Many of my patients have a variety of questions regarding their skin care, especially those with sensitive skin.  I recently sat down with my colleague Dr. Bobby Buka, section chief of the department of dermatology at Mt. Sinai School of Medicine, and discussed various steps you can take to improve your skin’s health AND appearance if you have sensitive skin. 

Don’t over do it!
Dr. Buka feels a balance of skin care products is the key and not to “overdo it” with too many different lotions and facial care treatments — especially if you have sensitive skin.  “Too many of my patients end up with ‘itchy red bump syndrome,’ a condition that results from putting too much stuff on your face,” says Dr. Buka.  He further explained how the skin’s delicate balance can be upset by well-intentioned patients who apply more than 3 products to the face at the same time. His rule of thumb is to use no more than 3 items per application.  Your skin can’t possibly absorb more than 3 products anyway, so Dr. Bukka says chill out, 2-3 targeted items to the skin’s surface are plenty.

Some patients who also have seasonal or year-round allergies, as well as sinus problems, may also experience below eyelid puffiness or “shiners” that can wreak havoc with your appearance. When those affected are actually tested, many individuals have allergies as well as possible contact or skin allergy to products used in the eyelid and facial areas. Covering up these dark circles with facial cosmetics (foundation, etc.) won’t fix the problem.  Dr. Buka and I often collaborate to develop a long-term solutions patients with sensative skin-related issues.  

Drink up!
Finally, stay hydrated — this means what may seem like a massive amount of water each day — 8 glasses! So drink up, your skin and (your internal organs) will thank you for it.  But sensitive skin or not, protection against UV rays remains the single most important thing you can do to protect your skin and delay the signs of aging! Dr. Buka and I recommend SPF 30 or higher for patients — not only when planning to spend the day outside, but also as part of their daily skin regimen.  So get out there and take charge of your sensitive skin care for optimal health, and look better!

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

The National Institutes of Health recently published an interesting study in the “BMJ,” where they approached 1,200 internists and rheumatologists about what they called “placebo treatments,” where patient expectations rather than an expected physiological response was the rationale for the treatment. Only 679 physicians responded, which limited the conclusions, along with the design of the study itself, as this type of survey is a weak form of science. Nevertheless, the results were disturbing – about half of the responding doctors indicated they prescribed these kind of treatments on a regular basis, and more than 60 perecent believed there was no ethical problem in doing so. It has long been known that cures and responses to treatment can be affected by a patient’s mental attitude and expectation, and that healing itself involves suggestion as well as chemical intervention.

But I find these results deeply disturbing for the following reasons:

1) Most of those surveyed were not using sugar pills or harmless salt water, they were using medicines with potential side effects. These included over-the-counter analgesics (41percent), vitamins (38 percent), sedatives (13 percent), and antibiotics (13 percent).

2) More than 90 percent of upper respiratory infections are viral, yet physicians are knowingly prescribing antibiotics to meet patient expectation.

3) Patients are fueled to ask for pills because of advertising, the Internet and a culture of instant gratification.

4) Physicians are motivated to provide a quick fix rather than a more elaborate explanation which could eliminate the need or urge for the treatment. A study published in the “Annals of Family Medicine” published in 2005 concluded that physicians only spend 55 percent of their time in face-to-face patient care. In this environment of 5 to 10 minute office visits, it is often easier for doctors to provide a quick placebo treatment rather than a more elaborate diagnosis and explanation.

5) This is a survey of doctors, but it is highly doubtful to me that patients would be satisfied with this approach. I suspect that a similar survey of patients would reveal that less than 10 percent of patients believe that it is okay for placebo treatments to be given for deceptive reasons, with false expectations. I suspect that most patients would like an interaction with their doctor to be completely honest and based on full disclosure.

Do my readers agree?

VIDEO: Watch Dr. Siegel Talk About The Placebo Problem

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News Medical Contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: the Truth About the Epidemic of Fear” and “Bird Flu: Everything You Need to Know About the Next Pandemic”. Read more at www.doctorsiegel.com

In early September, the Food and Drug Administration said it would release its first list of 20 drugs that are being investigated for possible side effects. The agency’s new policy of regular quarterly releases of drugs under investigation is the result of 2007 mandatory congressional legislation. There are potential pros as well as cons:

Pros:
* Public awareness may grow about drugs that are commonly misused. Oxycontin, a narcotic with a very high potential for overdose and addiction, was listed as being under investigation.
* The FDA is being held to a higher standard of disclosure, and this way the public can track its thinking and investigative processes rather than just being shocked by news reports of unpredicted black box warnings.
* Physicians may be more cautious to prescribe new treatments without considering potential side effects.

Cons:
* Patients may abruptly stop treatments that are working without checking with their physicians.
* The lists are cursory – they don’t include all drugs under investigation or complete information of the drugs being investigated. Statistics on deaths, hospitalizations,  or even numbers of reported side effects are not included.
* Knowing that a drug is being reviewed may create fear, and a public perception that is out of proportion to the actual risk. Tysabri is a very effective drug for the treatment of Multiple Sclerosis that is now being investigated for association with skin cancer. Cymbalta is a powerful anti-depressant that is being investigated for urinary complications. Public awareness of these ongoing investigations may severely limit patient willingness to take very effective treatments.

Suspicion of prescription drugs is the prevailing trend, despite the fact that many of these treatments are lifesaving. A case in point is Byetta, a diabetes drug that has been on the market since 2005 with close to a million patients benefitting from its biochemistry. Byetta is an incretin mimetic, which means it is a synthetic hormone which stimulates insuin secretion in response to meals. Not only is this often a smart treatment, and a good arrow to add to the medical quiver, but it also can cause weight loss, which in itself can help to improve glucose control in diabetics.   

But news reports of a rare death from pancreatitis (the rate of pancreatitis associated with Byetta is only one in 10,000 cases, and has not been proven as due to the Byetta) has led to public fears of the drug. The drugmaker, Amylin, has seen its stock drop 43 percent in the month since the FDA announced that it was considering a stern warning in response to the potential risk of pancreatitis.  

Warnings can be helpful. But fear of essential treatments can also be harmful.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News Medical Contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: the Truth About the Epidemic of Fear” and “Bird Flu: Everything You Need to Know About the Next Pandemic”. Read more at www.doctorsiegel.com

For the nearly 50 million allergy sufferers, a complementary or alternate approach is sometimes a breath of fresh air. Some practitioners of “integrative medicine” prescribe a combination of botanical supplements, anti-stress therapy (i.e. biofeedback, meditation, exercise and yoga), acupuncture, and/or acupressure as well as fish oils for individuals with allergies and allergic-type asthma.

A true pioneer in this field is Dr. Roberta Lee, who is currently the medical director of the Center for Health and Healing (www.healthandhealingny.org) in New York City. She has also edited a textbook on integrative medicine with a special focus on preventative aspects to human health.

For example she has recommended a variety of approaches to her patients who suffer with allergies which include: fish oils, quercetin, stinging nettles and well as anti-stress therapy to complement traditional medications. She also believes that various factors including foods, chemicals (scented products), and artificial ingredients may impact one with allergic triggers. Dr. Lee and I routinely recommend nasal and sinus saline (salt water) irrigation for persistent sinus disease.

In many cases natural is quite good, but it’s important to discuss any botanical supplements or herbs with your health care provider before using them. They may interact with prescription medications. I will follow-up in future blogs about complementary and/or alternative focused treatment. In any event, if you suspect you may have an allergy, get tested for proper care.