May 2007: Health Briefs from Baylor Health Care System

Sensible Skin for Men and Women

Everyone likes to put their best face forward, but with thousands of skin care products out there, how do you know which ones work or which ones you really need?

Kendra Rorrie, M.D., and Daniel Smith, M.D., dermatologists on the medical staff at Baylor Medical Center at Garland, offer the following tips for sensible skin care.

Both doctors agree that an effective skin care regimen doesn’t have to be complicated: Use sunscreen, moisturizer if your skin is on the dry side, and a gentle skin cleanser.

For Him:
Shaving is about as close as most men come to an actual skin care routine.

“It can be hard to get men to use products, because they often dislike certain fragrances and having a ‘greasy’ feeling on their face,” says Dr. Smith. “But adding just one product to their shaving routine can really make a difference.”

Dr. Smith recommends a good lotion to apply to the skin after shaving, instead of aftershave. He advises men to go to the pharmacy or grocery store and find a face lotion that feels and smells good to them, and that has an SPF (sun protection factor) of 15 or 30.

“There’s no real reason why a man has to use aftershave,” he says. “A lotion works just fine and has the added benefit of sunscreen.” Hooked on aftershave? Go ahead and apply it after shaving, then follow up with the lotion.

There is no “magic formula” for shaving cream or gel.

“Pick the one you prefer. If you get irritation from shaving, try not to shave as closely, or switch to an electric razor,” says Dr. Smith.

For Her:
Makeup is where women move above and beyond the basic skin care regimen. There’s a plethora of makeup products, so how do you choose?

“In general, all widely available makeup products in the U.S. are safe. We recommend choosing a foundation that is oil free and noncomedogenic, meaning it won’t clog pores,” says Dr. Rorrie. She says to avoid products containing herbal or botanical extracts, which can cause skin allergies. Sunscreen in your foundation is an added bonus. And always remove your makeup before you go to bed.

Dr. Rorrie often sees rosacea and adult acne in women. Using a gentle skin cleanser and daily moisturizer can help; if skin is not overly sensitive, try an over-the-counter acne medication containing benzoyl peroxide or salicylic acid. Toners and astringents are only indicated for excessively oily skin, she says, and if you use soap, stick to moisturizing varieties, since deodorant soaps are extremely drying.

“Plain petroleum jelly is a terrific moisturizer, and it’s available at a fraction of the cost of other products,” adds Dr. Rorrie.

Aging Gracefully:

If you’re concerned about wrinkles, forget those exotic—not to mention expensive—concoctions at department stores.

“If you like the smell or texture of a certain product, or if you like the way the package looks, by all means spend your money,” Dr. Smith says. “But some non-prescription product’s ‘anti-aging’ claims may not be as effective as they claim.”

“The only products that have been proven to reduce fine lines and wrinkles are topical retinoids that contain Retin-A^® (tretinoin) and those are available only by prescription,” adds Dr. Rorrie.

Sunscreen Do’s and Don’ts:
Do:

• Apply a sunscreen daily with an SPF of at least 15. During strenuous/prolonged outdoor activity, use SPF 30 or greater.
• Use a generous amount, filling your palm instead of using your fingertips.
• Wait about 30 minutes after applying before going outside.
• Use a water-resistant sunscreen while swimming.
• Remember that SPF measures UVB blockage; for UVA coverage, choose a product containing mexoryl SX or avobenzone.
• Find a sunscreen that feels and smells good to you so that you will use it.

Don’t:

• Forget the neck, cheeks, nose, ears, bald spot and back of the calves.
• Forget to reapply every two to four hours.
• Believe expensive brands are any better.
• Think using sunscreen means you can lie out in the sun or in a tanning booth.
• Forget to apply on overcast days.
• Rely entirely on sunscreen for protection. Wear a broad-brimmed hat and long sleeves when possible.

Health Advice for Men

For some men, taking care of the house or the car might come more naturally than paying attention to their health. Roger Tolar, M.D., a physician on the medical staff at Baylor Regional Medical Center at Grapevine, talks about why regular checkups are important.

Q: Is an annual physical that important?
A: Annual physicals help identify risk factors and early signs of disease before symptoms or complications develop. Many patients get a yearly physical because it’s covered by their insurance plan and it provides them with preventive counseling and advice, as well as peace of mind knowing they’re healthy.

Q: At what age should you start?
A: There are varying guidelines, but we recommend a baseline physical at age 18, then one every two to three years if you’re healthy. If there are issues such as borderline high blood pressure or cholesterol, we recommend an annual exam. Beginning at age 50, everyone should have a yearly physical. Men ages 18 to 35 should also do monthly testicular self-exams.

Q: What does a yearly checkup include?
A: A medical and surgical history, comprehensive head-to-toe exam and lab tests (cholesterol, liver function, blood sugar, thyroid study and blood cell count) are standard. Certain situations call for additional screenings such as:

• EKG for men over 40 or those with high blood pressure or a family history of heart disease
• chest X-ray and breathing studies for smokers
• testosterone level if there’s depression, fatigue or decreased sex drive
• prostate exam and PSA blood test for men over 40 to screen for prostate cancer
• colonoscopy starting at age 50 to screen for colon cancer and remove any precancerous polyps.

