Free skin cancer screenings Oct. 6 at Martha Morehouse Medical Plaza

The OSUCCC-James is offering free skin cancer screenings on Monday (10/6) from 1-4:30 p.m. at Martha Morehouse Medical Plaza, Tower Building, Fourth Floor Clinic. Call The James Line at 293-5066 or (800) 293-5066 to schedule an appointment if you have any of the following conditions: moles that are changing in color, size, or shape; new growths on your skin; skin lesions that are painful, itchy, or bleeding; or sores on your skin that won’t heal.

Melanoma – Some Advice from Family Nurse Practioner Students

Protect your skin from the sun

ABCD pattern:  A - Asymmetrical

ABCD pattern:  B - Irregular Borders

ABCD pattern:  C - multi-colored

ABCD pattern:  D - diameter

Ohio State Family Nurse Practitioner Students Promote Melanoma Awareness:

According to the CDC, skin cancer is the most common form of cancer in the United States. If diagnosed and treated early, skin cancer is very curable. Unfortunately, if skin cancer is not diagnosed until later stages, it can result in disfigurement and even death. Each year over 60,000 Americans are diagnosed with melanomas of the skin.  Please be aware of the amount of sun exposure you receive this year. You can help prevent skin cancer and still have fun in the sun outdoors by protecting your skin. Protection includes seeking shade, applying sunscreen, and wearing protecting clothing, hat and sunglasses. Remember the amount of sun exposure you get in your youth directly impacts your risk for skin cancer later in life.

The Skin Cancer Foundation recommends that you perform a full body skin exam on yourself once a month and that you have one done by your doctor/dermatologist once a year. Schedule an appointment with your doctor/dermatologist if you notice any mole or skin changes following the ABCD pattern of melanoma.

For additional information, please visit http://www.skincancer.org/skin-cancer-information/early-detection/step-by-step-self-examination

Submitted by Ohio State Family Nurse Practitioner Students:  Jennifer Ashton, Shannon Brown, Christopher Daughtery, and Amanda Warner

Help us spread the word, like our Facebook page:  http://www.facebook.com/melanomaeducationandawareness

Reviewed by Tina Comston, M.Ed.

Photo Credit: www.skincancer.org

Spring Break – Feeling the Burn

Sunscreen!!

And more sunscreen!!

 

If you are fortunate, you will be leaving Ohio soon to travel to a warmer (and sunnier) destination down south. After spending months hibernating in your room from the dreary winter weather, sunscreen is the last thing on your mind. Without fail, you head out to the beach or pool the instant you arrive and are lucky if you remember to grab your towel. Upon returning to your room hours later, you notice a distinct reddening of your skin and feel the heat radiating from the area. Because it’s the first day of your trip, you panic and wonder what can be done to minimize the pain and redness; a bright red face wasn’t the look you were going for on spring break.

Though time is the best component of the healing process, there are a few things you can do to minimize the pain and help the healing along. First of all, an over-the-counter pain medication such as Motrin (ibuprofen) or Tylenol (acetaminophen) will help decrease overall pain, redness, and swelling. As for topical relief, you may want to try cool compresses or aloe to soothe the stinging. Additionally, it is important to stay hydrated (with a bottle of water, not a bottle of another favorite spring break beverage) because the burn tends to draw fluids out of the skin and make you more dehydrated. Keep in mind that alcohol also dehydrates your body, which is why we don’t recommend trying to hydrate with it. Moisturize your skin with lotion or cream to decrease the look of peeling and flaking skin (using a product with Vitamin C or E may have additional healing benefit). Calamine lotion or Benadryl (diphenhydramine) may help reduce itching.

If the sunburn has caused nausea, vomiting, blistering, heat stroke, or confusion it is best to seek medical attention. Stay away from products containing benzocaine or lidocaine because they may cause further irritation to your skin. Also avoid products containing petroleum (i.e. Vaseline) because this may trap the heat. To prevent further burning of your skin (more redness, more pain) stay indoors or if you just can’t stay away from the sun, wear clothing that will cover the area and slather on that sunscreen that was wedged into the bottom of your suitcase.

