Are Over-The-Counter Wart Treatments Safe?

You can’t damage yourself with these treatments. If you get salicylic acid on normal skin, it can cause burning or redness but never infection or scarring. All you have to do is stop using it on irritated areas, and the skin returns to normal. Still, it’s probably better not to use salicylic acid on sensitive areas like the face or groin, where it’s likely to make nearby skin raw and uncomfortable.

It generally is recommended that salicylic acid not be used in people with diabetes or in areas where there is poor circulation (because of concern about how normally the skin can heal; however, in practice, salicylic acid is withheld only when there are clear signs of ongoing inflammation of the skin).

Likewise, nonprescription freezing products are also safe but must be used carefully and only according to package instructions.

Are wart treatments effective?

Above all, wart treatments require patience. How well wart treatments work is another matter. Warts can appear and disappear without an identifiable cause and may disappear on their own without treatment. Some warts sprout offshoots near the main wart, and others don’t. Some hurt, and others are painless. Certain warts, even of the same type, respond to treatment, while others (even on the same person at the same time) don’t. All treatment methods often require many sessions over weeks, months, or longer to succeed.

Here is a practical approach to the treatment of warts:

• • Plantar warts: Warts on the bottom of the foot feel deep, but they are still within the superficial layer of the skin. Salicylic-acid drops and plasters help remove the thick overlying callus and make the wart feel less like a marble in your shoe. Nonprescription aerosol freezing may be used as well.
  • Common hand warts: These are typically unattractive, although not painful. Salicylic acid can make them smaller and go away in some cases, as can nonprescription freezing.

1. If you can ignore your warts, do so. Eventually, they’ll go away (although eventually can mean a long time — even months or years).

2. If you have an easy case (a single wart on the face or one or a few on the hands), see a doctor for a quick freeze or electrical zap. This method is simple, almost painless, and non-scarring.

3. If you have a hard case, you can start by treating the warts for a few weeks on your own. Examples:

If you have an all-but-impossible case, don’t try too hard. You don’t want to make the treatment worse than the disease. Examples:

• Warts under the nails: These are extremely resistant to treatment. One or two tries by the doctor are worth a shot, but if they fail, putting acid on them yourself just makes them look rough and unattractive.
• “Mosaic” warts: Tiny, so-called “seed warts” can proliferate by the dozens or hundreds all over the sole of the foot. They don’t usually hurt, and they rarely respond to any sort of treatment, although in this case, too, one or two tries at treatment may be in order.
• Flat warts: These are small, flat, flesh-colored pimples and may be numerous on one part of the body (for example on the face, arms, or groin). Getting rid of them by a light application of salicylic acid or other method is easy enough, but they have a tendency to recur.

Using Lasers and IPL for Pigmentary Lesions

Lasers and intense pulsed light sources are frequently used for the treatment of pigmented lesions, and the appropriate selection of devices for different lesions is vital to achieving satisfactory clinical outcomes. In dark-skinned patients, the risk of post-inflammatory hyperpigmentation is of particular importance. In general, long-pulse laser and intense pulsed light sources can be effective with a low risk of post-inflammatory hyperpigmentation (PIH) when used for the treatment of lentigines. However, for dermal pigmentation and tattoo, Q-switched lasers are effective, with a lower risk of complications. In the removal of melanocytic nevi, a combined approach with a long-pulse pigmented laser and a Q-switched laser is particularly applicable.
Key Words: pigmented lesions, hyperpigmentation, lasers, intense pulsed light sources

The cutaneous application of lasers and intense pulsed light sources for the treatment of pigmented lesions can be divided into the following categories:

• a)  Tattoos
• b)  Epidermal pigmentation such as lentigines and café au lait patches
• c)  Dermal pigmentation such as nevus of Ota, acquired bilateral nevus of Ota, and melanocytic nevi

Tattoos

The use of lasers has been effective in the removal of some,  but not all, tattoos. Q-switched lasers have been found to be safe and effective in the treatment of tattoos. The response to laser treatment can vary greatly due to the wide range of tattoo ink. Previous in vitro quantitative chemical analysis of tattoo pigments found that the most common elements were aluminium, titanium, and carbon. Titanium overrepresentation was identified as the main reason for a poor response to laser treatment. Picosecond lasers were found to be more effective in achieving a greater degree of clearing. To improve the clinical outcome, more recent developments have included the external application of magnets to improve the removal of magnetite skin tattoos after Q-switched laser treatment, and the use of intradermal focusing of the Q-switched laser. In terms of complications, tattoos can darken after laser treatment due to the reduction of ferric oxide to ferrous oxide. This can be rectified with repeated Q-switched laser treatment and the use of a resurfacing laser. Less common complications include the development of allergic dermatitis or even anaphylactic shock after the laser surgery. Such reactions are thought to occur due to the release of allergic pigment into the extracellular space after laser exposure.

