Sunscreen Decoded

What does SPF means?

SPF, or Sun Protection Factor, indicates how long it will take for UVB rays to redden skin when using a sunscreen, compared to how long skin would take to redden without the product.  UVB rays cause sunburn and can contribute to skin cancer, however we now also know that UVA rays also contribute to both photo-aging and skin cancer as well.  UVA contributes to and may even initiate the development of skin cancers.  Therefore, the SPF is only telling you how much protection you are getting from the UVB rays, and not the damaging UVA rays!

What is broad spectrum protection?

Broad spectrum simply means that it blocks BOTH UVA and UVB rays. Therefore, you MUST always choose a sunscreen that is broad spectrum.

But what SPF level should I use?

While certain oils and lotions with low SPF are labeled as sunscreen, I always recommend using a sunscreen with at least SPF 30.  Beyond 30, the protection gained becomes negligible.  To give you an idea of how well you are protected, SPF 15 blocks 94% of rays, SPF 30 blocks 97%, SPF 50 blocks 98%, and SPF 100 block 99% of rays. But be careful! Just because you use a sunscreen with a higher SPF does NOT mean you are protected for a greater length of time – you must reapply EVERY 2 HOURS. 

Do the ingredients in sunscreen matter?

Yes!!!  Broad spectrum sunscreens contain either chemical blockers or physical blockers.  Physical blockers such as Titanium Dioxide and Zinc Oxide are more effective and are my ingredients of choice. Make sure that these ingredients are listed in the active ingredients of the sunscreen you choose. 

How often should you reapply?

I recommend reapplying sunscreen every 2 hours if you are consistently outside.

Should I use sprays or lotions?

I don’t love sprays simply because I don’t like the idea of inhaling all of those chemicals. 

I always sit in the shade so I don’t need sunscreen, right?

This is a common misconception.  While sitting in the shade generally protects you from getting a sunburn, sand and water can still reflect UV radiation, so you are still exposed! Similarly, even if it is a cloudy day, UV rays can break through a cloud cover.   I am a huge fan of sun protective clothing. As someone who lives at the beach, you will always see me in a rash guard and wide brimmed hat.

I wear sunscreen every time I go outside – what else can I do?

Make sure that you are protecting every part of your body – ears, neck, feet, head, and lips are often neglected.   Remember to apply sunscreen at least 15 minutes before exposure, not when you get to the pool.  Hats, lip balm, and shoes can all help protect exposed parts that are often forgotten.

 

It is tick season...

It is tick season in The United States.  Whether it is The American Dog Tick (a carrier of Rocky Mountain Spotted Fever and Tularemia), the Blacklegged Tick (most in famous for spreading Lyme, Anaplasmosis, and Babesiosis), the Dog Tick (carrier of Rocky Mountain Spotted Fever), or the easiest of the bunch to identify, the Lone Star Tick (carrier of Ehrlichiosis, Tularemia and STARI), ticks are omnipresent at this time of year no matter where you live.  If you live on the East Coast, chances are that you know someone who has recently removed a tick or has been diagnosed with Lyme’s disease.  There is so much confusion when it comes to this topic and so back by popular demand, the Dr. Dana Tick Blog.  Here are some tips and resources to help you and your family stay safe this summer!

 

Prevention:

·      Check for ticks daily, especially under the arms, in and around the ears, inside the belly button, behind the knees, between the legs and in the buttocks, around the waist, and on the hairline and scalp.  Children should be checked every night at bath time as part of your spring/summer routine if you live in a tick endemic area.

·      If you have spent time in a wooded or grassy area remove, wash and dry all clothing on high heat and shower as soon as possible.

·      Permethrin based insect repellant can be very effective for tick prevention.  The product should be sprayed on clothing or shoes and NOT directly on skin.  Several brands such as Repel are available on-line.

·      Create a “tick-safe” yard by mowing the lawn frequently, keeping leaves raked, and having children play away from tall grasses.  Consider having your property sprayed.

·      Treat your dogs and cats as recommended by your veterinarian.  Do not allow them into your bed or on your furniture, as they are a possible vector for carrying ticks.

 

How to safely remove an attached tick:

·      Fine tipped tweezers are best.

·      Place tweezers as close to the skin as possible.  Try to grab at the base of the tick (the tick’s head).  Pull upward with a slow and steady motion.  Do not be alarmed if part of the tick remains embedded, as disease transmission is not possible without the whole tick.  Try to remove the remaining segments.