Some medications may cause you to burn more easily. Check out this past blog post if you think your medication might be one of them. http://shs.osu.edu/blog/do-i-need-to-avoid-the-sun-if-im-on-medication

Of course, the best way to treat a sunburn is to not get one in the first place.  Check out this past blog post for tips on prevention. http://shs.osu.edu/blog/sunscreen-advice-from-a-dermatologist-to-prevent-skin-cancer

Submitted by Emily Burns, PharmD Candidate 2014

Reviewed by Jason Goodman, PharmD, RPh

A Spot is not always just a Spot

Actinic Keratosis

Squamous Cell Carcinoma

About three months ago, when I was drying off after taking a shower, I noticed that there was an area on my face that felt tender.  Not sore, just that when I moved the towel across it I noticed.  I checked it out in the mirror and saw that I had a slight pink spot on my face.  I really didn’t give it too much thought and went about my day.  I would totally forget about the spot until the next day, in the shower, it would again feel tender. 

As time went on the spot became more noticeable, changing from a slight pink to more of a red and it appeared to have a scale or dry skin over it.  I thought that perhaps there was something in there that just wasn’t healing so I put some peroxide on it in the morning after getting out the shower – bad idea!  This just made it even redder and the spot became bigger.  I stopped the peroxide. 

I switched from peroxide to lotion and that did seem to help.  The spot shifted back from red to more of a pinkish hue and decreased a bit in size, but three months later and I still had the spot.  My mom has horrendous psoriasis and so I was concerned that I too may be heading that direction and I scheduled an appointment with a dermatologist. 

Five minutes into my appointment I had the diagnosis – Actinic Keratosis.  This is a small, scaly patch caused by too much sun and it can be an early warning sign of skin cancer, specifically Squamous Cell Carcinoma.  The treatment was easy enough.  The dermatologist brought out a can of liquid nitrogen and froze the area on my face.  The process was quick, taking just a minute or so, relatively painless, and I was told that it should be healed in 8-10 days.  No more Actinic Keratosis and no more risk of skin cancer.

These types of patches typically occur on the head, neck, or hands, but can be found elsewhere.  Fair-skinned, blond, or red-haired people with blue or green eyes are most at risk.  If you discover an area on your body that just doesn’t seem to heal, don’t wait three months like I did.  Schedule an appointment with a dermatologist and have it checked out.  It may be nothing, but then again, it may not.  Better to be cautious than cancerous.

Submitted by Tina Comston, M.Ed.

Sunscreen advice from a dermatologist to prevent skin cancer

www.prommafia.com

KevinMD, “social media’s leading physician voice” has a great guest post by a dermatologist at the MD Anderson Cancer Center about how to use suncreen and other measure to protect yourself from skin cancer.  What better way to celebrate the last week of May!

We’ve talked about the risks of skin cancer before, and we know that for most of you out there in the world of college and grad/professional school, cancer is a remote topic that is only relevant to old people.  So let’s put it in terms that may be more relevant for you.  Sun damage to the skin not only puts you at risk for skin cancer down the road, but in the short term, it will set you up for wrinkles and other signs of premature aging of the skin.  So it’s not just about your health, it’s about looking good too.

If you have any problems with your skin – moles that you’re worried about, rashes, bumps, you name it – come in and see us.  If we can’t figure it out, we can set you up with a dermatologist who can.

John A. Vaughn, MD
Student Health Services
The Ohio State University

Can a wart on my finger spread to my genitals?

common wart

plantar wart

Q: Can a wart on my finger spread to my genital area?

A:  All warts (or “verrucae”) are caused by Human Papilloma Virus (HPV).  On the hands, they’re referred to as common warts; on the bottom of the feet they’re called plantar warts; around the fingernails they’re called periungual warts; on the genitals or around the anal area they’re called genital warts.

Take a deep breath… I know those 3 little letters strike fear in the hearts of all college and grad students, especially those who are sexually active, but there are over 150 distinct strains of HPV and they all prefer certain body parts and skin types.  For instance, HPV-1 has a foot fetish and causes plantar warts while HPV 6 and 11 prefer to hang out in the “junk yard” and cause genital warts. 

So while you technically have HPV on your finger – which I know is creepy to think about – it really likes the neighborhood and has no plans to move down to the “Short North” so to speak.  I know the blogosphere and wiki-land is ripe with people who swear that they got genital warts from fingers (either their own or someone else’s) – and while the mysterious nature of life (and fear of lawyers) preclude me from “never saying never” – the odds of that really happening are extremely small.

On the surface (ha ha) warts seem like a silly thing to worry about, but they can become a serious emotional issue – the thought of being “infected” by anything can make you feel gross and the fact that they are visible and are spread by skin-to-skin contact can make them especially embarrassing and even affect relationships.  But it’s very important to remember that besides the strains of HPV that cause cervical and some other extremely rare types of cancer, warts are only a cosmetic issue.  They are not a threat to your health or the health of your partners, and they almost all clear on their own within a year or two.