Epidermal Lesions

Lentigines

Lasers have been used for the treatment of lentigines, and although this is often effective for light-skinned patients with limited complications, for dark-skinned patients with a higher epidermal melanin content it can be associated with complications such as hyperpigmentation. Two years ago, our group performed an in vivo study of 34 patients and compared a Q-switched 532nm Neodymium:Yttrium-Aluminum-Garnet (QS 532nm Nd:YAG) laser to a long-pulse 532nm Nd:YAG laser. We found that the long pulse 532nm Nd:YAG laser (2msec pulse duration, 6.5-8J/cm2 fluence, 2mm spot size, with slate gray appearance as the clinical end-point) can result in a lower risk of PIH when used in the treatment of lentigines in Asians. We created controversy when we suggested that the photomechanical effect of QS lasers might not be desirable when used in such treatment. Intense pulsed light sources (IPL), which emit a broad band of visible light from a non-coherent filtered flashlamp, produce only photothermal effects. Recent studies that investigated the use of IPL to remove lentigines in Asians confirmed their effectiveness. Interestingly, no case of PIH was observed in two independent studies.

These observations confirm our hypothesis that the photomechanical effect of Q-switched laser for the treatment of lentigines in Asians is not desirable. The main concern regarding the use of the long-pulse laser for the treatment of cutaneous pigmented lesions is the potential of thermal diffusion from the epidermis to the dermis, which increases the risk of scar formation. To prevent such an occurrence, the pulse duration should be shorter than the thermal relaxation time of the epidermis basal layer, which was estimated to be in the range of 1.6-2.8ms if the epidermal basal layer thickness was 20mm.

It is now our routine approach to test patients with a long pulse 532nm Nd:YAG laser (2ms pulse duration, 6.5J/cm2 fluence, 2mm spot size), and if they respond well, we offer them full treatment. Those who do not wish to have down time, or those who develop post-inflammatory hyperpigmentation after the test, are offered IPL treatment, which requires several more treatment sessions to achieve the desired clinical outcome.

Café au Lait Patch

The use of lasers in the treatment of the café au lait patch has yielded variable results, and although some early studies indicated complete removal without recurrence, such findings have not always been repeated. Previous studies showed that 510nm pulsed dye lasers and copper vapor lasers can be used successfully, with no recurrence, at least one year after treatment. These reports were confirmed by others. Grossman, et al. used a QS Ruby laser and a frequency double Q-switched Nd:YAG laser, and found that the degree of clearance varied across lesions. Moreover, the categorization of the patches into the two histological sub-types that they identified did not help to predict the extent of the clinical response. We looked at the use of normal-mode ruby laser (NMRL) and compared it to QS Ruby laser in the clearing of café au lait patches in 33 patients. Our preliminary data indicated that there was a lower risk of recurrence when the NMRL was used (42.4% of recurrence, as compared to 81.8% recrrence in those who were treated with QS Ruby laser) 3 months after a single treatment. By affecting the follicular melanocytes, the long-pulse laser may reduce the recurrence rate. Further histological study is necessary to confirm this hypothesis.

Dermal Lesions

Nevus of Ota

Q-switched Alexandrite (QS Alex), QS Ruby, and QS 1064nm Nd:YAG have been used for the treatment of nevus of Ota with excellent results and minimal risk of complications. The clinical efficacy of the QS Ruby was confirmed when Watanabe and Takahashi⁶ studied 114 nevus of Ota patients and found that a good-to-excellent degree of lightening was achieved after three or more treatment sessions. The side-effects were few, with transient hyperpigmentation after the first treatment being the most common. Studies comparing the use of QS Alex and QS Nd:YAG lasers found that most patients better tolerated the former. However, QS Nd:YAG laser appeared to be more effective than QS Alex in the lightening of nevus of Ota after three or more laser treatment sessions. In terms of complications, hypopigmentation was common, especially among those treated with QS Ruby. The original pigmentation could also recur in patients after complete laser-induced clearing, which is an important issue, especially for pediatric patients. The risk of such recurrence is estimated to be between 0.6% and 1.2%. However, the use of QS Ruby laser for the treatment of nevus of Ota in children can achieve an excellent result in fewer sessions and at a lower complication rate than later treatment.  Hence, the advantages and disadvantages of treating nevus of Ota early in childhood should be thoroughly discussed with the patient’s relatives.