·      Wash the area with soap and water.

·      Put the tick in a sealed baggie ie. a ziplock™ and label the bag with the date the tick was removed and location.  Your dermatologist can have the tick analyzed to identify the type of tick as well as whether that particular tick has the organisms within it that cause disease.  This information can be very helpful in guiding therapy.

 

Important tick facts:

·      In general ticks need to be attached for 36-48 hours before they can transmit Lyme disease bacteria.

·      If you find a tick that has likely been attached to your skin for less than 72 hours and you are >8 years old, an important study has shown that taking one dose of Doxycycline can dramatically reduce your chance of getting Lyme’s Disease.  (87% effective) Call your dermatologist to discuss the best approach for you.

·      There are several different types of ticks (Ixodes, Lone Star, Dog Tick etc), and each tick has different stages of growth when they may or may not carry disease.  This is why identifying the tick can be very helpful.

·      Most humans are infected through bites of immature ticks called nymphs.  Nymphs are tiny (less than 2mm) and difficult to see without a magnifier; they feed during spring and summer months.

·      Ticks can be carried by deer, rabbits, birds, squirrels, mice, dogs and cats and therefore all of these animals are potential vectors for the spread of tick-born illness.

Please call my office if you would like to come in to have a tick tested or if you have any tick related questions or symptoms.

In The Country, we are located at 325 Meetinghouse Lane, Southampton 

631.287.7307

 

In The City we are located at 905 Fifth Avenue at 72nd Street

212.734.4007

www.drdanastern.com (for direction to the offices)

Tick Resources:  Tick Hotline 631.726-TICK; Eastendtickresources.org & Tickencounter.org

Your Manicure, Your Health

The recent article in The New York Times highlighting the nail salon industry in the metropolitan New York City area exposes the economic, social, and health-related hardships of the nail technicians.  As a board certified dermatologist and nail specialist, with a nail focused practice on the Upper East Side of Manhattan, I also find the health implications for consumers of a virtually unregulated, fast-growing, $8.54 billion a year industry to be of grave concern.

The prolific growth of the nail salon industry over the last few decades has resulted in the commoditization of manicure and pedicure services.  Like all commodity businesses, the low cost provider generally prevails.  In New York City, the nail salon capital of the U.S., there is a salon on practically every block and consequently enormous pressure for salon owners to keep costs as low as possible.

Every day in my office I see patients with salon related nail issues ranging from trauma induced lifting of the nail to serious staph infections.  There have been reports of hepatitis acquired from improper disinfection of nail equipment.  More common is the spread of fungal infections and warts caused by the re-use of ‘one-time use’ disposable items such as emery boards, buffers and toe separators.  These are porous tools that cannot be disinfected.  Too often, salons are re-using these items to cut costs with little regard for the safety of their customers.  Lack of regulation, coupled with an extremely low margin service has resulted in an environment where health, safety and a clinically driven educational emphasis within the salon environment are low priorities. 

According to NYC Public Advocate Letitia James’s policy report in September 2014, based on data from the Department of State inspection of New York City salons from 2008 to 2012, the majority of salons — 56 percent — were in violation of health and safety rules.  Currently, the City of New York is not responsible for addressing health and safety in salons.

Proper disinfection of salon equipment requires employing best practices and training technicians; an investment of time and money.  Pedicure footbaths, for example, should be disinfected for 10 minutes with an EPA-registered hospital disinfectant after every client.  In a salon setting, where margins are lean and time is money, it is challenging for technicians to follow proper disinfection protocols.

Continuing education for salon technicians is offered at tradeshows, conferences and online.  However, these courses are costly and not a reality for nail technicians who are making significantly less than the minimum wage.  Instead, in-salon training is provided by salon owners whose priorities are driven by increasing the bottom line, which can be in conflict with promoting health, safety and educational growth of their employees.

The salon industry in NYC is not necessarily representative of how salons do business nationwide but the current NYC urban salon paradigm poses a significant threat to the nail salon industry as a whole.  The existing economics foster a situation where cost saving choices have compromised the health and well being of both the salon worker and the customer, giving rise to a significant public health issue. 

