Too much sweat?

Question:  Is there such a thing as sweating too much? What can I do about it if I’m constantly soaking through my clothes? It’s so embarrassing, especially at work!

shutterstock_155697284Answer:   Yes, the condition definitely heats up during the summer months but can plague sufferers all year long with overly sweaty armpits, palms and even on soles of the feet. It  is called hyperhidrosis which just means “excessive sweating.”

Hyperhidrosis is simply abnormally heavy perspiration. Sweating is a normal bodily function, but some people may have overactive sweat glands that produce more sweat beyond what is required for regulation of body temperature. It can be most noticeable at the armpits because sweat can soak through clothing and become obviously embarrassing. Or you may also be aware your palms are often sweaty so you avoid shaking hands with others.  Hyperhidrosis can occur  in many parts of the body whether exposed to triggers such as heat, physical activity or exertion, embarrassment, stress or not.

How do we treat excessive sweating?

First, we’ll evaluate your excessive sweating for any potential causes of secondary hyperhidrosis (for example, an underlying disease that causes excessive sweating such as hyperthyroidism).

To gauge your sweating problem, we will try you on stronger prescription-grade antiperspirants which can also help block sweat glands to reduce sweating. Typical over-the-counter antiperspirants are 1-2% aluminum chloride but prescription products can contain up to a 20% solution of aluminum chloride hexahydrate or similar aluminum salts. While these can be irritating in those with sensitive skin and sweat glands, they do reduce perspiration, however they require continuous usage.

After a few weeks of trial, if the prescription products do not reduce your sweating problem well enough, we can now use Botox® (onabotulinumtoxinA), which is FDA approved for the treatment of excessive sweating of armpits. We also use Myobloc® (rimabotulinumtoxinB) or Dysport® (abobotulinumtoxinA) off-label as an alternative, especially for those who have excessive sweating on palms and soles of feet.

These injections work to temporarily de-nerve the sweat gland and results in a local reduction in sweating where injections have been administered for up 5 months. Injections must be repeated at regular intervals to keep excessive sweating at bay and you may still need to use an antiperspirant.

-Jodi

Black Salve no skin cancer salvation!

Question:  I’ve read many accounts online about an alternative therapy of using an herbal “Black Salve” to treat skin cancer, but then I also saw many scary photographs and read many scary stories of disfiguring skin damage from the treatment. What’s your opinion?

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Just say “NO” to Black Salve and alternative cures you see online as skin cancer cures!

Answer: My opinion is firm:  When it comes to any type of skin cancer, medical treatment has more than a 90 percent cure rate when lesions are caught early and removed and conventional medicine has an excellent track record in successfully treating skin cancer and restoring health. In fact, while there may be a genetic predisposition (family history or skin type) to skin cancer, statistics show that 90 percent of all skin cancers are caused by long-term, unprotected exposure to the sun’s UV rays. Those at highest risk are people with fair skin, blond or red hair, and those with blue, green or grey eyes and workers in outdoor occupations.  So skin cancer prevention falls on you for keeping unprotected sun exposure to a minimum and in checking your own skin for suspicious growths and actively having them checked at least once per year by a dermatologic practitioner.

The skin cancer fear factor…

Once cancer is diagnosed, patients can get scared and can fall prey to online cure scams and alternative therapies that can do more harm than good, according to a 2009 FDA release entitled, “Beware of Online Cancer Fraud.”   “Anyone who suffers from cancer, or knows someone who does, understands the fear and desperation that can set in,” said Gary Coody, R.Ph., the National Health Fraud Coordinator and a Consumer Safety Officer with the Food and Drug Administration’s (FDA) Office of Regulatory Affairs. “There can be a great temptation to jump at anything that appears to offer a chance for a cure.”

Black Salve on the FDA list of Fake Cancer Cures

From what I’ve read, Black Salve is the most the most widely known alternative therapy you will find online. It is an herbal topical treatment classified as an escharotic which is a substance applied to the skin that causes tissue to die and fall off.  The types of Black Salve available on the internet today can be made from ingredients such as zinc chloride, chapparal (larrea tridentata) or bloodroot which are all caustic (or escharotic) to the skin.