Acquired Bilateral Nevus of Ota-like Macules (ABNOM) or Hori’s Macules

Acquired bilateral nevus of Ota-like macules (ABNOM), or Hori’s macules, are a pigmentary disorder that is clinically characterized by speckled or confluent brownish-blue or slate gray pigmentation over the face, and histologically characterized by diffuse upper dermal melanocytosis. Unlike nevus of Ota, the pigmentation occurs in a symmetrical bilateral fashion, has a late onset in adulthood, and does not involve the mucosa.

One hundred forty patients with ABNOM were treated with a Q-switched Ruby laser (7-10J/cm2 fluence at a repetition rate of 1Hz, 2-4mm spot size). Complete clearance was obtained in 131 patients, and hyperpigmentation was observed in 7%. Hypopigmentation persisted in 2.1% of the patients, and there was no recurrence after 6 months to 4.3 years of follow up (mean was 2.5 years). QS Nd:YAG laser was also used to treat ABNOM, and the rate of PIH was estimated to be between 50% and 73%.⁸ Our group showed that QS Alex laser is effective in the treatment of ABNOM. Post-operative pigmentary changes were frequent, and the use of topical bleaching agents was necessary to achieve a satisfactory result. The risk of transient hypopigmentation was high, and it affected up to 50% of the patients. More recently, a combination approach with a scanned carbon dioxide laser followed by a Q-switched Ruby laser has been found to be effective.

Melanocytic nevi are common, and often removed for cosmetic reasons. Various pigmented lasers have been used in their removal. A previous study using a QS Ruby laser found that an average clearance of 76% occurred after eight treatment sessions.10 However, recurrence can be a problem depending upon the depth of the nests of melanocytes. The use of a normal mode ruby laser (NMRL) for the treatment of melanocytic nevi is based upon the principle that with longer pulse durations, a greater degree of clearance is achieved when nests of cells are destroyed. A combined approach with a QS Ruby laser followed immediately, or 2 weeks later, with an NMRL has more recently been used with the intention of removing the superficial pigment first with the QS Ruby laser, thereby enhancing the penetration of the NMRL. A previous study found that although 52% of the nevi showed a visible reduction in pigment, no lesion had complete histological clearance. The short- and long-term histological findings of congenital nevi that have been treated with the NMRL indicated that subtle microscopic scars of up to 1mm in diameter are frequent. It has been proposed that such scars cover the underlying nevus cells, which leads to cosmetic improvement. Better cosmetic results were produced by first using an NMRL to remove the epidermis, immediately followed by multiple passes of a QS Ruby laser.¹¹ This approach effectively removes the epidermis, and in doing so enables a greater degree of penetration by the QS Ruby, of which multiple passes further enhance the clinical efficacy. A similar approach using a long-pulse pigmented laser immediately followed by multiple passes of a Q-switched pigmented laser can obtain similar results.

Conclusion

For epidermal pigmented lesions, long-pulse pigmented laser or IPL can be effective with a lower risk of post-inflammatory hyperpigmentation, especially when used on dark-skinned patients. Q-switched laser is necessary to remove dermal pigment and tattoo in order to avoid the risk of scarring. A combination approach can be used for the removal of melanocytic nevi.

H.H.L. Chan, MD, FRCP¹, and T. Kono, MD^2
1Division of Dermatology, Department of Medicine, the University of Hong Kong, China
²Department of Plastic and Reconstructive Surgery, Tokyo Women’s Medical University, Tokyo, Japan

Organic Skincare Products

Your Organic Skin

Skin is the armor of the body. It is the outside waterproofing, element-fighting surface that protects our internal organs and skeletal structure from the harsh outside elements. Yet skin, overall is ignored most of the time. Healthy skin is important for a glowing completion of course, but if your body is unhealthy – your skin will be also.

