September Newsletter

Dermatologists continue to air arguments over the “best” treatment of AKs, or actinic keratoses (also called solar keratoses), which develop after years of sun (over)exposure. These lesions appear one-at-a-time or in groups as rough, scaly, reddish or brown patches of sun-damaged skin that can, though rarely, turn into squamous cell carcinoma. What then: Surgery? Liquid nitrogen (cryotherapy)? Chemo-topical or other lotions? Combo treatments? Or even watchful waiting?

More than one million people will get skin cancer this year, projects the AAD. Of those, up to 80 percent will be basal cell carcinoma (or BCC, which doesn’t metastasize) and 16 percent or so will be squamous cell carcinoma (SCC), which can metastasize. (Another 4 percent will be melanoma, the most dangerous form of skin cancer, which can spread even when the lesion is small.) People who have many AKs have about a 10 percent risk of developing SCC over their lifetime, which also means 90 percent of this subpopulation won’t suffer this cancer. A cure is highly likely for basal cell and squamous cell cancers if detected and treated early, according to the American Cancer Society. For SCCs that metastasize, the five-year survival rate is less than 50 percent.

As patients get to know the family of treatments from which to choose for AKs and nonmelanoma skin cancers, the initial urge to “cut it out” may not be the most prudent course, dermatologists say. Still, because topical creams take weeks to work and carry side effects such as redness, pain, swelling, and scabbing, those who develop numerous AKs may opt for surgery or cryosurgery, while remaining aggressive and alert. As for aggressive surgical treatment, “In order to get a clear margin, you can be ‘chasing’ for a long time,” adds Dr. Lum. “There are other, perhaps better ways to achieve the [desired] reduction effect.”

A further choice for patients with AK is light therapy, or photodynamic therapy, which combines a somewhat new, two-step treatment. First, Dr. Hester applies ALA, or aminolevulinic acid (different drugs may be used); next, after an “incubation” period, the doctor aims pulses of photodynamic (blue) light at the field via an applicator that stimulates the drug. Photodynamic therapy appears most effective for small nonmelanoma cancers or precancerous areas.

“Some actinic keratoses can resolve on their own, but they should be monitored every four months or so,” says Shawn Allen, MD, a Boulder, Colorado, dermatologist and Mohs-trained skin cancer surgeon. (Mohs surgery involves a specially trained dermatologist or surgeon removing thin slices of the cancerous area, one by one, and examining each slice under a microscope until no tumor cells remain.) “And cancer patients or others who are immuno-compromised should know that those who tend to develop a lot of AKs, or who develop squamous cells, can be facing a more threatening situation.”

Dermatologists attending the AAD meeting believe that while every patient has a right to decide how and when to treat precancers of the skin, they expressed concerns about how long some patients might opt to wait to treat.

Read more about actinic keratoses from the American Academy of Dermatology.  

BEAUTY with Chasity Hester, PA-C

Wrinkles may be an inevitable part of aging, but that doesn't mean fighting them is useless. Protecting your skin from exposure to ultraviolet radiation is the most significant thing you can do to prevent wrinkles, sagging, and discoloration. As for damage control and improvement of appearance, we can do that too!  Dr. Hester and his staff can safely provide medical  applications such as chemical peels, Botox, dermal fillers, Laser and IPL.  

What about protecting your skin from the inside?  Erase wrinkles NO, look younger YES Studies show that what you eat, or don't eat, has a definite effect on the health of your skin. As the outermost barrier of the body and your largest organ, the skin is continuously exposed to various sources of stress, including many environmental factors. So, although a new diet won't clear away all your wrinkles or halt skin aging, nutrition can make a huge difference not only in how you look, but also how you feel. This in turn will influence how young or old you may appear to be.

A study in 2003 revealed that people whose diets are rich in vegetables, beans, olive oil, nuts, and multigrain breads are less likely to wrinkle than those who feast on red meat, butter, and sugary foods. Experts suspect that antioxidant vitamins A, C, and E and the minerals zinc and selenium may keep wrinkles at bay by reducing the amount of potentially damaging free radicals produced by skin cells. One study revealed that a supplement that included a combination of these antioxidant vitamins helped protect the skin from aging due to solar UV exposure. Another study suggests that for light-skinned people, consuming a diet rich in carotenoids offers similar UV protection and also may contribute to healthy skin coloring. To achieve a healthy, youthful glow, turn away from the sun and turn to carotenoid-rich foods such as cantaloupe, apricots, carrots, sweet potatoes, spinach, and other fruits and vegetables that have deep green, yellow, orange, and red hues. A multivitamin may provide your skin further protection against aging.

In addition, several research reviews have revealed that botanical antioxidants show promise as an effective means of protecting skin cells against ultraviolet radiation; this is another good reason to eat at least four servings of fruits and five of vegetables each day.

Imagine what happens to a plant when it goes without water for too long. It begins to droop, then it becomes dry and brittle. Watering the plant may bring it back, but it will likely have damaged leaves. Water works similarly within people. By drinking water, you moisturize your skin from the inside out, helping to maintain its elasticity and suppleness—less drooping, less drying, and less damage. Monitoring such things as your thirst and energy levels, as well as the concentration of your urine, is a good way to assess whether you're getting enough to drink. Alcoholic beverages and caffeinated drinks such as coffee, tea, and colas don't count; they have a diuretic effect that may deplete your body's water supply. Exercise and low humidity climates also can affect your body's water level. Remember to drink extra water each day to account for these factors.

The bottom line: you'll get out what you put in It may not be a sure cure for crows' feet, brow furrows, or laugh lines, but improving a few food and behavior choices could save your skin. Although studies specific to wrinkle prevention are currently limited, a host of other studies reveal that the same vitamins and nutrients that may protect your skin also are beneficial to the health of your eyes, teeth, nails, bones, and circulatory system. So, if a more youthful appearance is what you seek, then skin is only a portion of the equation. By eating a diverse diet, including five servings of vegetables per day, you can make your RealAge as much as 4 years younger. And adding more antioxidants and essential oils can bring out a healthier and younger-looking you.

The public is responding. Growing numbers of people are turning to alternative anti-aging medicine to address their needs. This new break­through medicine recognizes the wisdom and effectiveness of this ap­proach to health, which blends mind, science, and experience. In 1993, a study published in the New England Journal of Medicine found that over a third of those surveyed chose alternative medicine over traditional con­ventional medicine because people have grown weary of the medical es­tablishment’s continued emphasis on diagnostic testing and treatment with drugs without focusing on them as the patient.

Here’s the good news: It’s not an either/or scenario. It’s important to recognize that practitioners of alternative medicine are not opposed to conventional medical practices and do not hesitate to resort to them when appropriate, especially when dealing with patients who have life-threatening, acute illnesses. Anti-aging medicine aims to stay a step or two ahead of sickness and disease; it also works at toxic avoidance and detox­ification, knowing that toxins create malfunctioning cells and cell death is the gradual end to us as a species. It’s that serious. I am a great admirer of anti-aging medicine ... it appeals to my common sense. Drugs will never heal; they abate. Restorative treatment as practiced in anti-aging medicine approaches the body with true healing in mind.

Dr. Hester's response: We all agree aging is inevitable, but how you age is not. Be Medispa was established in 2004 to be your gateway to next-generation medical science… a comprehensive, evidenced-based approach to managing your aging process. Now that is an offer that resonates with individuals of any age who wish to AGE WELL. Forget conventional thinking about aging, and diagnose-and-treat philosophies. Preventive-aging shifts the emphasis from disease-driven medicine to an innovative, health-focused practice. A healthy aging plan helps you take control of the aging process and improve your health span.