The study, published in the Journal of Clinical Investigation, examined the effects of vitamin D3 on human keratinocytes (skin cells). Researchers at various institutions in California treated cultured human keratinocytes with the active form of vitamin D (1,25D3). The scientists also administered topical 1,25D3 to patients following skin injury. The in vitro and in vivo cell responses were analyzed.

The researchers found that the keratinocytes from a wound increased the expression of immunity genes, which increased production of cathelicidin (an antimicrobial protein). "These genes were induced by 1,25(OH)(2) vitamin D(3) (1,25D3; its active form), suggesting a role for vitamin D(3) in this process," the study authors write. The study results suggest that skin wounds require vitamin D3 to protect against infection and for healing.

"Thus, we demonstrate what we believe to be a previously unexpected role for vitamin D(3) in innate immunity, enabling keratinocytes to recognize and respond to microbes and to protect wounds against infection," the study authors conclude.

REFERENCES:
1. Schauber J et al. Injury enhances TLR2 function and antimicrobial peptide expression through a vitamin D-dependent mechanism. J Clin Invest 2007 Mar 1;117(3):803-811. Epub 2007 Feb 8.

The study, published in Biomed Central Medicine, investigated the effect of tea extracts on skin toxicity and its underlying molecular mechanisms. Researchers at the University of California, Los Angeles and the University of Freiburg in Germany analyzed the data of 60 patients undergoing radiation therapy for cancer of the head and neck or pelvic region. The participants were treated three times daily with topically-applied green or black tea extracts.

The researchers found that the tea extracts significantly reduced the duration of skin toxicity. No significant differences were seen in the effectiveness of green or black tea extracts in participants with head and neck cancer. However, green tea had a greater effect than black tea in participants with cancer of the pelvic region. Findings also revealed that the black and green tea extracts blocked inflammatory pathways and protected skin cells from ionizing radiation.

"Tea extracts are an efficient, broadly available treatment option for patients suffering from acute radiation-induced skin toxicity," the study authors conclude. "The molecular mechanisms underlying the beneficial effects are complex, and most likely not exclusively dependent on effects of tea polyphenols such as epigallocatechin-gallate."

REFERENCES:
1. Pajonk F. The effects of tea extracts on proinflammatory signaling. BMC Med 2006 Dec 1;4:28.

For the study researchers looked at a group of 46 people, most of whom admitted to using skin bleaching products. The average use was 14 years, though some used these products for as many as 38 years.

The researchers wanted to determine side effects, if any, of using skin lightening products. They were also interested in the effect the medications had on other systems in the body, which could or could not explain the side effects.

The most commonly used drugs for skin lightening were glucocorticoids, hydroquinone, and clobetasol. Most people reported using more than one medication at a time, which could compound side effects.

The most common side effects were damages or changes to the skin. Interestingly one of the side effects was hyperpigmentation, even though the drugs were being used to lighten the skin. The areas of increased color were over joints, such as knuckles. Stretch marks and skin atrophy were also two commonly reported side effects. The medications caused the skin to loose its normal elasticity and suppleness, leaving it weak and thin.

A less common side effect, but much more serious, was adrenal suppression. High doses of glucocorticoids can case the adrenal gland to shut down, which can affect other hormones besides glucocorticoids that are made in the adrenals. The drug clobetasol was associated with adrenal insufficiency in this study. Some participants were taking doses almost 10 times as much as needed to affect the adrenal glands.

Adrenal insufficiency can lead to more serious health problems and can be related to high blood pressure and diabetes.

The authors wanted to raise caution about the use of these common skin lightening medications. The side effects are serious and not uncommon. Another interesting finding is that many people had used the products for so long because they found it difficult to quit. Their bodies had become addicted to the drugs, which often mimic and replace some of the bodies own hormones.

The serious side effects caused the researchers in France to recommend against any use of skin lightening products at this time.

Sunscreens have been shown to filter out UVB rays, the ultraviolet (UV) rays that cause sunburn. However, sunscreens offer less protection against UVA rays that more deeply penetrate the skin and cause skin cancer. Even wearing a sunscreen with broad-spectrum UVA/UVB protection will only offer partial protection from the UV spectrum. As a result, lengthy exposure to the sun even while wearing sunblock will accumulate UV damage to the skin over time.