The toxic world of industrialization has finally caught up with us. Producing toxic waste disasters, disease and tons of garbage buried so deep it can never breakdown. All these “modern advancements” have left our food supply as little more than a chemical compound in itself. If you can do ONE thing to give your skin and your body a fighting chance, you would be wise to choose as organic a diet as possible. To maintain a healthy skin, organically grown food is must.

In light of recent organic trends in our food, organic skin care products are also gaining popularity. For healthy lifestyle and healthy skin, limiting the amount of toxins and chemicals you put in your body is a must. If the environment or living “green” is important to you, you should also be aware of companies that produce the products you buy and their manufacturing practices.

Organic Skin Care is the most rapidly developing field in the beauty industry. Now what does Organic mean? Organic refers to anything grown or raised naturally. But more specifically, it means plants are grown on certified natural land without the use of synthetic fertilizers, pesticides, genetic modification or irradiation. In many cases, these organic farms are highly regulated by the Federal Food Safety Commission. Organic skin care means protecting your skin from harmful chemicals and using organic products whenever possible.

There are many organic products available on the market today. Most can be found at a local organic specialty stores, food suppliers or a national health food chain like Whole Foods. As organic products become more and more popular, many standard food stores, Like Safeway or Albertsons’ are also providing these products on their shelves. There are also plenty of websites offering organic skin or beauty care products online.

An organic product is preferable for natural skin care balance as it will generally contain far fewer chemical properties then it’s drugstore counterparts and thus have less possibility to cause inflammation or irritation. Of course, even an herbal product can have side effects as they are “chemicals” in their own right, so always be aware of the list if ingredients in the products you buy and the reactions your skin personally has to allergens.

Skincare Dollars and Sense

Many consumers are frustrated by skin care products that don’t do what they claim to. Worse still is investing in an expensive yet ineffective cream or treatment only to discover the cheapest drug-store brand would work just as well. In a world of hyper-consumerism, false advertising and a plethora of products from which to choose, how do you choose the good from the bad?

There are some great products on the market that can genuinely improve your skin’s appearance and help your skin look smoother, more radiant, and youthful. But, there are literally thousands of products to choose from and unless you spend hours a day researching beauty products, it’s difficult to find the one of the few that actually produces real results and eliminates years of aging from your face and body.

Not only should a quality skin product help reduce bags under, and fine lines around, the eyes, but it should even out coloration inconsistencies caused by age spots and other unwanted pigment concentrations.

In a marketing-rich world of super models and glamorous actors, many will understandably spend any amount of money to make themselves look better or younger. Cosmetic surgery and skin care is a multi-billion dollar industry.

As the law of supply and demand proves, the higher the demand for youth and beauity, the more manufacturers will rush to provide the solution. Many times this rush results in the creation of an inferior product with little to no research and development to back it.

All of the money goes into the marketing of the product. On the surface everything looks great. The bottles and jars that the creams come in look appealing. The magazine advertisements are glossy, complete with a youthful looking model or a well known celebrity who doesn’t even really use the products.

You can’t really blame these companies. When you are spending a fortune paying for marketing, whether it be on the product containers, magazine, radio, and TV ads, royalties paid to celebrities and models, you have to charge a lot of money for your products or you’re going to lose money.

On the other hand, this doesn’t mean you and I have to fall for these types of marketing schemes. After all, these companies aren’t going to encounter any shortage of people who will open their wallets and purses to purchase their products anytime soon. The reality is most people simply won’t take any time to research products and understand what ingredients work and what ingredients are actually bad for your skin!

Retinoids and Dry Skin

Dry skin recommendations and supplements that can help your skin

RETINOIDS
The group of medicines known as retinoids are derived from Vitamin A. Creams containing the retinoids retinol and retinaldehyde can be obtained over the counter at pharmacies and supermarkets. Other topical retinoids containing tretinoin or isotretinoin require a doctor’s prescription. Adapalene is a related prescription medicine.  Topical retinoids can be applied to any area but are most often used on the face, the neck and the back of hands.