The FDA release outlines how the salves are sold online despite being illegal and how they are sold with false promises that they will cure cancer by “drawing out” the disease from beneath the skin. “However, there is no scientific evidence that black salves are effective,” says Janet Woodcock, Director of FDA’s Center for Drug Evaluation and Research (CDER). “Even worse, black salves can cause direct harm to the patient.” The corrosive, oily salves “essentially burn off layers of the skin and surrounding normal tissue,” says Woodcock. “This is not a simple, painless process. There are documented cases of these salves destroying large parts of people’s skin and underlying tissue, leaving terrible scars.”

Black Salve does not distinguish diseased from healthy skin.

If you are questioning an alternative cancer cure you see online, check the FDA list, “187 Fake Cancer Cures Consumers Should Avoid.”

That being said, I would not recommend desperate attempts at using Black Salve or other alternative therapies once skin cancer has already taken hold, especially since Melanoma is dangerous and can spread. Here’s why:

  • Alternative therapies have not been medically and scientifically tested for efficacy and safety .
  • The use and sale of alternative therapies online is completely unregulated so you cannot be sure the purity or concentration of ingredients you are putting on your skin.
  • Alternative therapies can contain unknown compounds with questionable benefit and the potential for great harm and they are promoted on the internet illegally without full consideration or information about potential toxicity.
  • With alternative therapies instead of surgical procedures and medically researched treatments, there is a large risk of incomplete tumor removal and tumor growth and metastases (spreading).
  • Alternative therapies untested on healthy skin leaves unwary patients open to damage of surrounding healthy tissues and marked scarring with poor cosmetic outcomes

If you think you have a lesion, spot or growth that could be skin cancer, go directly to the dermatologist who will test the tissue via a biopsy and advise you whether the tumor needs to be removed.  In cases such as skin cancer, when medical treatment has a high success rate, don’t look elsewhere at alternative therapies.

Have you been tempted by Black Salve? Did the online photos scare you away?

Are you making these top sunscreen mistakes?

This is how much sunscreen you should be applying to your body when spending the day in the sun...every two hours!

Question: I recently went out for a day on a boat with friends and even though I used SPF 50 sunscreen all day, I still got burned. What did I do wrong?

Answer: There’s a lot of news in sunscreen ingredients and thinking these days so lets update how you buy, use and apply sunscreen so you don’t get burned again (or needlessly exposed to the rays that cause aging, wrinkles and skin cancer):

Mistake:  Not applying enough sunscreen

The current guideline is to apply a shot glass-worth, one full ounce, of sunscreen to your body when spending the day in the dun. And, the most important part, you should reapply this amount of sunscreen  every two hours regardless of the SPF noted on the bottle, so you could go through half of an eight-ounce bottle in one day in the sun!

Mistake:  Believing that sunscreens are “water-proof”

The FDA, in its new labeling guidelines, has declared that the use of the term “water-proof”  misleading and banned brands from using it. The word will need to be removed from labels by December 2012.  Now, the guideline is that sunscreen is “water-resistant” and only for a tested time limit of 40 or 80 minutes when spending time in the water, after which the product will need to be re-applied.

Mistake: Applying the sunscreen when you get there

The best way to allow sunscreen to do it’s work is to apply it a full 30 minutes before going into the sun, so it has time to bond to skin, instead of getting immediately rubbed off by a towel you lay on or washed off by jumping directly into the water.

Mistake:  Not protecting your skin from UVA rays

It used to be that sunscreens only protected against UVB (the burning rays) but now a slew of new chemicals can absorb UVA rays (the ones that penetrate deeper to cause aging, wrinkles and skin cancer).  Choose a sunscreen with the new designation “broad spectrum” because these have been tested by the FDA to provide protection against both UVB and UVA rays. Consumer Reports recently tested and rated sunscreens according to the new FDA labeling requirements and found these three top-rated choices:

  • All Terrain AquaSport SPF 30 (for athletes and outdoor workers)
  • Coppertone Sport High Performance Ultra Sweatproof SPF 30 (for athletes and outdoor workers)
  • No-Ad with Aloe and Vitamin E SPF 45 (for the budget minded, every-day body user)

Mistake:  Thinking the higher the SPF, the better the protection…

According to Consumer Report’s recent ratings, top-rated sunscreens are between SPF 30-45. The new thinking is that higher SPF does not really not afford more protection. Here’s why:  an SPF 15 filters out approximately 93% of all incoming UVB rays, SPF 30 filters out approximately 97% and SPF 50 filters out approximately 98%. No sunscreen can block out 100% (which is why the FDA has also banned the use of the word “sunblock” on labels) of all UV rays so after an SPF 30, you can see the difference in filtering is negligible. The old  thinking:  If your skin starts reddening in 20 minutes when exposed unprotected to sunlight, using an SPF 15 should prevent your skin from turning red for 15 times longer (approximately 5 hours). The new thinking: No sunscreen protection lasts more than 2 hours. Choose an SPF 30-45 and reapply one ounce every two hours for real protection.

