The dangers of sunscreen – A dermatologist’s perspective.

by Jackie Dosal, MD


Is my sunscreen going to kill me? Perform a search on sunscreen safety and some scary stuff shows up! Retinyl palmitate causes skin cancer. Oxybenzone causes estrogen-like effects on the body. I have seen these statements repeated over and over again all over social media and in real life. I recently heard from a patient, “I was using Neutrogena but then stopped because I heard it wasn’t so good for you.” How do we protect ourselves and our families from skin cancer without any nasty side effects?

I’d like to offer up my take — from a organic-loving, Whole-Foods-shopping, yoga-practicing, green-tea-drinking MD (dermatologist), with an eye for interpreting both media and science…

For those not able to read the whole post (we are all busy, I know!), here’s the quick summary of my findings. You can read on for more info too!

Sunscreen won’t cause hormonal disruption — it would take 200 years of application to even reach questionable levels of exposure.

Sunscreen won’t cause skin cancer — the use of sunscreen is directly correlated to the prevention of skin cancer. Retinyl palmitate is an anti-oxidant that occurs naturally in the skin.

Nanosize sunscreens are safe for use, as they clump in real life, preventing them from being absorbed.

I’ve researched the issues of sunscreen safety personally, and WOW! It’s confusing and contradictory. I’ll at least say this— we always need to critically and scientifically analyze the sunscreen ingredients we use for both efficacy and safety. And just as important, let’s not perpetuate myths that are based on unsound science. If you are interested in sorting through the muddy waters of sunscreen information — read on!

Environmental Working Group’s Rankings of Sunscreens.

Most of the information about safety stems from the Environmental Working Group’s sunscreen rankings. The Environmental Working Group is a not-for-profit organization that searches to identify harmful chemicals in our environment. While I applaud the intentions of the EWG to find safe and environmentally responsible materials, we need to be fair and look at these issues seriously, and not just solely how presented by the EWG.

Do sunscreens cause hormonal disruption?

The EWG advises avoiding any products with oxybenzone (an excellent UVA and UVB blocker) as it may cause effects similar to estrogen. The concern comes from a study performed in rats, where the rats were fed supratherapeutic doses of sunscreen (let me say that again, the rats ATE sunscreen at megadoses), and the size of their uterus enlarged.

Edited graph from PMID 11333184

There is a monstrous difference between eating super high doses of sunscreen and applying it to your skin daily — and concluding that topical use in human sunscreen causes estrogenic effects is an unrealistic stretch. A study in 2011 in JAMA Dermatology showed that it would take 200 years of daily sunscreen application to reach the same amount exposure as the rats in this study. To the author’s credit, their word-for-word conclusion in the abstract was: “Our findings indicate that UV screens should be tested for endocrine activity…” The authors do not say that the UV screens cause hormone activity in humans… they can’t. In order to substantiate their EWG’s claim, you would need to show hormone disruption in real live humans.

Luckily, such a study was performed. Human patients applied more than 3 times the real-life quantity of a high percentage oxybenzone sunscreen (10% oxybenzone, compared to the commercially available 6% oxybenzone) to their whole body daily for one week. Oxybenzone was in fact detected in the urine of the volunteers (as have some other sunscreen agents). Sound the alarm bells! — this is concerning. It indicates that there is some absorption from topical use (medications that are applied directly to the surface of the skin). However, the body quickly excreted it through the urine (which is a good thing). Much can be said about the fact that it was absorbed, but the take-home message was that the researchers were UNABLE to show a hormone disruption despite this absorption (again, this was at 3 times real-life dosage). There was no accumulation of the ingredients over time.

So we have a study in humans of real-life sunscreen use that shows no hormonal effect, or a study where rats ate sunscreen — which do you believe?

To be fair, when researching this blog post, I did come across an alarming number of lab and animal studies showing absorption of various sunscreen agents, with some experiments suggesting hormonal disruption. There were almost as many that showed no absorption nor hormone disruption. A good summary of those studies can be found here. But we have to look at what’s important… no human studies have shown hormonal disruption, and that is what counts.

Of note, it is important to mention that oxybenzone can cause allergic skin reaction in a fair percentage of people, so there should be some caution with its use.

And by the way, soy is weakly estrogenic. Where are the cries for banning or avoiding soy milk because of hormonal activity? There are many natural skin care products on the market containing soy, several of which I recommend and are excellent. A little perspective is important, and we need to remember that topical use is very different from ingestion.