Q: What about vitamins and exercise?
A: Vitamins aren’t a substitute for eating well, but a daily multivitamin can help “fill the gaps” in our typical Western diet. For patients with elevated cholesterol, I also recommend omega-3 fatty acid supplements (fish oil), which have been shown to have a beneficial effect on lipids. Exercise 30 minutes a day, three times a week as a minimum; 45 to 60 minutes five to six times a week is better. Include a mix of aerobic exercise and resistance training with weights or calisthenics.

Q: Are there any other concerns to be aware of?
A: We tend to be overworked, overstressed and under-rested, and I see a large amount of disease related to this imbalance. The mind, body and spirit are all intimately connected. We need to create a balance of work, family and personal time for optimal health. 

Weight Loss Surgery May Help You Lose Weight and Gain Back Your Health

Being overweight is burdensome at best. It can be embarrassing and inconvenient, but most importantly, it’s detrimental to your health. People who are severely over-weight or obese are at an increased risk for many health conditions, such as heart disease, stroke, type 2 diabetes, osteoarthritis and sleep apnea, as well as some cancers including endometrial, breast and colon cancers.

If you’ve ever been overweight, you know how difficult losing weight is. You’ve probably tried countless crash diets, exercise gadgets and “miracle” cures. And you’ve probably gained every pound back, maybe even then some. But what if there were an option that could lead to successful weight loss, decreased incidence of disease and improved quality of life?

“Weight-loss surgery can save lives,” says Margaret Qualls, program director of the Weight Management and Surgery Program at Baylor Medical Center at Southwest Fort Worth. “People who are obese have shorter life expectancies.”

Gregory Barnes, M.D., medical director for the program and a physician on the medical staff at Baylor Southwest Fort Worth, says, “Weight-loss surgery is a lifelong commitment, and we have a comprehensive program that offers lifelong care.”

The program has three dedicated weight-loss surgeons on the medical staff, plus dietitians, psychologists and support group facilitators on staff to help patients lose weight. Pre- and post-surgical psychological and nutrition counseling and support group sessions are all included in the program.

How does it work?
Three types of weight-loss surgeries are available:

• Roux-en-Y gastric bypass—a small pouch is created at the top of the stomach and stapled off from the rest of the stomach. The new stomach—which is about the size of an egg—is then connected directly to the intestine.
• LAP-BAND^® procedure—creates a small stomach pouch by placing a band around the organ. The band, which is fully adjustable, is calibrated to let food through to be digested. No resection is necessary.
• Gastric sleeve resection—the newest weight loss surgery procedure, removes the bulk of the stomach through stapling. What’s left is a tube instead of a pouch. This option has a better success rate than the LAP-BAND^®, but is not reversible, though it can be changed to a Roux-en-Y gastric bypass.

Are You a Candidate?
Weight-loss surgery is only for people with a body mass index of 40 or higher, or 35 or higher, if serious health problems are present.

Mixed-Up Medicines: Simple Tips to Help You Avoid Medication Errors

Medication errors are a leading cause of health problems and experts estimate that half of the 1.5 million problems that crop up each year are due to communication errors. The Dallas County Medical Society and the Dallas-Fort Worth Hospital Council are teaming up to create an “Educate Before You Medicate” campaign to help people avoid these errors.

Doug Coffey, Pharm.D., clinical pharmacist at Baylor Medical Center at Waxahachie, offers these steps you can take to stay safer:

Know what you take. Ask your pharmacist for a printout of all of your prescriptions. Lots of people today fill prescriptions at multiple pharmacies, shopping around to save money. You’ll need to get a list from each store or chain. Keep a list in your purse or wallet.

Fill in the blanks. Prescription medications can interact with over-the-counter medicines, so add vitamins and minerals, herbal supplements and anything else you take regularly to your list.

Keep it together. When you get a prescription filled, pharmacists recommend you leave them in the original bottle. If you do place them in a case that holds medicines for the different days of the week and times of day, keep the prescription bottles with the case.

Ask questions. Your doctor or pharmacist can explain what effect your medication should have and what side effects might occur. If there’s anything you don’t understand, ask.

Read labels and handouts. Prescription medications come with sheets that explain possible interactions and side effects. Over-the-counter medicines have lots of information on the label. Familiarize yourself with the warnings and active ingredients.

Share the information. Many people today see several specialists—your cardiologist may prescribe cholesterol-lowering drugs while your endocrinologist is treating your diabetes with other drugs. Make sure all of your doctors know all the medications you are taking. Not all interactions are bad—sometimes drugs work in partnership to enhance effects—but it’s important for your doctor to know what to expect.

For more medication safety tips, to read more about the “Educate Before You Medicate” campaign, or to print out a medication card for your wallet, visit dfwhc.org* or call 972-923-5755.