When you first start using the retinoid, apply your night cream first then re-apply the retinoid. Do this every third night for two weeks. Then apply moisturizer followed by retinoid every other night. If no redness occurs after two weeks you can adjust your regimen and apply the retinoid after cleansing but before your night cream. Then apply the night cream after the retinoid. Do this, using the retinoid every other day, for one week.

If you experience redness or flaking, begin using the retinoid every night. In about twenty-four weeks you will notices fewer wrinkles and smoother skin as well as preventing future wrinkles. Since retinoids speed up the rare at which skin cells divide, some flaking is normal. This flaking is not additional dryness, but rather dead skin cells sloughing off. You can use a facial scrub once or twice a week before an important event to remove these fakes, allowing your skin to look radiant. Stronger products are more irritating than those with a lower percentage of retinoids, so you can switch products depending on your needs.

Skin Care Ingredients to Look For

Before we have a discussion of specific ingredients, it’s important to educate ourselves a little bit more on skin itself and what makes a product good or poor. Your skin is the largest organ of the body. Anything you put on it can be easily absorbed through the pores. When you use skin care products, they are typically applied all over the face, neck, and body. This covers a lot of surface area and, therefore, a great deal of chemical absorption occurs.

The biggest reason our skin, whether on the face or the rest of the body, develops lines and/or starts to sag, is that the collagen and elastin in our skin begins to break down. Collagen is a protein that is fibrous in nature. What makes collagen different from other kinds of protein is that it possesses great tensile strength, which means, among other things, it provides firmness to the skin.

You don’t need to be a scientist, therefore, to understand that as collagen breaks down due to aging, the firmness of our skin becomes…well, less firm. Wrinkles appear and skin starts to sag.

Elastin, too, is a protein that helps skin stay “flexible” and firm. If your skin is stretched, elastin is the protein that helps it return to its original position.

What all of this means for you as a consumer is you do want to avoid buying products that are nothing more than wrinkle or fine line ‘fillers.’ Some creams will give the appearance of plumper fuller skin while it still sits on the surface, but once absorbed or removed, the illusion is gone. Want you want to look for is a product that actually stimulates new collagen and elastin production in your skin. If you achieve this, you will, in reality, begin to turn back the clock.

Unfortunately, some cosmetic manufacturers will include some great ‘active ingredients’ while filling the majority of the product with inferior filler. Because these active ingredients are beneficial for the skin, they include just enough to be allowed to legally list them on the product label. This way, the typical consumer thinks they are getting a great product of high-quality. But, because these ingredients are expensive, and because, many well known companies spend much of their budget on marketing, the amount of these ‘active ingredients’ is limited to have any real benefit for your skin.

So, when choosing a skin care product, it’s not just about selecting one with good ingredients; it’s also about choosing one with a high concentration of these good ingredients.

•    Collagen

After the brief review of the importance of collagen, you would think that buying a product with collagen in it would be a great thing. And the marketers who sell products that contain collagen know this. But, again sadly, collagen molecules are much too large to penetrate into the skin when applied topically and there presence in a beauty product has no effect whatsoever. To be of any benefit, you must purchase a product with ingredients that have been shown to stimulate your body’s own collagen production.

•    Phytessence Wakame

Phytessence Wakame is an exotic kelp, native to the Japanese Sea. It works by blocking a harmful enzyme in your body called hyaluronidase. Hyaluronidase breaks down hyaluronic acid in your skin. Without hyaluronic acid, the elastin and collagen fibers lose their “glue,” which leads to a loss of youthful appearance and dark eye circles. Hyaluronan is a major component of skin, where it is involved in tissue repair.

•    CoQ10

If you look at the ingredient list for some of the better skin care products, you’ll often see CoQ10 listed. CoQ10 is short for Coenzyme Q10, so you may also see it listed this way. CoQ10 is a vitamin like substance that is found in all of our body’s cells and is very important for healthy skin. CoQ10 is a powerful antioxidant. A lot of skin damage and aging comes from free radicals wreaking havoc in our body’s cells. CoQ10’s antioxidant ability can counter these free radicals before damage occurs.

Unfortunately, like many other vital substances, as we age, the amount of CoQ10 in our bodies becomes depleted.

Although CoQ10 is a great ingredient, not all forms are equal. One in particular stands head and shoulders above the rest. This version of it is called Nano-Lipobelle H-EQ10.Most of the CoQ10 you buy in a typical skin care products are not readily usable when applied topically to the skin.