Let’s move on to sunscreen and skin cancer.

Does my sunscreen increase my risk of skin cancer?

 A few years ago there was media buzz about a toxicology study that suggested that retinal palmitate, a common inactive ingredient in sunscreens, may actually increase your risk for skin cancer by increasing oxidative damage, or reactive oxidative species (ROS). Oxidative damage is like rust on metal — it corrodes our body and makes us more prone to inflammation and cancer. Let’s dive into this deeper.

Retinyl palmitate is an interchangeable form of retinol that is present naturally in our skin, and this should already be a clue that it’s not dangerous. Retinyl palmitate is not just in sunscreens; is approved by the FDA for use in prescription and over the counter medications, as well as a food additive in dairy products and cereals. It was selected for testing due to its prevalent use in common agents, not for any concerns of safety up to that point.

Once again, we have to look at the details of the study that created the buzz. It was never published in a peer-reviewed journal (the standard for medical literature — data needs to be vetted by people in-the-know), and was not performed in humans (also a huge red flag). It was performed in hairless mice, known to have an already increased risk of skin cancer, and these mice were burned with and without retinyl palmitate (RP). The studies showed the production of oxidative damage and increased risk of malignancy. However, these studies take RP out of human context, which is a very complex interactive antioxidant system. According to Dr. Steven Wang, the lead investigator in the study, “when a sunscreen with retinyl palmitate is applied to the skin, a number of antioxidants work together to alleviate the risk of free radical formation seen in these in vitro experiments. If studied on its own — outside of this environment — its antioxidant properties can rapidly be exhausted, allowing the production of oxygen radicals. In these non-human studies, retinyl palmitate was the only compound studied — making the biological relevance of these findings to humans unclear.” Even the lead investigator is not ready to recommend avoiding retinyl palmitate.

The final and probably most convincing evidence of the safety of retinyl palmitate comes from real life use in humans. We often use the family of retinoids (of which retinyl palmitate is a member), as a pill for the prevention of skin cancers in those most at risk (immunosuppressed organ transplant patients). We also have decades of experience using retinoids in acne medications; and topical retinoids are one of the best anti-aging creams on the market — I personally use one (Retin-A) every night. Undeniable human research shows it can reverse oxidative damage and signs of aging, keeping the skin healthy and youthful.

If you are interested in more, I encourage you to read this study by the Journal of the American Academy of Dermatology detailing the properties of retinyl palmitate and discussing its safety.

What are nano particles, and are they safe?

Nanoparticles are molecules that have been divided into nanometers (one billionth of a meter). By making the molecules small, it makes sunscreens more cosmetically acceptable and elegant, thus making it more attractive for people to use (i.e. not thick, sticky, or opaque like the old sunscreens found on lifeguards’ noses).

Concerns arose that these molecules might be small enough to penetrate through the skin into the bloodstream. Time and time again, human studies have shown that these particles are unable to penetrate through the skin because, in nature, these nanoparticles aggregate into clumps that are too large to penetrate the skin. There was also some thought that these ingredients could increase reactive oxidative species (ROS). We now know that this is meaningless if tested outside of the complex human antioxidative system. With this in mind, we should all embrace these new technologies that makes sunscreens less opaque, pastey, and more consumer friendly!

Nanoparticles clump on the skin. Photo credit: PMID: 22123418

Be Cautious of Media Sound Bites

The EWG extrapolates data (usually from animal studies, not humans), and uses scare tactics to make us feel like we are hurting our children if we use certain products. What I don’t like is that they ignore actual sound studies that show safety in humans. Their sound bites are alarming and catchy for headlines. I’ve actually seen website titles citing the EWG reading: “The Most Dangerous Sunscreens For Kids (And They’re Probably Hiding in Your Beach Bag).” Talk about mommy guilt!

I love this story which explains why we need to critically interpret how the media presents headlines: Chocolate Causes Weight Loss!

Background: A scientist wanted to show just how easy it was to convince the media to pick up a poorly designed faux scientific experiment that was catchy for headlines. It was a completely fake, but intriguing idea — eating chocolate can help loose weight. It turns out, it was really easy to get experienced journalists to pick up the headline! Read here: I Fooled Millions into Thinking Chocolate Helps Weight Loss. A critical eye is really needed in these days of rapid information sharing.

What does this all mean?

I don’t agree with the EWG rankings. Many of the poorly ranking sunscreens are very reputable and excellent brands. You can’t take the data from one animal or lab study and ignore other science and human experiments that are in disagreement. That’s not how science works. That’s the reason why thousands of drugs that work in animals never get to the market — because animal studies and in vitro studies often don’t translate into efficacy in the complex environment of the human body.