Consumers must be able to objectively evaluate salons in order to make informed decisions.  Salon workers deserve to work in an environment where their health, safety and well-being are a priority and where they are compensated fairly.  Bronx Borough President Ruben Diaz Jr. recently proposed implementing a letter grading system for salons in New York City akin to the system now in place for scoring city restaurants.  The grades should reflect adherence to strict health guidelines as well as an evaluation of the health and well being of the salon workers.  This system would promote greater transparency and allows the consumer to choose a salon using an informed decision making process.  Lower graded salons, that presumably pose a health risk to both the public and salon workers, would inevitably be weeded out and close.

 The current salon model is failing both its customers and its workers.  A serious change in oversight and accountability is needed.  This will benefit the public, salon workers and the salon owners who take seriously the quality of the services they provide.

 

 

Dr. Dana's Top 10 Salon Safety Tips

My patients and closest friends are always asking me if I am pro mani-pedi and what nail salon is cleanest?  My answer is simple.  I believe that everyone should be able to enjoy a relaxing manicure and pedicure, after all when our hands and feet are manicured we feel put-together, in control and ready for anything.  As a dermatologist, surgeon, and mother I like to keep my nails short and clean while never compromising on style.  However, nail care MUST be done in a healthy and safe way.  I like to tell my patients that they need to take their health into their own hands.  Why?  According to NYC Public Advocate Letitia James’s policy report in September 2014:

 • When the Department of State inspected New York’s salons from 2008 to 2012, they found a majority — 56 percent — to be in violation of health and safety rules.

• Customers have been infected with hepatitis and staph infections due to unclean conditions in nail salons.

• There are no regulations governing proper ventilation in salons.

• Nearly 75 percent of nail salons in the U.S. don’t comply with standards for disinfecting nail equipment. This includes reusing nail files and failing to sanitize foot baths. The latter can cause staph infections, hepatitis and bacterial infections.

While most of us want to turn a blind eye to these statistics, it is my job and mission to educate my patients and friends so that you can continue to enjoy salon services but do so in a healthy and ultimately beautiful way.  I go to salons and you too can and should enjoy your next mani pedi. With the help of my top ten salon safety tips, you are now armed with information and ready to kick back, relax and be healthy and beautiful.

 

 1.  Cuticle oil dropper vs. brushCuticle oil must be dropped as opposed to brushed onto a client’s cuticles.  Cuticle oil brushes are not sanitary to use on multiple clients because oils can easily harbor organisms such as bacteria and fungus.

 2.  Emery Board – This is a one time use item and should be used on only one client and then discarded!  Porous emery boards can harbor organisms such as bacteria and fungus. 

 3.  Buffing Block – These tools can be miracle workers for buffing out superficial nail alterations or for polishing the nail to a beautiful shine but be careful that your nail technician is using the right grit for your nails!  Buffing grits vary like sandpaper grades and many of the buffers out there are meant for acrylics and not natural nails.  This is a one time use item and should be used on only one client and then discarded!  Porous buffing blocks can harbor organisms such as bacteria and fungus.

 4.  Orange Sticks – These harmless looking double sided sticks often have a sharp tip on one end that is used for cleaning under the nail and a blunt tip on the other end used for pushing back at the cuticle.  Be careful with cleaning under the nail as a sharp object under the nail can cause the nail to separate from the nail bed.  In salons these tools should be one time use only!

 5.  Toe separators – Although great for keeping your toenails from smudging your perfect pedi, these foamy devices can harbor organisms such as bacteria and fungus and should be disposed after use.

 6.  Whirlpool footbaths – I apologize in advance for this one, you are not going to like what you hear.  You should never place your feet in a salon foot spa that has jets.  It is impossible to clean in the space behind the jets and these baths are supposed to be disinfected by using a 10-minute bleach bath in between every client.  These tubs can therefore put you at risk for acquiring a bacterial or fungal infection.  In an extreme case, there was a death reported secondary to a pedicure in the state of Texas when a woman acquired a staph infection from a pedicure footbath.  Alternative options do exist.  Do not be embarrassed to ask for a plastic basin to soak your feet in.  You can also visit salons that only use basins without jets or you can always request a dry pedicure.  

 7.  Hand washing – This may sound obvious, but you might be surprised!  Your nail technician should always wash his or her hands before and after attending to you. 

 8.  Ventilation – Have you ever walked into a salon and been overwhelmed by the smell of chemicals in the air?  While there may be some of you out there like Jennifer Lawrence's character Rosalyn in American Hustle who love the smell of a really sticky top coat, salons are supposed to have special ventilation systems to ensure the health and safety of both the salon workers and the salon clients.  A super, toxic smell is never a good sign!

