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Shingles, a localized reactivation of the chicken pox virus, is a serious illness that can leave adults in severe pain, cause eye damage, lead to hearing problems, encephalitis and, in rare instances, death. A recent survey found that only 38% of adults in the U.S. knew a vaccine for shingles was available.Shingrix, which received FDA approval last year, was found to be 97% effective in adults aged 50 to 69 years, and more than 90% effective in those 70 years of age as well as those past 80.Adults older than 50 years — even those who have already had shingles, have been vaccinated against the disease with the older, less effective shingles vaccine, Zostavax, or are not sure if they have had the chickenpox — should receive two doses of Shingrix. The second dose is administered 2 to 6 months after the first one.Patients should not get the Shingrix vaccine if they currently have shingles, have ever had a severe allergic reaction to any ingredient in the vaccine or after a dose of Shingrix, are not immune to the virus that causes chickenpox or are pregnant or breastfeeding.Adverse events tied to the Shingrix vaccine include headache, feeling tired, muscle pain, shivering, fever, stomach pain or upset stomach, swelling, or redness at the injection site. These events are usually mild and go away within a few days.Shingrix is available for administration at many pharmacies. It’s advisable to discuss any questions you have about this vaccine with your physician.

Wrinkles typically improve three to four days after treatment with Botox. While facial exercises, such as frowning and grimacing, have been advocated following Botox injections to enhance the benefit and/or onset of action, data has been lacking. A recent randomized controlled study comparing exercise vs no exercise has confirmed the benefit of facial exercises.Forehead wrinkles were rated as looking better within just two to three days after the treatment if the injections were followed by facial exercises, compared with three to four days without the exercises. After two weeks, there was no difference between those who did or did not do facial exercises. The exercises also made no difference in how long the effects of treatment lasted. Based on this study, facial exercises after treatment with Botox make sense when a rapid benefit is desired.

As microneedling has grown in popularity, the procedure has been used to treat a range of dermatologic applications, including pigmentary issues (such as melasma), as well as a potential tool for combating hair loss.Microneedling has shown the most promise as a treatment for:

• Acne and surgical scars
• Skin rejuvenation and wrinkles

An article published in the journal of Dermatologic Surgery earlier this year found that microneedling produces substantial clinical improvement of scars, stretch marks and wrinkles with expedient recovery and limited side effects. The benefits appear to be due to controlled wounding of the skin with stimulation of healing leading to collagen production.The authors conclude that microneedling is a safe, minimally invasive, and effective esthetic treatment for acne and other scars, wrinkles, and stretch marks. Given its quick post-treatment recovery, limited side effect profile, and significant clinical results, microneedling is a valuable alternative to more invasive procedures such as laser skin resurfacing and deep chemical peeling.

Childhood sunburns increase the risk of developing melanoma, the deadliest form of skin cancer, later in life. An Australia study found that using sunscreen in childhood reduced the risk of developing melanoma by 40 percent in young adults.Researchers at the University of Sydney analyzed data collected from nearly 1,700 Australians, ages 18 to 40. They looked at those who were regular users of sunscreen in childhood and compared to those who rarely used the products. The study showed that regular use of sunscreen protects against the damaging effects of sun exposure. As with most cancers, the risk of melanoma increases with age. But according to the American Cancer Society, melanoma is one of the most common cancers in young adults (especially young women).It is estimated that in 2018, more than 91,000 people in the United States will be diagnosed with melanoma. In the last 10 years, rates for new cases of melanoma have been rising on average 1.5 percent each year, according to the U.S. Centers for Disease Control and Prevention.To minimize exposure to damaging UV radiation, adopt the following measures:

• Stay in the shade, especially during midday hours (10am- 3pm).
• Wear clothing that covers your arms and legs.
• Wear a hat with a wide brim to shade your face, head, ears, and neck.
• Wear sunglasses that wrap around and block both UVA and UVB rays.
• Use sunscreen with a sun protection factor (SPF) of 30 or higher, and both UVA and UVB (broad spectrum) protection.
• Avoid indoor tanning.

Finally, examine your skin regularly to detect new or changing skin lesions, lesions that look unusual (the ugly duckling sign), and lesions that are irritated or non-healing. It’s also advisable to see your dermatologist periodically for skin exams.