And the good news is that if you don’t want to wait that long, there are pretty good treatment options available at the Student Health Center to get rid of them quicker.  I’ll talk about them in my next post, but for now, rest assured that you don’t need to wear gloves every time you go to the bathroom!

All photos: UpToDate.com

John A. Vaughn, MD
Student Health Services
The Ohio State University

What can I do about my eczema?

Click to enlarge

Q: What’s the deal with this eczema? It’s even on my face.
 
A: Eczema, the “itch that scratches”, is a chronic inflammatory skin problem that causes a characteristic red, itchy rash. It commonly occurs on skin overlying joints and other areas that stretch and fold, but can occur anywhere on the body.

The cause of eczema remains a mystery. We know a couple of things, though. It often occurs in families. When one identical twin is affected there is an 80% chance the other will have eczema too. Overall, about 20% of the population in the US has eczema. It typically starts before five years of age, affects city folk more than rural inhabitants, and females a little more than males.

Eczema can be mild and limited or there can be diffuse involvement over a lot of the skin surface. Often eczema is worse in the winter, when skin tends to be drier by virtue of the harsh environment. While we don’t know what causes eczema, we know that the top layer of the skin-the thin epidermal line that protects you from the environment-becomes disrupted. The tissue can’t retain moisture effectively and leaves you susceptible to infection. 

The mainstays of therapy to protect the barrier involve both medication and lifestyle modification. Steroid creams are first line treatments. They work like a charm but can be tricky to use in the long run: they make skin thinner (which restricts their use on the face and neck where skin is already thin); they can cause a rash that looks like acne; can leave skin discolored and can also cause stretch marks.  When we have to use a steroid, we try to use one with the lowest potency for the shortest amount of time necessary to keep the eczema under control.

The other equally important part of treatment has two parts: avoiding triggers and adding moisture to the skin. 

  • Anything that might make already inflamed skin more irritated should be avoided. For example, perfumes, lotions with alcohol base and fragrance, certain detergents, deodorant soaps, or wool clothes can be quite irritating to somebody with eczema.
  • Long hot showers dry the skin (especially in the winter) and they release histamine from the mast cells in the dermis, making you itch and scratch like a fiend, which further disrupts the barrier.
  • Use bland soap without lye base. As noted above, avoid deodorant soaps.
  • A good, thick emollient is key. Petroleum jelly is the gold standard, but it’s hard to use. It stains clothes and bedding and covering your whole body in it is, well, icky and sticky. The thicker the emollient, though, and the sooner you use it after bathing the better. Ointments are generally better than lotions at moisturizing. Eucerin, Cetaphil, and Nutraderm are good products.
  • Antihistamines like loratadine (Claritin) or diphenhydramine (Benadryl) are sometimes helpful in controlling the itch during severe exacerbations.
  • Phototherapy (light treatments) or oral immune-modulators (i.e. chemotherapy) under a physician’s supervision can be helpful with severe chronic disease.

Schedule an appointment here at Student Health Services if you’ve having problems with your eczema, or any other skin problem.

John A. Vaughn, MD
Student Health Services
The Ohio State University

What can I do to prevent chapped lips?

click to enlarge

Q: Why are my lips so chapped and what can I do about it?

A: Ah winter, that time of year when the freezing wind whips past your face and dries out your skin. Lips have a very thin layer of skin compared to the rest of the face, so they are especially susceptible to drying out in the cold wind and low humidity of winter. Add to that your natural tendency to lick your lips to rewet them, and you’ve set yourself up for dry, cracked and painful lips.

So what can you do to prevent and/or treat your chapped winter lips? Keep ‘em covered!  Balms and ointments containing petrolatum or beeswax are the best for sealing in moisture and creating a barrier between your skin and the elements, although if you have acne you might want to look for petrolatum-free products as these are less likely to cause blackheads and breakouts.  Try to look for one with some SPF protection as well, especially if you spend a lot of time outdoors. You can get burnt even when it’s cloudy!  In general, ingredients such as eucalyptus, menthol, and camphor tend to be irritating so try to stay away from them.

Make sure to apply treatment before you go out into the cold and especially before going to bed, as many of us tend to sleep with our mouths open, which leads to lips drying out. You may also want to consider investing in a humidifier to use during the winter, when the heater tends to dry out the air indoors. Also, make sure you drink plenty of water and stay hydrated.  If you’re doing all of the above and still have trouble with chapped lips, take a look at your cosmetics and skin care products – sometimes, the ingredients can cause an allergic reaction that irritates your lips.