While in general, I’m in favor of the organic movement, real foods, and responsible farming practices, I often laugh when I see websites recommending chemical-free everything, including sunscreens. Chemicals are in everything, and there is no such thing as a purely chemical-free susncreen. Of course, live in moderation — extreme use of any susbtance can lead to some bad effects, but to say that normal day-to-day use of products causes the same effect seen with extreme use or oral ingestion doesn’t make any sense.

The dose is the poison, not the chemical itself. Almost any substance, including natural or beneficial substances, can be toxic under certain conditions, such as high temperatures, pH, concentrations, or when in the presence of other chemicals. Even too much Vitamin C can be lethal to skin cells at certain doses. The age-old mantra still holds true — everything in moderation.

Let’s thank the EWG for their laudable efforts in keeping us safe, but ask them not to demonize valuable products when the science shows otherwise. I completely agree that more testing needs to be done on household and cosmetic ingredients, but I wish they were a little more unbiased when it came to promotion of their agenda. And the media perpetuates these news snippets with negligible investigation into the validity of the EWG claims. It serves our society poorly.

Feel good about protecting your family — and apply that sunscreen this summer!

Why patients should buy skincare products from their Dermatologist

By: LESLIE S. BAUMANN, M.D. | June 16, 2015F_33088


The Internet has changed many facets of modern life, and the practice of medicine has not gone untouched. Consider, for better or worse, the reliance of many patients on WebMD and various other sites for self-diagnosis before consulting with a physician. Even before the Internet, patients would self-diagnose their skin type (more than 80% of them get it wrong). The Internet allows them access to most cosmeceutical brands, the misuse of which leads to unintended consequences that can affect skin health. Clearly, patients who receive advice from a trained medical professional have better outcomes. One reason for this is that the doctor (or aesthetician) spends time with the patient, explaining what products to use and in which order to use them, and follows up with the patient to assess the outcome and adjust the regimen as needed. The problem arises when these patients decide to purchase the products from a source other than their treating physician. Only about 30% of patients buy refills from their doctor for second purchases, and just 15% purchase products from their doctor the third time around. Why is this? It is likely the convenience and the low cost that drive patients to purchase from sources other than their physician or aesthetician. This desire to save money carries significant risks. Many the products online are expired or counterfeit, or are old containers refilled with a different formulation. Patients should be cautioned to only buy products from a source they trust.

I have had dozens of patients bringing in counterfeit products in the last few months. It seems that the problem is becoming more common. I interviewed several companies about this to see whether others were experiencing the same trend. This is what I found: Some companies report that they have seen their samples and trade size containers being sold on eBay. Joe Ragosta of Topix Pharmaceuticals reports that when his company has asked such sellers if they are obtaining these products – marked as samples – from the company, they hear a range of defensive responses, including: “I got it at a show” or “My doctor gave me samples, and I decided to sell them” and “I work at a doctor’s office, and they let me take products as needed.” Make sure that no one on your staff is taking samples and selling them online.

One example: NeoStrata is concerned about the fraudulent use of their products. They recommend that patients purchase their products only from a known physician, ideally from the physician’s office rather than the website. The company understands that customers may want to save money wherever they can and might prefer to buy products online. NeoStrata urges customers who opt to buy online to make such purchases through physician-affiliated websites, where the doctor is clearly identified. At the very least, the company urges patients to choose only sites where they can contact someone and obtain the name of a physician. Further, they strongly discourage using eBay or other auction sites, which do not vouch for the safety and authenticity of products sold through their services.

Other potential problems with skin care products sold online include the following.

Counterfeit products

Several reports have indicated that counterfeit skin products originating in other countries have made their way into the United States and, according to the article published on the website Fact Based Skin Care, pharmaceuticals and personal care products, including cosmetics, are among the top five types of products seized by U.S. Customs and Border Patrol agents (Coy, C. Dangers of Counterfeit Cosmetics, Aug. 4, 2014). Such products include old bottles refilled with inexpensive imitation creams or bottles made to look like legitimate products that in fact contain imitation creams. I once had a patient present with an adverse reaction to a retinol product, which she brought with her to the visit. I sent the bottle to the company, which confirmed my suspicion that the product was counterfeit – a different bottle with a similar label.