•    Nano-Lipobelle H-EQ10, on the other hand, is a special nano-emulsion form of CoQ10, which penetrates far down into the skin, thereby providing much greater benefits for skin health. In fact, Nano-Lipobelle H-EQ10 has been shown to penetrate seven layers deep into the skin, making it extremely effective at gobbling up free radicals in your skin. The result is a powerful anti-wrinkle effect.

Skin Care Ingredients to Avoid

Many consumers are frustrated by skin care products that don’t do what they claim to. Worse still is investing in an expensive yet ineffective cream or treatment only to discover the cheapest drug-store brand would work just as well. In a world of hyper-consumerism, false advertising and a plethora of products from which to choose, how do you choose the good from the bad?

There are some great products on the market that can genuinely improve your skin’s appearance and help your skin look smoother, more radiant, and youthful. But, there are literally thousands of products to choose from and unless you spend hours a day researching beauty products, it’s difficult to find the one of the few that actually produces real results and eliminates years of aging from your face and body.

As the law of supply and demand proves, the higher the demand for youth and beauty, the more manufacturers will rush to provide the solution. Many times this rush results in the creation of an inferior product with little to no research and development to back it.

Caveat Emptor – or “let the buyer beware” - is the rule to live by. Do your homework. Know where you are “voting” your hard-earned money. If it is important to you, make sure you are investing in a quality, skincare ingredient backed by proven results. If the environment and being ‘green’ is important to you, then be aware of the manufacturing practices of the company and product you support with your purchase.

Ingredients to Avoid

Due to certain preservative requirements, many skin care products are unfortunately loaded with ingredients that actually harm your skin over time. Following are a few prominent ingredients widely used in skincare products to day and are to be avoided if you prefer you skincare to be more natural or organic.

•    Mineral Oil. This oil has been used in literally hundreds of products. Mineral oil may also go by the alternative names liquid paraffin, paraffin wax and petrolatum on the product label. Mineral oil is used pervasively in skin care products as a moisturizing agent due to its low cost.

Mineral oil, once applied, is meant to ‘trap’ moisture in the skin, but once applied, actually prevents the skin from “breathing.” As such, it clogs pores, interferes with your skin’s natural ability to eliminate toxins, and can lead to acne flare ups. Also, it is irritating to the skin and if used for any length of time, your skin can become dependent on it, causing chapping and dryness. Lastly, it can lead to premature aging of the skin.

•    Dioxane: (a synthetic derivative of coconut). This substance is widely used in skincare products. It often contains high concentrations of 1,4-dioxane, which is readily absorbed through the skin. In the State of  California, 1,4-dioxane has been reported as “known to cause cancer.”

•    Fragrances: No one wants to smell bad, but if you want to be on the safe side, you are better off choosing an organic essential oil or diluted cologne, hydrosol or even a bodyspray. Your skin care products typically contain chemically engineered fragrances to mask the unpleasant “chemical odor” of the foundational product itself. Many of these masking fragrances are produced from ingredients that are known to be toxic or carcinogenic.

Your skin is the largest organ of the body. Anything you put on it can be easily absorbed through the pores. When you use skin care products, they are typically applied all over the face, neck, and body. This covers a lot of surface area and, therefore, a great deal of chemical absorption occurs. However, with perfumes and colognes, you can achieve what you want by a small dab here and there, which will result in less chemical absorption overall. If you really want a beauty product to smell great without the harsh side effects, try buying a fragrance-free product and add your own essential oil blend. You can customize a whole line of products with you won signature scent!

•    Parabens: methyl, propyl, butyl, and ethyl paraben. Many skin care products (and moisturizing products) will use parabens as a preservative so their products have a long shelf life. The reason is purely economical. However, studies suggest that they may cause cancer and interfere with the body’s endocrine system, as well as causing allergic reactions and skin rashes.

•    Alcohols:  ethanol, ethyl alcohol, methanol, benzyl alcohol, isopropyl  alcohol and SD alcohol. Not all alcohols have the same properties, but these, which are commonly found in skin care products, are very drying and irritating for the skin. Alcohols such as these strip away the skin’s natural acid mantle, making you more vulnerable to bacteria, moulds and viruses.

Now that we’ve looked at some of the bad, let’s examine some of the good ingredients and some ingredients that sound good but in fact aren’t.