 9.  Pumices – We are not huge fans of these volcanic derived stones that are often used as abrasives for removing callus.  Although they can work well for callus removal, they are extremely porous, cannot be disinfected and once they become wet they become the perfect place for molds, bacteria and fungus to flourish.  Instead use a file with removable grit or a stainless steel file that can be disinfected after each use.

 10. The "foot razor" - Used to remove calluses, is illegal in many states and should be!  Salon workers are not medically trained to deal with accidental mishaps that can occur with these blades such as cuts or lacerations.  Additionally, if these blades are reused they can transfer serious infections between clients.  Protect Yourself: Use a callous solution or heel cream at home to safely break down hardened skin.  Callus can also be safely removed at the salon with a removable grit file or a stainless steel file that can be disinfected after each use.

 

 

 

Male Nail Care - Is There Such A Thing?

I am very popular at dinner parties.  Inevitably, the typical scenario is several people know or learn that I am a dermatologist and at some point during the evening I am oh so subtlety motioned into a dark corridor or to a far reaching powder room where I am asked to view a suspicious mole on a leg, an odd and persistent rash on someone’s chest, or commonly an abnormal looking toenail.  Modesty does not usually come into play during these intimate interactions and very often these bathroom consults veer off into additional personal anecdotes relating to prescriptions, sleep habits and sexual issues. 

Recently at a dinner party I was seated at a table with a healthy mix of hedge funders and art world.  Prepared for the usual discussions of the art bubble, where everyone is booked at Basel and the latest activist investor controversies, the conversation suddenly turned to me and my area of expertise – nails.  It soon became apparent that everyone at the table – (yes, the macho Wall Street guys too) was openly discussing their last pedicure experience. 

This was so much more interesting than the usual dinner party chatter and it was so enlightening to learn that men are not only engaging regularly in professional nail care but that they are talking about it openly and unapologetically.

Perhaps it is no surprise, then, that the salon and beauty industry are taking notice.  Man cave stylized Hammer & Nails Salon, an all male salon that opened on Melrose Avenue in LA was the brain-child of Michael Elliot who observed that men want to feel groomed but don't necessarily feel comfortable walking into a female dominated and decorated space.  Per The New York Times, over half of the men’s treatments in the Essie nail area at the posh Samuel Shriqui Salon on the Upper East Side are finished with polish, usually clear.  And while men are currently favoring a naked nail, shiny buff or a simple coat of clear there is a definite new openness towards color.  Thanks to social media, celebrity culture has shared and embraced the “man-icure” trend.  From Snoop Dog’s nail art on Instagram to Brad Pitt’s rainbow stripe manicure that he recently sported at the Palm Springs International Film Festival, it is clear that nail care is no longer exclusively a female cultural norm.

Nail care is about being kempt and caring about your appearance, hygiene and health.  Soft feet and well manicured toenails are appreciated by any partner under the sheets.  For those who are still not ready to enter a nail salon, here are some tips that you can do at home to step up your hand and foot game.

 1) Invest in the right tools.  For a basic manicure and pedicure all that you will need is a new high quality fingernail clipper, toenail clipper, nail file and a cuticle nipper.  If you suspect that you may have toenail fungus, you will need two sets of implements and should see a dermatologist.

 2) Use the tools properly.  After clipping your nails use the file to smooth any sharp edges.  The cuticle nipper is only used when you have the occasional hang nail.  Hang nails should never be pulled off or bitten as they are a very common site for infections.  For general cuticle care simply push them back after a shower with a wash cloth and apply your favorite cuticle cream, balm or oil, especially in cold, dry weather.

3) Remember to clean your tools by rinsing them with antibacterial or dishwasher soap and then soaking them for 5 minutes in either Isopropyl alcohol or Ethyl Alcohol (70%-90%).  Swab the tip with alcohol before use.

As I wandered back to join the rest of the dinner party despite the fact that I had disappeared into a dark corridor with a mystery guest my husband had not batted an eye.  He knows the drill, he asks me how many consults I have done so far that evening and suggests that I send a bill in the morning…

You Can Share A Sandwich

Recently, it was reported in “AIDS, Research and Human Retroviruses” that a woman had contracted HIV by sharing manicure equipment with a cousin who was unknowingly HIV positive at the time.  This mode of HIV transmission although possible is extremely rare.  It is also very difficult to prove and in this particular case, the patient was diagnosed many years after becoming infected.  

