Monday, April 11, 2005

Scaling Back

My husband had a scratch on the tip of his nose that didn't heal, so I suggested he go to the dermatologist. Interestingly, the dermatologist wasnt concerned about the scrape (which turned out to be a broken blood vessel), but he was concerned about the scaly skin surrounding it. This, he said, was precancerous skin cells on his nose. Fortunately, the problem was caught and taken care of early. Now he is growing back a new layer of healthy skin.
To learn more about how to cope with actinic keratoses -- precancerous growths that appear as patches of rough, dry or scaly skin -- I consulted Barney Kenet, MD, a dermatologist at New York Hospital-Cornell Medical Center in New York City, and Michael Traub, ND, of the Lokahi Health Center in Honolulu.
These skin lesions, which most commonly develop on the face, scalp, arms and hands, result from years of sun exposure. They may be tan, pink or flesh-colored. Although actinic keratoses, or AKs, are most common in fair-skinned people over age 40 -- like my husband -- dermatologists are beginning to see them in teenagers in such sun-drenched climates as Florida and southern California. Its best to nip skin abnormalities like these in the bud. Left untreated, AKs may develop into squamous cell carcinoma, a form of skin cancer that metastasizes and invades deeper tissue.
According to Dr. Kenet, there are three primary ways to treat AKs...
*Cryosurgery. This is the most commonly used treatment. Liquid nitrogen is used to freeze surface skin and destroy the abnormal cells. The damaged skin flakes off and is replaced by new, healthy skin. The most common side effect is redness.
*Topical chemotherapy. A topical anticancer cream or lotion (most commonly 5-fluorouracil, brand name Carac or Efudex) is applied once or twice daily for three to four weeks. Common side effects include redness, dryness, burning, pain, erosion (loss of the upper layer of skin), swelling and eye irritation. Dr. Kenet notes that a side benefit of this treatment is healthy clearing of skin.
*Photodynamic therapy. This is a two-part process. First, a chemical is applied to make skin more sensitive to light. Several hours later, the skin is exposed to a blue light that activates the chemical to destroy AKs. This creates a focused destruction because cancer cells take up the chemical more readily than healthy cells, explains Dr. Kenet. Exercise caution, however. Skin should not be exposed to light afterward -- it is extremely vulnerable. If some exposure is unavoidable, it is absolutely essential to cover up completely with clothing and a broad-brimmed hat. Sunscreen cannot protect treated skin from photosensitivity after treatment. Dr. Kenet adds that photodynamic therapy is not the first choice in treatment, and insurance is more likely to cover the other two options.
Following therapy, the traditional choice for helping skin heal is steroid cream. Dr. Kenet explains that this is used for only one or two weeks at a time to avoid such side effects as pimples. My husband opted for a milder nonsteroidal cream. There also are natural alternatives.
To learn about natural alternatives to heal skin after treatment of AKs, I contacted Dr. Traub in Hawaii. He suggested several soothing topical remedies...
*Aloe vera. Apply aloe vera gel to relieve pain, promote healing and decrease inflammation and itching at the treatment site. Dr. Traub notes that aloe vera contains salicylic acid, which acts as an analgesic and an anti-inflammatory by inhibiting prostaglandin production.
*Calendula officinalis. Available in cream form, the soothing anti-inflammatory impact of calendula officinalis, or marigold, is thought to be due to compounds known as triterpenoids. Studies show that this herb also has antimicrobial and immune-enhancing properties.
*Matricaria chamomilla. According to Dr. Traub, research demonstrates that topical chamomile is as effective as hydrocortisone in treating contact dermatitis. The anti-inflammatory, wound-healing and antimicrobial effects of chamomile are attributed to chemical compounds such as sesquiterpene alcohol, bisabolol, chamazulene and flavonoids.
Dr. Traub notes that there is evidence that drinking tea can help prevent skin cancer from developing in the first place. Teas contain polyphenolic compounds, which have valuable antioxidant qualities. Studies comparing the effectiveness of black and green teas in protecting against UV-induced skin tumors are not conclusive as to which is more beneficial. Research also suggests that tea is not for drinking alone -- topical application can be beneficial as well, and may protect against inflammation and tumor initiation. Many cosmetics and skin-care products have recently been supplemented with green tea.
To protect yourself from precancerous skin changes and skin cancer, exercise smart sun protection and monitor your skin for suspicious changes. Also, visit a dermatologist for an annual body check. The American Academy of Dermatology offers periodic free skin-cancer screenings. For more information, visit www.aad. org/public/SkinCancerScreenings/skincancerscreen.htm


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