Here are a few common sunscreen myths:1. Sunscreen sprays offer better protection than lotions: FALSE. Sprays can be convenient but it’s easy to miss or skip exposed areas. It helps to apply to your hands first and then to exposed areas. To minimize inhaling, apply only while outdoors and never directly on the face.2. Kids need special sunscreens: FALSE. The same ingredients are present in children’s products as in those marketed to adults. The difference is packaging! The same sunscreen can be used for the entire family. Sunscreens should be used starting at 6 months of age.3. A little bit goes a long way. FALSE. Studies have demonstrated that most people apply less than the recommended amount significantly reducing the effectiveness of the sunscreen. For this reason, applying a sunscreen with a higher SPF value may help compensate. The general guidelines include the “teaspoon rule” for each exposed body part or a shot glass for the entire exposed body (see last months blog for details).4. The SPF value noted on the product label is reliable: FALSE. Consumer Reports recently reported that most of the sunscreens they tested offered significant protection, however, they didn’t have as high an SPF as promoted.5. Doubling the SPF of a sunscreen doubles the protection. FALSE. When applied properly, sunscreens with SPF values of 30, 50, and 100 convey 97%, 98%, and 99% protection from UVB rays. For those with very fair complexions, certain photosensitizing conditions, taking photosensitizing medications, or spending significant time outdoors, the difference can be significant.

This past weekend’s Wall Street Journal (June 30-31) included an article titled, “Burning Question: How Much Sunscreen” highlighting the fact that most of us do not apply enough product to receive the full protection benefit. The general rule of thumb for an adult is to apply a shot glass full of product rubbed into the skin to cover exposed areas. This amount should be adjusted according to body size. Recent research suggests the “teaspoon rule”: Use more than half a teaspoon for each arm, or the face and neck, and more than one teaspoon for each leg, the chest, and the back for a total of about 6 teaspoons, or 1 fluid ounce. (A shot glass holds 1.5 fluid ounces.)What about SPF? The American Academy of Dermatology recommends using a broad-based sunscreen (blocks UVA and UVB rays) with a minimum SPF 30. It should ideally be applied at least 15-30 minutes before outdoor activity and reapplied every 2 hours and after water activity or heavy sweating. Sunscreens with SPF values above 50 were thought to be of no greater value but a recent study (paid for by Johnson & Johnson) found otherwise.Keep in mind that sunscreen is one of the important measures for protecting yourself from overexposure to the sun. Others include wearing protective clothing, hats, sunglasses, and minimizing outdoor activities between the hours of 10 am and 3 pm.

UV Lights Used During Gel Manicures Can Increase Risk Of Skin Cancer.Dr. Chris Adigun said in an American Academy of Dermatology report, “The UV dose that you receive during a gel manicure is brief, but it’s intense. Over time, this intense exposure can add up to cause skin damage.… For many patients, a gel manicure can be life-changing.” Dr. Carolyn Jacob, the director of Chicago Cosmetic Surgery and Dermatology, said, “Whether indoor tanning, UV lamp, outdoor tanning, all of those can cause aging of the skin and potential for skin cancers.”Sunglasses Are Just As Important As Sunscreen.Wind, dry weather (low humidity) and the sun can cause eye problems. The sun’s UV rays are particularly damaging, especially UV-B. Wearing the correct type of sunglasses can protect your eyes and help prevent skin cancer of the eyelids and surrounding skin. When shopping for sunglasses look for a UV label – blocking at least 99 percent of UV-A and UV-B rays.

A common question we’re asked by patients we see regularly for skin cancer screening exams is, “Hey Doc, did that mole change?” In reality, it’s often difficult to detect subtle changes without the benefit of a visual baseline. Digital Mole Mapping is a valuable tool that captures multiple clear images at a standard exposure. Photos taken at a later time can be compared side by side. In addition, our system has a software program that alerts us to new lesions and lesions that appear to have changed. Patients with multiple moles or atypical (irregular) appearing moles are excellent candidates for monitoring with mole mapping.MAY IS SKIN CANCER AWARENESS MONTH:See our blog from May 4, 2016: How to Detect Early Signs of Skin Cancer. If you haven't had one recently, this is a good time to schedule an appointment for a skin cancer screening exam: Call 310-626-4631 ext. 227

Men are interested in looking healthy, young, and staying fit. They want to look as good as they feel. They desire cosmetic improvements that look natural. During the past decade there has been a significant increase in the number of non-invasive and minimally invasive cosmetic procedures performed on men. Men are also spending more money on skin care and grooming products. Common male cosmetic concerns include hollowness beneath the eyes (tear troughs), double chin, wrinkles surrounding the eyes (crow’s feet), and forehead lines.The most common concern among men, however, is hair loss. Men are generally less forthcoming about discussing cosmetic issues with their physician until they establish a rapport. The dermatologists of Dermatology Associates Medical Group have expertise in cosmetic treatments for men. If you have questions or would like to schedule a consultation, please call 310.626.4631, ext 227.