In February 2014, CBS New York ran a segment on the potential inclusion of carcinogenic and other harmful ingredients found in online personal care products touted for their low prices (CBS New York. Counterfeit Cosmetics May Be Harmful To Your Health. Feb. 27, 2014). Not even 2 weeks later, CNN reported on the arrest of two brothers in New York alleged to have masterminded a multimillion-dollar counterfeit health and beauty product ring (CNN. Zulueta A. Massive Fake Health and Beauty Supplies Ring Busted. March 9, 2014). ABC’s Good Morning America followed suit with a segment in April 2014 that exposed aspects of the use of knock-off cosmetic products (ABC News, Good Morning America. Online Beauty Bargains: Is It the Real Deal? April 3, 2014).

The Federal Bureau of Investigation has posted memos concerning counterfeit and potentially compromised and hazardous cosmetics and fragrances, offering tips aimed at readily identifying or avoiding unauthorized products.

Torie Hardee of EltaMD summarized that counterfeit products can sometimes be identified by lack of an expiration date on the bottle, discoloration or slightly different fonts on bottles and packaging, and the manufacturer’s address on the bottle.

Jan Marini Company representative Stuart Mohr noted that their company has received returns of products that they had not manufactured, as well as their own current or discontinued products returned years after the expiration date. The Jan Marini Co., and most other companies, will not guarantee any product purchased via nonauthorized resellers, because the authenticity and safety of such products cannot be verified.

“These unauthorized resellers are sophisticated, often even working in rings, and find it easy to hide their real identity,” said Mr. Mohr. “Addresses are often hidden or vague; emails are not linked to any specific person; and it’s easy to use false names. If a person is caught in an unauthorized online transaction, it’s easy to change the email address or name and start again,” he added.
FBI’s tips for spotting counterfeit cosmetics and fragrances

• The product is a sample size.

• The packaging differs slightly from the authentic brand (different color or font).

• The product’s wrapping appears haphazard.

• The product is being advertised as a “limited edition” even though the authentic manufacturer doesn’t offer it as a limited edition.

• The product is not listed on the manufacturer’s website.

• The price is drastically lower than the MSRP.

• The product’s consistency or texture doesn’t feel or look like the authentic brand.

• For fragrances, something seems off about the scent, and the color of the fluid in the bottle might be different than the original.

• They are being sold at nonauthorized retailers, including flea markets and discount stores.

• The label does not contain lot number, bar code, manufacturer’s address, or expiration date.

Expired products

Unscrupulous online retailers may slash prices on expired products and remove the expiration date from the package. In my practice, a patient experiencing an erythematous reaction brought in the “SkinMedica” product bottle, which looked suspicious to me. The packaging that the product was in had been discontinued 8 years earlier. It is important to remember that ingredients, particularly retinol, degrade with exposure to air, sun, and heat, and over time. This is most likely what caused my patient’s adverse reaction, and her initial savings from the product caused her several weeks of irritated skin.

Diverted products

SkinMedica reports that diverted products are a trickier issue than counterfeit products, because their packaging and formulas are sufficiently complex to make counterfeiting too difficult to be profitable. Instead, their products have been sold on the so-called gray market below the manufacturer suggested retail price (MSRP), typically online. In these cases, the company cannot help patients with returns or complaints because they cannot verify the chain of custody of the purchased product. They are addressing this problem, though, with an awareness campaign called “Authentic and Authorized.” Its goal is to alert patients and the physicians who dispense their products of the benefits of a physician-dispensed model of skin care, with best outcomes achieved when doctors are prescribing a skin care regimen. SkinMedica emphasizes that no website can guarantee outcomes comparable to a skin care professional and product quality and safety can only be enforced when dispensed through authorized channels.

Potentially illegal or toxic ingredients

Several products that have entered the United States marketed as skin lighteners, antiaging agents, and acne treatment products have been found to contain mercury, according to a consumer update from the FDA. Arsenic, lead, beryllium, and other harmful toxins as well as allergy-inducing fragrances or preservatives not approved as safe in the U.S. may also be found in such products of dubious origin.

Improper storage

Products purveyed online are often stored in hot warehouses. As mentioned above, heat degrades and alters ingredients, rendering compounds such as retinol, benzoyl peroxide, peptides, and ascorbic acid worthless. Extreme cold can also damage the chemical integrity of products. Notably, organic products are more vulnerable because they lack preservatives to gird them against temperature variations and microbes that grow in hot, damp environments.