Mistake:  Ignoring your scalp

Most people protect their eyes with sunglasses and slather on the sunscreen but completely ignore their scalp. This is very dangerous, especially if you have any hair loss or thinning issues. Apply sunscreen to any areas experiencing hair loss (a widening part-line, bald spot or receding hair line) and definitely wear a hat!

Mistake:  Believing that the sun does not affect your face every day

I advise everybody to apply a basic “broad-spectrum” sunscreen every day to face, underneath makeup or in makeup for women,  especially to protect against photo-aging and skin cancer that you cannot see happening. One that I personally recommend, that was also recommended by the Consumer Reports Ratings, is La Roche-Posey Anthelios 40 with Mexoryl SX SPF 40.

Have you made any of the mistakes on this list recently? Tell us your worst sunburn story in the comments!

What you must know about new FDA sunscreen label rules

Courtesy FDA

Sunscreen labels are changing for the better...learn what the differences mean to you. Photo courtesy FDA.

Question: “I read about some new sunscreen labeling rules in a magazine but I don’t really know how they apply to me when I’m standing in the store aisle trying to choose sunscreen! Can you help?”

Answer:  Of course! These new FDA sunscreen label requirements are meant to clear up confusion about exactly what type of protection a sunscreen provides. There are some new terms you will see on sunscreen bottles starting this summer (although brands have until December 2012 to comply) that will help you make a more informed choice.

  • “Broad Spectrum”  This designation means the sunscreen protects against both UVA and UVB sunlight rays, and will distinguish sunscreens from those that only protect against UVB. To earn the designation, brands now need to pass the FDA’s broad spectrum test to claim they are, in fact, broad spectrum. Furthermore, only those labeled “broad spectrum” with an SPF of 15 of higher can claim that they protect against sunburn caused by UVB rays but also decrease skin cancer risk and protect against skin aging caused by UVA rays.
  • “FDA Skin Cancer/Skin Aging Alert”  For sunscreens with SPF values below 15 or those that are not broad spectrum (because they only protect against UVB rays), you will see the following new FDA alert:

“Spending time in the sun increases your risk of skin cancer and early skin aging. This product has been shown only to help prevent sunburn, not skin cancer or early skin aging.

  • “Water-Resistant”  This tells users exactly how much time they can expect to get the declared SPF level of protection while swimming or sweating, based on new standard testing. Labels will specify 40  or 80 minutes. If this term with a time limit is not on the label, the product is not water-resistant.
  • “Drug Facts”  Information such as active ingredients, usage, warnings and directions will now appear in the drug facts chart , like the one above, so you can see it at-a-glance and choose accordingly.

The following terms have been banned from labeling because they are misleading and inaccurate, according to the FDA:

  • Waterpoof
  • Sweatproof
  • Sunblock
  • Instant Protection

The biggest mistake you can make, no matter what sunscreen you choose, is not applying enough of it and not re-applying it. The general guideline is to apply a shot glass worth (about 1 ounce) to your body, but studies have shown that most people are applying only one-quarter of that amount! And, no matter what the SPF, no sunscreen protection lasts beyond two hours, so to protect skin fully, that same one ounce should be re-applied every two hours when spending the day outdoors in the sun.

I think sunscreen and skin cancer protection is really a year-round concern and sunscreen should be worn on areas exposed to the sun such as arms, neck and face every day, even if cold or cloudy. Have you seen that recent photo of the truck driver whose left side of his face looks dramatically older than the right side of his face? That’s proof of the sun’s aging power and the case was studied  by Jennifer R.S. Gordon and Joaquin C. Brieva, dermatologists at Northwestern University, with findings published in the New England Journal of Medicine.

Tell the truth:  Do you wear enough sunscreen? Will you change how you choose and apply sunscreen this summer?