 I found this case particularly interesting however, because the woman who discovered that she was HIV positive had no other risk factors for acquiring the disease; and further, genetic analysis of the viruses from both cousins showed that the two women had highly related viral sequences, thus providing substantial evidence that the mode of transmission was likely secondary to the sharing of the manicure tools.

 Although the risk of contracting HIV from manicure tools is extremely low, this case should make people aware that sharing of improperly disinfected manicure tools with possible blood-blood contact (needles for drugs, tattoos or acupuncture) can result in transmission of viruses such as HIV or hepatitis C.  More commonly, the sharing of improperly disinfected manicure equipment, coupled with nail compromise, cuts or skin breakage, may result in the acquisition of fungal or bacterial infections.

 Most people going to the nail salon don’t think twice about how the manicure tools are being disinfected.  Metal tools are usually removed from a disinfectant liquid or UV light box, and it is assumed that the salon follows strict guidelines. 

 Healthy nails are beautiful nails.  Take your health into your hands by bringing your own set of tools to the salon, never sharing your manicure set, and by properly disinfecting them at home by following these simple steps: 

 1)          The first step is to sanitize your tools as well as a pair of metal tongs by cleaning your nail implements with hot water and antibacterial soap.  Don a pair of gloves and scrub away with a bristle brush.  Make sure that you rinse off all excess soap.

2)         The next step is to disinfect your tools. You can either boil your tools for 15 minutes in a pot of boiling water by carefully placing them in the water with your sanitized tongs or “bake” your tools for 15 minutes in the oven at 375°F in a disposable aluminum pan.  Use your tongs to remove the tools and place them on a stack of clean paper towels  where your tools can dry or cool.  Now your tools are ready to be put into a clean carrying case.

3)         Swab the tips of your tools with rubbing alcohol before using.

Think Pink All Year Round

I really love seeing pink everywhere in October in support of Breast Cancer Awareness Month.  From ribbons and bracelets to pink-themed cocktails and think pink manis and pedis, Breast Cancer Awareness Month brings much-needed attention to the disease and promotes funding for finding a cure.  

With October coming to a close, I want to encourage women everywhere to continue to think pink all year round.  One in eight women in the U.S. is affected by breast cancer, and chances are most people know someone who has suffered with the disease.  We have come along way.  If identified early via regular screenings and diagnostic programs, breast cancer can be successfully treated.   Janelle Hail, co-founder and CEO of the National Breast Cancer Foundation (NBCF), states “Early detection saves lives!  Research shows that when breast cancer is detected early, in the localized stage, the five-year survival rate is 98%.” To help increase early detection, the NBCF helps provide free mammograms and resources to those in need, and partners with companies like Medline nationwide to advance breast cancer awareness and prevention.

 

Before months end, I encourage you to purchase a bottle of your favorite pink polish.  Just seeing it in your medicine cabinet will remind you to think pink every month and to remember October’s message – focus on breast health!  Early detection, increased education, and access to resources and support will help us to continue the fight against breast cancer.   

 

For more information about how to create an early detection plan visit: http://www.earlydetectionplan.org/

For more information about breast cancer, getting involved or supporting the cause please visit:  http://ww5.komen.org/

Salon Visit: Paintbox Nails Studio

I love to visit nail salons in order to stay current with the latest trends in nail beauty.  The array of innovative products and cool new nail services offered by salons is amazing!  As your nail authority, it is important that I do this research so that I can confidently make salon recommendations to my patients and friends.

 I was recently invited to Paintbox Nail Studio in SoHo to experience their fabulous salon “first hand.”  Eleanor Langston, a former beauty editor and founder of Paintbox Nail Studio has succeeded in creating an entirely new manicure-only experience that combines a well curated line-up of polish colors and brands, a look-book of incredibly artistic fashion-forward nail designs and most notably an environment that is fastidiously clean, well ventilated and super luxe.  Paintbox takes their nail tech talent seriously, manicurists are highly trained, and communicative to ensure that everything was up to my (high) standards.  I was pleased to learn that tools go through a double disinfection process and one-time use items like buffers were appropriately discarded after use.

 As I took my last sip of champagne, iphone now fully charged, I felt relaxed, pampered and ready to show off my fabulous fingernails.

