that had had h/o BCC in another area. If cleared, you would be fine to treat the cosmetic condition. I did not want anyone reading this to think that I was indicating that the IPL was meant to actually treat the BCC. I do think that it can be preventative of precancers buy removing damaged pigment cells and pigment, but that is obviously an impossible study. Hope that helps!

Dr. Sabine Zenker: Aesthetic Dermatologist In Munich, Germany

Dr. Sabine Zenker welcomes us to her clinic in Munich, Germany and she shares her thoughts on cosmetic dermatology, technology, and the operations of her clinic.Dr. Sabine Zenker Munich Board Certified Dermaologist

Dr. Sabine Zenker is a well know European dermatologist who has a passion for clinical research and teaching that we've been wanting to interview for some time. We finally got together to learn what this German dermatologist thinks. 

Name: Sabine Zenker, MD
Clinic: Dr. Zenker Dermatology
Location: Munich, Germany
Website: dr-zenker.de

That's interesting: Dr. Sabine Zenker is the consultant dermatologist for L'Oreal Paris and an internationally recognized authority on micro-invasive techniques. She is well known for her clinical research into both established and innovative technologies and treatments, teaching, training, and continuing professional development both in Germany and internationally.

She contributes regularly to medical journals, public press, print, TV and multimedia. Sabine Zenker is a member of a large number of national and international societies including DDG, AAD, ASCDAS, AAAACS, EADV, ISDS, DASIL etc. She serves as executive board member of ESCAD. She is also a speaker and clinical trainer on almost any recognized national and international congress in the aesthetic medical field

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