Lookalike imposters

Generic formulations are packaged to piggyback onto the success of well-known products. Such products found in drugstores may be packaged to look like Cetaphil or Aveeno items, but cost less, and deliver less. While the ingredients on the copycats are identical to those found in the branded preparations, the order in which ingredients are added, the temperature, pH, and even when and how fast ingredients are stirred are part of the proprietary recipe of the company and play a significant role in the potential of the end product and the actions the product exerts on the skin.


Whether or not you sell skin care products in your office, there is much you can do to educate your patients about skin care product safety. Namely, the farther a consumer gets from the source of the product or from reliable endorsers of products, the greater the opportunity for encountering fraudulent or counterfeit products. Patients are best served by sources they can trust, such as their dermatologist. If you sell products in your office, encourage your patients to buy refills from you so they can be assured of the proper formulations. Finally, encourage your patients not to skimp when it comes to the health of their skin, reminding them that it may cost them much more in terms of time, skin irritation, improper treatment, and all related expenses to buy products cheaply from unreliable sources.

Give your patients a copy of this article so that they will understand the enormity of the problem.

Dr. Baumann is chief executive officer of the Baumann Cosmetic & Research Institute in the Design District in Miami. She founded the Cosmetic Dermatology Center at the University of Miami in 1997. Dr. Baumann wrote the textbook “Cosmetic Dermatology: Principles and Practice” (New York: McGraw-Hill, 2002), and a book for consumers, “The Skin Type Solution” (New York: Bantam Dell, 2006). She has contributed to the Cosmeceutical Critique column in Dermatology News since January 2001. Her latest book, “Cosmeceuticals and Cosmetic Ingredients,” was published in November 2014. Dr. Baumann has received funding for clinical grants from Allergan, Aveeno, Avon Products, Evolus, Galderma, GlaxoSmithKline, Kythera Biopharmaceuticals, Mary Kay, Medicis Pharmaceuticals, Neutrogena, Philosophy, Topix Pharmaceuticals, and Unilever.

Tattoos may stop Apple Watch

May 08, 2015
By Bill Gillette – tattoo-apple-watch


Parents trying to convince their teenager not to get a tattoo might try this: Give the teen an Apple Watch and pass along the following news.

According to a CNN report, some Apple Watch wearers say their wrist tattoos prevent the device’s heart-rate sensor from functioning properly. And since the Apple Watch uses the wearer’s heart rate to determine whether the device is being worn, a wearer who has wrist tattoos might not be able to place calls, receive notifications or use certain apps.

Tattooed Apple Watch wearers have complained about the issue on social media, and Apple blog iMore confirmed that the problem does indeed exist.

According to CNN, the way in which the Apple Watch senses the wearer’s heartbeat causes the problem. Apple says the back of the device flashes green and infrared light at the wearer’s skin, and the light is absorbed or reflected by the blood. When the heart pumps more blood to the wrist area, the device senses it, and it also senses the diminished amount of blood between beats. The Apple Watch calculates the wearer’s heart rate by sensing the timing between heartbeats.

Solid-colored tattoos—red ones especially—also absorb the green light and reflect the red light. Black tattoos, which absorb both green and red light, can also interfere with the Apple Watch’s heart-rate sensor. Dark-colored skin, scars and skin abrasions, which are translucent, don’t interfere with the device’s heart-rate sensor. Tattoo ink is opaque, however, and prevents light from penetrating the skin.

CNN reports that users have found that turning off the Apple Watch’s wrist detection function allows notifications to come in, but it also prevents the wearer from using the Apple Pay function and receiving calls.

Read more about how to remove unwanted tattoos here

Our PA, Jang Mi Johnson, featured on BBC for a story on race in America

Our PA, Jang Mi Johnson, was featured in a short political documentary in Great Britain for a story on race in America.

PA B. Jang Mi Johnson’s WGN interview about her former student who perished in Nepal’s earthquake

Doctor Who Trained In Chicago Among Nepal Earthquake Victims

by Dana Kozlov – general assignment reporter for CBS 2 Chicago.

A doctor and former Malcolm X College student was among a group of climbers killed on Mt. Everest when a massive earthquake in Nepal triggered an avalanche on Saturday.

Marisa Eve Girawong was working as a base camp physician assistant for Madison Mountaineering’s expedition on Mt. Everest. Before leaving for Nepal last year to pursue her career as a physician assistant, she graduated from Malcolm X College in 2012, and completed her medical training at John H. Stroger Jr. Hospital of Cook County.

