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

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.