 

 Schedule your visit to Paintbox by visiting their website:

Paintbox | A Modern Manicure Studio

It's pumpkin season, and don't be frightened to dig in!

As fall rolls in, the parade of pumpkin everything follows.  From jack-o-lanterns and lattes to pies and bread - Pumpkin is everywhere!  It turns out that pumpkin is loaded with  important nutrients for your skin and nails!  This news couldn’t come at a better time as when the temperature and humidity drops, our hands and nails tend to become dry and cracked.  Over the next few weeks as you are carving and dipping your hands into pumpkin, consider this quick and simple recipe for an anti-aging, hand and nail mask packed with antioxidants that will leave your skin exfoliated, smooth and moisturized:

 

1/4 Cup Pumpkin Puree  -  packed with antioxidants beta-carotene, vitamins A, C, and E

1/4 Brown sugar  - natural exfoliator

1 tbsp Extra Virgin Olive oil  - rich in Vitamin E and Vitamin A, Vitamin K, Omega-3, Omega-6, Oleic Acid

 Mix these ingredients in a bowl, and massage on your hands for a couple of minutes.  Rinse with warm water and pat dry. 

 

 A few facts about pumpkin:

 -       Antioxidants ward off free-radical damage that can result in skin aging

-       Vitamin A smooth’s skin tone, and boost collagen

-       Vitamin C combats photodamage, and boosts collagen

-       Vitamin E protects against free radicals 

Policy Report by Letitia James: How clean is your salon?

Policy Report by Letitia James: How clean is your salon?

 Recently public advocate for the City of New York Letitia James released a report “How Safe is Your Nail Salon?” outlining several public health concerns with NYC nail salons and calling for more meaningful regulations as well as increasing the number of inspectors and establishing more stringent guidelines in order to protect the public health and safety of New Yorkers.  As a dermatologist and nail expert with a New York City practice focused on nail disorders and nail surgery I am at the forefront of the issues that Letitia James describes such as nail care products with harmful ingredients that can be damaging to the skin and nails, inconsistent salon safety standards, government safety and hygiene regulations that are not being enforced, and infectious and trauma related issues.  I am privileged to be in a position to offer treatment to patients with nail issues who seek my care on a daily basis and although I believe that everyone should be able to enjoy a relaxing manicure or pedicure there are several precautions that you should take in order to prevent a manicure or pedicure disaster. 

 

 The first impression of the salon is very important.  When you walk in, does the overall appearance feel clean?  Look around at certain details.

 

-Are the floors clean?

-Are the technician’s licenses displayed, and do the photos match up?

-Are the licenses up to date?

-Do the technicians wash their hands before and after each client?

-Are the products in properly sealed, well labeled containers?

-Is the salon well ventilated?

 

Look at the implements:

 -How are they being sanitized and disinfected?

-Where are they being stored in between clients?

-Are they using one-time use items such as emery boards, orange sticks, pumices, buffers, and toe separators once?  Or are they erroneously reusing?

 

There is quite a bit to take in when visiting a salon, especially for the first time.  Although most salons adhere to strict disinfection guidelines, if you are concerned and want to “take your health into your own hands” I would suggest that you bring your own tools and sanitize them at home by cleaning them in hot, soapy water, boiling, and then drying and storing them in a dry place.  Make sure that you never visit a salon if you have an open wound or active infections in the area where you are receiving your service as this could put you at risk for developing a skin or nail infection and having to visit me!  Last, but not least, never ignore abnormalities that appear after a salon service.  If you are concerned about an issue be it an allergy to a product or a possible infection then seek care from a board certified dermatologist immediately.

 

Here is Letita’s full report:

http://pubadvocate.nyc.gov/sites/advocate.nyc.gov/files/PublicAdvocate-AnnualReport-NAIL%20SALON-1.pdf 

Record tick season - Listen up!

Calling all East Enders!  We are having a record tick season on the East End of Long Island this summer.  Chances are that you know someone who has recently removed a tick or has been diagnosed with Lyme’s disease.  There is so much confusion regarding this topic and as a consequence, so much anxiety.  Here are some tips and resources to help you stay safe this summer out East!