While a higher-number SPF (sunscreen protection factor) does offer more protection, it is only minimal. An SPF 15 sunscreen will block about 93 percent of UVB rays and an SPF 50 sunscreen will block about 98 percent. Experts recommend wearing a sunscreen including zinc oxide, titanium dioxide or avobenzone for protection against UVA. Reapply sunscreen often, at least every two hours and after swimming or sweating. For full coverage, apply at least two tablespoons of sunscreen. In addition to routinely applying sunscreen, use protective gear like hats or umbrellas. Stay out of the sun when the rays are strongest between 10 am and 4 pm. Minimize your sun exposure even when wearing sunscreen.

According to the Food and Drug Administration, manufacturers' claims such as "waterproof" and "sunblock" are unsubstantiated. The FDA will produce new regulations for sunscreen claims by 2007, recommending more accurate claims such as "water resistant" and "sunscreen". In the meantime, consumer lawsuits are pending against makers of the top sunscreens, alleging manufacturers are fraudulent in their label claims.

REFERENCES
1. Sunscreens faulted on cancer protection. The Associated Press, June 16, 2006:
http://www.usatoday.com/news/health/2006-06-16-sunscreen_x.htm

The study, published in the Journal of Nutrition, investigated the effect of cocoa consumption on skin condition. Researchers at Universitat Witten-Herdecke in Germany administered cocoa high in flavanols (326 milligrams) or cocoa low in flavanols (27 milligrams) daily to 24 women with healthy, normal skin, for 12 weeks. The participants were exposed to 1.25 times the UV irradiation dose to cause skin reddening on the back and shoulder at the beginning of the study, after six weeks, and at the end of the study. The participants maintained their normal diets and were asked to not take nutritional supplements and to not sunbathe.

The researchers found that the high flavanol cocoa group had a 15 percent reduction of skin reddening after 6 weeks and a 25 percent reduction after 12 weeks, compared with the low flavanol cocoa group. Furthermore, the high flavanol cocoa group had an increase in skin blood flow and significant improvement in skin texture. After 12 weeks, the high flavanol group had a 16 percent increase in skin density, 12 per cent increase in skin thickness and 28 percent increase in skin hydration. No improvements were noted in the low flavanol cocoa group.

"Dietary flavanols from cocoa contribute to endogenous photoprotection, improve dermal blood circulation, and affect cosmetically relevant skin surface and hydration variables," the study authors write.

REFERENCES:
1. Heinrich U et al. Long-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in women. J Nutr 2006 Jun;136(6):1565-9.

The small pilot study, published in Dermatologic Surgery, investigated the effect of botox treatment on patients with major depression. Researchers at the Saint Dermatology and Cosmetic Surgery Associates in Greenbelt, Maryland administered five botox injections into the frown muscles of 10 depressed patients, for two months. The participants were evaluated for depression with the Beck Depression Inventory II (BDI-II) before and after treatment. The patients had previously been treated with antidepressants and psychotherapy.

Researchers found that 9 out of 10 of the participants were no longer depressed, and did not meet the clinical standards for depression. Furthermore, the tenth participant was still depressed, but reported an improved mood.

"To our knowledge, these are the first reported cases of depression treated with botulinum toxin A," write the study authors.

Due to the small size of the study and lack of comparison group, some experts question the study's findings. They suggest that definitive results will require further study in larger clinical trials.

REFERENCES:
1. Finzi E and Wasserman E. Treatment of depression with botulinum toxin A: a case series. Dermatol Surg 2006 May;32(5):645-9; discussion 649-50.

The study, conducted in Germany, used a new laser technique to look at the levels of collagen and elastin in facial skin of both men and women. They compared changes between the sexes in different age groups and found that women's skin contains less collagen than equally aged male counterparts.

The reason for this may be the decline in estrogen that occurs during menopause, or it could be a protective effect of androgens in the body, of which men generally have more of.

Collagen makes up the connective tissue of skin, it provides the strength and firmness in skin. Another component of skin that changes with age, elastin, keeps skin tight and smooth, and its loss is associated with wrinkles.

The study was the first to use a new laser technique that offers a non-invasive choice for dermatologists to examine the structure of the skin. The conventional means has been to take a biopsy to examine the skin layers from the epidermis (upper layers) to the dermis (where collagen and elastin are).