There are some common lip ailments that may be confused with chapping, the most common of which are cold sores and angular cheilitis.  Cold sores are caused by a herpes virus and may be improved with oral antiviral medications.  Angular cheilitis is a painful inflammation of the corners the mouth.  It can be caused by Vitamin B deficiency, mechanical irritation or a fungal infection.  It is treated by correcting the underlying cause and/or antifungal medication.

If you have persistently chapped or irritated lips that do not improve with the simple steps listed above, make an appointment at Student Health Services – we are always happy to see you!

John A. Vaughn, MD
Student Health Services
The Ohio State University

 

photo: portlandmainedentist.com 

How do I know if a mole is skin cancer?

uptodate.com

Over the past year or two, I’ve noticed two moles have come up around my hip area. Should I be worried? Could this possibly be a symptom of skin cancer? Can I get tested for that on campus?

We’ve covered skin cancer from a few angles.  How to use sunscreen correctly to prevent skin cancer.   How the incidence of melanoma – the worst kind of skin cancer – from UV light exposure has increased dramatically over the last three decades, particularly in young women.  Even whether spray tanning is a safer alternative.  But we’ve never talked about what to do when you have a mole that’s bothering you.

In this situation, a picture really is worth a thousand words.  Click on the photo to the right for an excellent visual guide and remember your ABC’s when it comes to figuring out if a mole is worrisome.  Moles that are skin cancer tend to:

Asymmetry – have one half that looks different than the other half

Border – have a jagged or uneven edge

Color – have different colors

Diameter – be larger than the eraser on the end of a pencil (about 6mm)

Evolution – change shape or color over time

Many moles and birthmarks are totally normal, even if they meet some of these criteria, but as a dermatologist once told me in med school – nobody has microscopic vision and the only way to tell for sure if a mole is abnormal is to look at it under the microscope. 

This is called a skin biopsy, and to answer your 2nd question, yes you can get tested for that on campus.  In fact, we can do skin biopsies right here at the Student Health Center and send the tissue sample over to the pathologists at the medical center to analyze.  We also have a great network of dermatologists here in town that we can refer you to if a mole is really large or in a cosmetically important area like the face. 

If you have any concerns at all about a mole, come in and see us.  We are more than willing and able to help you decide if it is something to be worried about, and we can get you the treatment you need if it is.

John A. Vaughn, MD
Student Health Services
The Ohio State University

My doctor said that my vitamin D level is low. Is that really bad?

webmd.com

It’s well established that Vitamin D is important in the regulation of the body’s calcium levels and bone development.  If people don’t get enough, they are at risk of diseases like rickets and osteoporosis.  But researchers have more recently discovered that vitamin D receptors are found on almost all tissues of the body.  This has caused a “boom” in vitamin D research; scientists are investigating its role in everything from heart disease and diabetes to depression, cancer and the common cold. 

You get Vitamin D in two ways: by consuming it in foods or supplements, and by making it in your skin when sunlight hits it.  Vitamin D doesn’t occur naturally in a lot of foods – unless you’re a really big fan of cod liver oil or mackerel, you wouldn’t get nearly enough – so many foods are fortified with it.  Almost all of the milk sold in the U.S. is fortified with Vitamin D, as are many cereals, juices and yogurts. 

This time of year in Columbus ain’t exactly the most Vitamin D friendly environment – the sun seems to head south for the winter – so it’s not unusual for people around here to have a low Vitamin D level.  But what does that really mean?  How low is too low?  And does having a low Vitamin D level increase your risk for depression, high blood pressure, the flu?  We don’t know for sure.  There’s even a lot of debate going on right now about whether or not the current cut off for a “normal” Vitamin D level is too high and that a lot of people are being told they have a deficiency when they really don’t. 

That being said, people build up the majority of their bone density during their twenties so it wouldn’t hurt to take a daily adult multi-vitamin containing around 600 IU of Vitamin D to help prevent osteoporosis later in life.  It’s also a good idea to get some regular sunlight exposure whenever you can; even if it’s cold, it’ll turn on your skin’s Vitamin D factory.  But don’t overdo it – taking too much (over 4000 IU) can cause damage to the heart, blood vessels and kidneys.  And excessive uv radiation exposure can damage your skin and put you at risk for really bad things.   

The National Institutes of Health has a great site about Vitamin D supplements, and the Mayo Clinic also provides a lot of good information.  And of course, you can always make an appointment to see us if you’re worried about your Vitamin D level.   

John A. Vaughn, MD
Student Health Services
The Ohio State University