 Prevention:

  • Check for ticks daily, especially under the arms, in and around the ears, inside the belly button, behind the knees, between the legs and in the buttocks, around the waist, and on the hairline and scalp.  Children should be checked every night at bath time as part of your spring/summer routine if you live in a tick endemic area.
  • If you have spent time in a wooded or grassy area remove, wash and dry all clothing on high heat and shower as soon as possible.
  • Permethrin based insect repellant can be very effective for tick prevention.  The product should be sprayed on clothing or shoes and NOT directly on skin.  Several brands such as Repel are available on-line.
  • Create a “tick-safe” yard by mowing the lawn frequently, keeping leaves raked, and having children play away from tall grasses.  Consider having your property sprayed (East End Tick Control is an experienced company on Eastern Long Island).
  • Treat your dogs and cats as recommended by your veterinarian.  Do not allow them into your bed or on your furniture, as they are a possible vector for carrying ticks.

How to safely remove an attached tick:

  • Fine tipped tweezers are best
  • Place tweezers as close to the skin as possible.  Try to grab at the base of the tick (the tick’s head).  Pull upward with a slow and steady motion.  Do not be alarmed if part of the tick remains embedded, as disease transmission is not possible without the whole tick.  Try to remove the remaining segments.
  • Wash the area with soap and water
  • Put the tick in a sealed baggie ie. a ziplock™ and label the bag with the date the tick was removed and location.  Dr. Stern can have the tick analyzed to identify the type of tick as well as whether that particular tick has the organisms within it that cause disease.  This information can be very helpful in guiding therapy. 

Important tick facts: 

  • In general ticks need to be attached for 36-48 hours before they can transmit Lyme disease bacteria
  • If you find a tick that has likely been attached to your skin for less than 72 hours and you are >8 years old, an important study has shown that taking one dose of Doxycycline can dramatically reduce your chance of getting Lyme’s Disease.  (87% effective) Call our office to discuss the best approach for you.
  • Not all ticks carry Lyme’s disease.  There are several different types of ticks (Ixodes, Lone Star, Dog Tick etc), and each tick has different stages of growth when they may or may not carry disease.  This is why identifying the tick can be very helpful.
  • Most humans are infected through bites of immature ticks called nymphs.  Nymphs are tiny (less than 2mm) and difficult to see without a magnifier; they feed during spring and summer months.
  • Ticks can be carried by deer, rabbits, birds, squirrels, mice, dogs and cats and therefore all of these animals are potential vectors for the spread of tick-born illness.
  • Ticks can carry several diseases including Lyme’s disease, Ehrlichiosis, Babesiosis, Tularemia, Anaplasmosis and others.

Please call my office to schedule an appointment if you would like to come in to have a tick tested or if you have any tick related questions or symptoms. 

631.287.7307   We are located at 325 Meetinghouse Lane, Southampton  www.drdanastern.com (for directions to our office)

Tick Resources:  

Tick Hotline for East End of Long Island 631.726-TICK

Eastendtickresources.org

Tickencounter.org

Your Anti-Aging Skincare Routine Decoded & Simplified

womanapplyingcreamtoface-300x199.jpg

I had so much fun filming a segment for CBS this week.  The topic – Decoding skincare ingredients in the quest for the best anti-aging skincare products.   There are over 10,000 ingredients in personal care products and if you are confused you are definitely not alone!!

My quest is to break it all down for you by recommending a simple regimen with effective and affordable products.  When choosing your skincare regimen, the key is keeping it simple.  You don’t need to spend your entire paycheck on the latest miracle cream and you also don’t need to be using a million products.  So where to begin?

1) A mild cleanser 

I have always loved Purpose Gentle Cleansing Wash and I am not alone.  This very affordable Johnson & Johnson cleanser is dermatologist recommended and is an Allure Best of beauty product.  I have been using this product faithfully since high school.

If you tend to be acne prone, then consider using a cleanser with salicylic acid (a beta-hydroxy acid).  Neutrogena makes several very elegant products in this category called Neutrogena Oil-Free Acne Wash.  If you tend to get dry, then use the foam or cream version of the wash.

2) A chemical exfoliant

Chemical exfoliators remove the superficial layer of dead skin cells and can help to improve fine lines, a dull complexion, and uneven skin tone.  They also give you an amazing “post-peel” glow so that your skin looks healthy and vibrant.  These exfoliators fall into (2) categories:

Alpha Hydroxy Acids (AHAs) – Glycolic Acid, Citric Acid etc.

or

Beta Hydroxy Acids – Salicylic acid is the classic

Glycolic acid is the best AHA and although you can get much stronger peels at your dermatologist’s office, one of my personal favorite at-home products is Avon’s Anew Clinical Advanced Retexturizing Peel.  Use it two or three times a week and you will never turn back.  I recently ran out of my supply and had them rush shipped!  Always use broad protection sunscreen when using chemical exfoliants.