One can protect the collagen in their skin by using a sunscreen that blocks the damaging UV rays. Sunscreen use can reduce the appearance of wrinkles and fine lines and prolong the life of your skin.

Over-the-counter and prescription strength dandruff shampoos can help fight dandruff. Now research reports that a llama fungal antibody targeting a specific protein on the surface of M. furfur may eliminate dandruff more effectively. Antibodies are proteins that fight disease and are formed by the immune system in response to infection. Shampoos that contain the fungal antibody can effectively get to the root of the dandruff by inhibiting the growth of M. furfur on the scalp.

The study, published in Applied and Environmental Microbiology, investigated the effects of antibody fragments on inhibiting scalp fungi causing dandruff. Researchers from the University of Utrecht in the Netherlands, vaccinated a llama with the M. furfur fungus three times a week, for five weeks. They extracted the antibodies produced by the llama's immune system to fight the fungus. The scientists then selected specific antibody fragments that bind to the cell wall protein of M. furfur.

The researchers found that the antibody fragments were still active against M. furfur when mixed with shampoo chemicals. The study authors plan to test shampoos containing the antibody fragments on the human scalp in future research.

REFERENCES:
1. Dolk E et al. Isolation of llama antibody fragments for prevention of dandruff by phage display in shampoo. Appl Environ Microbiol 2005 Jan;71(1):442-50.

Myth: You can safely tan when wearing sunscreen-
No tanning is considered healthy or safe, since tanning involves sun-related skin changes. Apply a sunscreen that blocks UVA and UVB rays with an SPF of 15 or greater, about an hour before you go out in the sun.

Fact: Everyone should wear sunscreen daily-
Sunscreen should be applied every day if you'll be exposed to the sun for more than 10 to 15 minutes. You can be indoors and still be exposed to the sun, such as sitting in front of a window or driving in a car. Sunscreen should also be applied on cloudy days or in the winter.

Myth: You don't need to wear sunscreen if you have darker skin-
Darker skin also tans and burns and is at risk for skin cancer. All skin types should routinely check for signs of melanoma skin cancer.

Myth: Your entire body needs daily sun exposure to produce enough vitamin D-
You only need to be exposed to the sun two to three times a week for five to fifteen minutes on your face and hands to produce adequate vitamin D. Vitamin D can also be obtained with multivitamin supplements and milk products.

Fact: Practice safe sun habits in addition to wearing sunscreen-
In addition to routinely applying sunscreen, use protective gear like hats or umbrellas. Stay out of the sun when the rays are strongest between 10 am and 4 pm. Minimize your sun exposure even when wearing sunscreen.

Myth: Tanning beds are safe-
Since tanning beds use ultraviolet (UV) light they are not safe. Tanning beds can expose you to even more UV light than the sun.

Fact: Too much sun can age your skin prematurely-
Skin aging can be seen on parts of your body regularly exposed to the sun, such as the hands and face, when compared to body parts not exposed to the sun.

REFERENCES:
1. Lesher J. Sun Safety Quiz, MCG Health System Press Release, April 28, 2006: http://www.mcghealth.org/News/Press_Releases06/4-28-06.html

Researchers conducted the experiment in a forest at Duke University where they increased the carbon-dioxide levels to those expected in 2050. Carbon dioxide is considered to be a major contributor to global warming. They found that the plants in this forest grew almost 3 times larger, suggesting carbon dioxide acts as a fertilizer for this bothersome plant.

So what can people do now? Avoidance is key. Knowing what poison ivy looks like is essential. Wearing clothing that prevents exposure of skin to brush and assuming that all brush contains poison ivy are critical. If exposure is suspected, wash the skin immediately because it only takes 10 minutes for a reaction to start. Once exposed, using drying soaps and lotions like calamine, and washing frequently using warm water and oatmeal baths can relieve some of the itch. Homeopathic remedies like Rhus toxicodendron can also provide relief.

In one study, researchers at the Pennsylvania State University College of Medicine, evaluated the effect of adapalene acne gel (Differin) in maintaining acne improvement. Patients with severe acne were treated with antibiotic alone or with adapalene plus an antibiotic. Following acne improvement, some patients were continued with adapalene treatment. The researchers found that the 75 percent of the patients who continued adapalene maintained their acne improvement, compared with 54 percent of the patients who didn't continue with adapalene.