B. Jang Mi Johnson, a senior physician assistant at the Illinois Dermatology Institute, was one of Girawong’s teachers in the Stroger Hospital-Malcolm X College physician assistant program.

“In a way, I feel like I’ve lost one of my children,” Johnson said.

She said Girawong, 28, wasn’t only an exceptional student, but an exceptional human being. Johnson didn’t want Girawong to be one of the earthquake’s anonymous victims.

“It’s hard when someone that amazing is gone,” Johnson said.

Laser Hair Removal: Busted Myths – part two

Eugene Mandrea, MD


Article by
Chicago Dermatologist


Here are some other myths about laser hair removal you should consider debunking:

• Myth 1. Laser hair removal hurts
Of course, we can’t say it’s painless. The level of pain depends on the individual pain tolerance. Some have described the sensation of laser hair removal to a slight sting on the skin. Others say it feels like a pinch on the skin. But just compare the little stings felt during a laser hair removal session with the huge pain induced by wax or mechanical depilation. There, now you have your own answer.

• Myth 2. Laser hair removal causes scars
Scars only appear when a needle touches your skin. The laser hair removal it’s not about needles or any other kind of scarring tools. On the contrary, the laser beam smoothly slides on your skin, removing all that unwanted hair.
• Myth 3. Laser hair removal is not for all type of skins

This is also an untrue myth. The fact is that the laser operates on melanin in hair bulb selectively. No melanin means no effect. So, if you’re asking whether if you can remove hair from dark skin persons, yes, laser hair removal works for dark skin tones too. Of course, by choosing an appropriate kind of laser and maybe a clinic in Chicago, a place best known for its professional laser hair removal clinics.

Laser Hair Removal: Busted Myths – part one

Eugene Mandrea, MD
Article by
Chicago Dermatologist


Although laser hair removal is a common practice, there are many misconceptions that can guide you on the wrong path. Basically, there are several myths around laser hair removal, that distort representations about its possibilities. Let’s check some of the most important ones:
• Myth 1. Laser hair removal is harmful to health
Nothing more untrue! The truth is that the depth of laser penetration it reaches only to hair follicles and the laser beam is smoothly sliding on the skin surface without damaging it. The only thing that may occur is a certain redness, but it disappears soon after the procedure and it’s a sign that the laser hair removal procedure went well.
• Myth 2. Laser hair removal is very expensive
In order this myth to be busted, just think how much money you spend during one year on razors, creams and other hair removal tools. Then compare the result with the laser hair removal procedure – basically it consists of 6 or 8 sessions with intervals of 2 or 3 months. Now you judge the difference!
• Myth 3. After the laser hair removal, the hair will grow more stringent than before
This is also a totally untrue myth. On the contrary, hair is significantly reduced and by the third or fourth session you can already notice a persistent long-term effect.

FDA approves a relatively new and effective toenail fungus infection treatment

capstone_popupRecently a safe topical fingernail and toenail fungus infection treatment has been introduced:
EFINACONAZOLE Lotion (Jublia) has been proven to be a very effective treatment for nail fungus infections unaccompanied by thickening of the nail bed.
If the nail bed is thickened, we use 40% nUrea Cream under occlusion at night and Jublia Lotion in the morning.
These treatments are very effective and relatively inexpensive, but take a very long time, due to the very slow rate of growth of the toenails: It takes from 12 to 18 months for the big toenail to regrow completely.


Use of Topical Steroids in Pregnancy

Pregnant women occasionally and rarely develop widespread skin eruptions that may be very pruritic (Itchy)

Strong topical steroids are very effective for the treatment of these eruptions but there is always much anxiety as to the possible effects on the unborn fetus.

A recent, controlled study from England shows that if administered CAREFULLY under close supervision by a Dermatologist, these strong steroids can be safe.
The treatment should be limitesd to the duration of the rash only, and should not exceed 300 grams.
It must be emphasized that, unless administered and supervised by a dermatologist, this treatment would NOT be safe.

Patients with Established Dermatologists Could Detect Melanoma Earlier

A recent study, published in the May issue of the Journal of the American Academy of Dermatology, found that patients having an established Dermatologist were more likely to 0010556394O-849x565self detect a “Melanoma in situ” ( pre-invasive) than those without an established Dermatologist.
Moreover, those with an established Dermatologist were able to self detect thinner invasive melanomas than those without an established Dermatologist.
This suggests that education of patients in the Dermatologist’s Office (conversation, pamphlets) may be of value regarding self detection of pre-invasive and early, thinner melanomas.