3) A prescription for tretinoin or other retina-A like cream.  This is the one category where a prescription is absolutely necessary.  Don’t be fooled by over-the-counter variants with ingredients that sound the same (Retinol or Retinyl Palmitate) but are in reality inactive forms of the prescription variant.  These creams are true skincare miracle creams that improve wrinkles, dark spots, and even acne.  Not safe if pregnant or nursing.

4) A good moisturizer with at least SPF 30 and  broad spectrum protection (Zinc oxide or Titanium dioxide)

Sun protection is the most important aspect of your anti-aging strategy and it needs to be daily, 365 days per year.  For this one you are going to have to look at that long list of ingredients and look under the Active Ingredients.  You want to see one of two ingredients listed under active ingredients:Titanium Dioxide or Zinc Oxide.  These ingredients are physical blockers and are capable of blocking both UV-B as well as UV-A radiation, thus they are broad-spectrum.  Two recommendations, Cetaphil Daily Facial Moisturizer with sunscreen SPF 50+ or Neutrogena Healthy Defense Daily Moisturizer with sunscreen Broad-Spectrum SPF 50 – Sensitive Skin

5) Prevention!  These are the products you use at night and often the most confusing category.  We talked about how prescription retinoids are a must but what about all of these other supposed miracle products that we are always hearing about?  I want to mention three of my favorite ingredients along with some specific product recommendations.

Peptides - These are small proteins that can stimulate the production of collagen.  Collagen production and replacement is a key anti-aging strategy because we lose collagen as we age. There are a lot of great products that are incorporating peptide technology now, Olay Regnerist and Strivectin-SD to name a couple.

Anti-oxidants.  Vitamin C is the most effective topical antioxidant in skincare at the moment.  Anti-oxidants absorb high-energy particles called free-radicals before they are able to damage our cellular DNA.  Thus, they prevent inflammation and once again that dreaded collagen loss.  Look for one of two specific Vitamin C molecules under the product’s active ingredients because these two are more readily absorbed into the skin:  Tetrahexadecyl ascorbate or Methyl Silanol Ascorbate

Happy hunting!  I’m always available to answer any questions that you may have on facebook.com/danasternmd

Five tips to get your nails healthy, beautiful, and back to work!

After Labor Day, as we get back to work , we begin to focus on our appearances.  Like a great new haircut or a terrific glow from a new skincare regimen, healthy, well-manicured nails are an integral part of a neat, well kept and put together appearance.

Here are 5 helpful tips to get your nails healthy, beautiful, and back to work!

  1. Don’t cut your cuticles.  Your cuticle is your nail’s natural protective seal.  Like the grout in your shower, the cuticle protects the entire nail from yeast, bacteria, and fungus.  Instead of cutting, the cuticle can be gently pushed back with a wash cloth after a warm shower or soak.
  2. Care for your cuticles.  Not only is the cuticle a protective seal, it also happens to live right above the most important nail structure, the matrix.  Any trauma to the cuticle area (cutting, biting, picking) can affect the matrix and ultimately will be seen as depressions, ridges and discoloration in the nail.  Apply a cuticle cream, moisturizer or cuticle oil to keep the cuticle hydrated and intact.
  3. Hangnails happen.  Resist the urge to tear at them, this can cause an infection called a paronychia.  Using a sterilized cuticle scissor or nail nipper, cut the hangnail at the root, then apply an over-the-counter antibiotic ointment twice a day for a couple of days.  Good cuticle care will help to minimize hangnails.
  4. Consider a nail polish holiday.  If your nails are dry, peeling, and cracking and nothing seems to be helping, it may be secondary to too much nail polish remover.  Polish removers can be drying to the nails, and sometimes just taking a short nail cosmetic holiday and going au natural for a while can be just the thing that your nails need in order to rejuvenate and refresh.
  5. If you notice something unusual on your nail, do not try to cover the defect with polish or an artificial nail as there may be something medically serious going on.  For example, melanoma, a potentially deadly form of cancer, can appear as a brown or black stripe on the nail.  If you don’t know what something is, seek the care of a dermatologist.