"This study demonstrates a clinical benefit of continued treatment with adapalene gel, 0.1%, as a maintenance therapy for acne," the study authors conclude.

In another study, researchers at the Skin Study Center in Broomall, Pennsylvania, evaluated the effect of another acne gel called tazarotene (Avage or Tazorac) in maintaining acne improvement. Patients with severe acne were treated with tazarotene and an antibiotic for up to 3 months. Following acne improvement, patients were continued with tazarotene plus a placebo, a placebo gel plus antibiotic or tazarotene plus antibiotic. The researchers found that all three regimens were similarly effective in maintaining acne improvement.

"A high percentage of patients with moderately severe to severe acne can maintain improvement in their condition with topical retinoid monotherapy," the study authors write. "Maintenance with combination tazarotene and minocycline therapy showed a trend for greater efficacy but no statistical significance vs tazarotene alone. Topical retinoid monotherapy should be considered for maintenance to help minimize antibiotic exposure."

REFERENCES:
1. Thiboutot DM et al. Adapalene gel, 0.1%, as maintenance therapy for acne vulgaris: a randomized, controlled, investigator-blind follow-up of a recent combination study. Arch Dermatol 2006 May;142(5):597-602.

2. Leyden J et al. Comparison of tazarotene and minocycline maintenance therapies in acne vulgaris: a multicenter, double-blind, randomized, parallel-group study. Arch Dermatol 2006 May;142(5):605-12.

The American Cancer Society states, "Most of the more than 1 million cases of nonmelanoma skin cancer diagnosed yearly in the United States are considered to be sun-related. Melanoma, the most serious type of skin cancer, will account for about 62,190 cases of skin cancer in 2006 and most (about 7,910) of the 10,710 deaths due to skin cancer each year."

The risk factors for nonmelanoma and melanoma skin cancers include:

1. unprotected and/or excessive exposure to ultraviolet (UV) radiation
2. fair complexion, sunburning easily
3. red or blond hair
4. light colored eyes
5. having many moles, freckles or birthmarks
6. occupational exposures to coal tar, pitch, creosote, arsenic compounds, or radium
7. family history of skin cancer
8. severe sunburns as a child
9. tanning in the sun or with a sunlamp

The key to preventing skin cancer is reducing avoidable risk factors and early detection. The American Cancer Society suggests you report to your physician immediately:

1. any change on the skin, especially in the size or color of a mole or other darkly pigmented growth or spot, or a new growth

2. scaliness, oozing, bleeding, or change in the appearance of a bump or nodule

3. the spread of pigmentation beyond its border such as dark coloring that spreads past the edge of a mole or mark

4. a change in sensation, itchiness, tenderness, or pain

Also make sure that your physician inspects your entire body each year to screen for skin cancer as part of the yearly physical.

An article published in the medical journal American Family Physician (2003;68:93-102,107-108) reviewed hair loss. The vast majority of hair loss is the type referred to as "male pattern baldness", or androgenetic alopecia, which is for the most part a benign, but psychologically bothersome condition. In men, the characteristic pattern of hair loss is along the front and sides of the head, while in women it involves central thinning. This type of hair loss in both men and women is usually genetic. However, in women, this type of hair loss may be due to hyperandrogenism (excess male hormones), and will be accompanied by other symptoms like hirsutism (hair distribution in a male pattern i.e. face and chest), menstrual problems, acne and infertility.

Another type of hair loss is telogen effluvium in which overall loss of hair from the scalp is increased and may include pubic and axillary (under arms) areas. This type of hair loss usually has a precipitating event 3-4 months prior such as injury or stress, giving birth, high prolonged fever, serious infection or illness, hypothyroidism, severe dieting and malnutrition. It may also be due to various types of drugs including chemotherapeutic agents, anticoagulants, hormones and anticonvulsants. Resolving underlying causes or with time, this type of hair loss resolves.

Alopecia areata is complete hair loss from an area, and may include the whole scalp (alopecia totalis) or the entire body (alopecia universalis). Patients can be genetically predisposed. The hair loss is the result of an autoimmune reaction in the hair follicle. It may resolve in 6-12 months, but can recur. There may also be concurrent conditions like thyroid disorders, vitiligo and pernicious anemia. Immune modulating drugs and corticosteroid shots may be prescribed, but have poor response rates, especially with entire scalp or body hair loss.

Other causes of hair loss include dermatophyte infection (tinea capitis), syphilis, trichotillomania (psychiatric disorder characterized by pulling out hair) and traction alopecia due to tight ponytails or braids.

Varicella zoster, the virus that causes chickenpox is spread via direct contact with sores. It can also be spread via blood. Most children will contract chickenpox by the age of 10 years, either from someone at school or a "chickenpox party". Because varicella is a herpes virus, it lives dormant in the nerve cells and can become activated in adulthood, causing a condition know as shingles.

Adults who have not had a primary outbreak of chickenpox in childhood can devleop adult chickenpox. In this group the disease can be very severe, causing hospitalization in some cases. In a child the disease is less severe and the greatest concern is having the child home from school for 2-3 weeks in some cases and the parents missing work during that time. There is no treatment for chickenpox, only symptomatic relief. Women who are pregnant and have never had chickenpox need to be extra precautious when an outbreak occurs because the virus can spread to the newborn.

The vaccine was introduced with the expectation that chickenpox outbreaks and total numbers of children with the disease would decrease. The new report seems to object to that idea. For the study one particular outbreak in an elementary school in Arkansas was studied. A total of 545 children who had never had chickenpox attended the school, 96% of whom were vaccinated against varicella. A total of 48 students contracted chickenpox during the outbreak. 90% of those who developed chickenpox had been vaccinated against varicella.

These results were quite surprising, given the preliminary trials of the vaccine. The children who had been vaccinated reported a more mild case of chickenpox than children who had not been vaccinated. Overall effectiveness of the vaccine based on this population was 82%, and 97% for preventing severe cases.

Given the low effectiveness of one injection, the authors conclude that a second booster dose may be able to increase protection. For many of the vaccines, more than one injection is required to reach 95% effectiveness. Each injection causes a small immune response that is cumulative to previous exposure or vaccine. The only way to have 100% protection against development of any disease is to contract the condition naturally.

Reference

1. Pediatrics June 2006.

COPD can be a deadly condition. The World Health Organization (WHO) has stated that by 2020 it will be the third largest cause of death in the world. COPD includes conditions such as emphysema and chronic bronchitis. It is often preceeded by long periods of increased mucous production and a chronic cough.

COPD is thought to develop from damage to the lung tissue caused by smoking cigarettes. The harmful chemicals contained in cigarettes can damage or paralyze the cilia lining the airways and make removal of mucous and phlegm difficult. Those same chemicals also increase the production of free radicals which cause oxidative damage throughout the lungs and body.

The skin is the other organ of the body most susceptible to oxidative damage. Over time increased damage causes the skin to lose its elasticity and smoothness, resulting in wrinkles. The wrinkles can be related to sun damage as well as smoking.

Given the strong coorelation between cigarette smoking, oxidative damage, and lung and skin disease researchers in England wanted to look for a relationship between the level of skin damage and the degree of lung disease, specifically the risk of COPD.

The results of the study were published in the journal Thorax this June. What the researchers found was not surprising, but may give insight into early diagnosis of COPD.

After reviewing the health of 149 smokers researchers concluded that heavy wrinkling may in fact be an early sign of COPD. Analysis included skin examinations by dermatologists and lung studies that included diagnositic imaging and breathing tests.

Those individuals with the highest degree of skin wrinkling had more changes in their lung function and tissue associated with COPD, without having a prior diagnosis of the condition. The results were significant after accounting for sun exposure, which can also cause heavy wrinkling due to oxidative damage from UV rays.

The authors were happy with the results and conclude that skin examination may be an important part of early diagnosis of COPD. Early treatment can have substantial effects on disease severity. Treatment with antioxidants can help decrease the damage to both the skin and lungs. However, the first step should be ceasation of smoking. It is a necessary step to avoid drastic changes to quality of life and early death.

References
1. Patel BD et al. "Smoking related COPD and facial wrinkling: is there a susceptibility?" Thorax, 2006 June 14.