Be kind to your skin in the spring

These simple treatments help fight dryness, bumps and acne

By Laurel Naversen Geraghty

July, not June, could actually be the cruellest month: The first glimpse of ashen skin, blue veins, callused feet, and unexpected hairs can make you feel as though the body is thoroughly unprepared. "July is really the month of self-discovery," says Ranella Hirsch, a dermatologist at Boston University Medical Centre.

What's more, the change of season can prompt a whole new set of issues. "It may be instantly hot and humid, so on top of all your dry skin, you're suddenly having oiliness and acne, or even an allergy that starts in the spring with the first burst of sun exposure," says Audrey Kunin, associate clinical instructor of dermatology at the University of Kansas School of Medicine.

Fortunately, skin responds well to kindness. The right treatments are new sources of hope ó something that spring manages to inspire even in the wasteland.

Your skin resembles your alligator bag

"The two keys are moisturisation and things that make the skin glow, such as exfoliation," says Jeffrey Dover, associate clinical professor of dermatology at Yale University School of Medicine. Start with a shower rubdown, using a moisturising body cleanser on a clean washcloth. Don't bother scrubbing your legs if you already use a razor, since shaving removes dead skin on its own. Tempting though it may be to follow this kind of body exfoliation with a heavy cream, it's an unwise move (except on your freshly shaved legs) because in warm weather, even slight perspiration can leave skin dripping. You can avoid the issue completely by applying a soothing cream at night. Otherwise, any light lotion that contains glycolic, alpha hydroxy, or fruit acid will quickly restore vibrance to dead-looking skin, says Dover.

For more intense exfoliation on the arms and chest, the microdermabrasion treatment Vibraderm, uses a vibrating paddle rather than abrasive particles or suction, and was shown in a study to remove over 75 percent of the skin's outermost layer on those areas in less than 10 minutes.

Your arms deserve a penalty for unnecessary roughness

The likely culprit is keratosis pilaris, a genetic condition that can resemble goose bumps (they tend to be white or red), and appears on the arms, legs, or buttocks of about half of all women. "Extra skin cells build up around individual hair follicles, giving you a bumpy texture and a polka-dotted appearance," says Kunin. Though there's no cure, a daily moisturiser containing urea, glycolic, or lactic acid can soften the bumps; Dover is partial to AmLactin, a lactic acid cream, while Kunin's Dermadoctor KP Duty also has a strong following. A body scrub can wear down the bumps even more, but dermatologists preach moderation, since overscrubbing can cause extra redness and inflammation. "Natural particles ó crushed seeds or nut shells ó have jagged edges that can injure the skin," says Kunin. Synthetic microbeads, on the other hand, are less likely to tear skin. For an instant improvement, apply a shimmery cream to refract light.

Your knees and elbows have faded to grey

"The skin in these areas is some of the driest on our bodies, and so it can take on a cracked, whitish, or greyish appearance ó especially on olive or darker skin," says Jeanine Downie, assistant attending dermatologist at Mountainside Hospital in Montclair, New Jersey. The best fix is a potent daily moisturising cream, or even petroleum jelly on the elbows and knees once a week before bed. "Trim the toes off a tube sock, and shimmy it up the arm so the Vaseline stays in contact with your skin instead of wiping off on your sheets," Downie says. Scrubbing, scratching, picking, or even leaning on knees or elbows can exacerbate ashiness. So, too, can sun exposure. "When the background skin gets darker, the ashy skin on top stands out more," says Downie, who recommends "constant" use of SPF 30 (or higher) sunscreen.

Acne pops up in unexpected ó and unpleasant ó places

As if the very presence of pimples on your back and rear weren't disturbing enough, the acne there is also most likely to produce a lasting scar. "The skin is thicker, and there are fewer blood vessels, which mean slower healing," says Dover. Wash the areas with a benzoyl-peroxide cleanser. But be sure to let any creams or gels sink in fully before dressing because they can bleach some fabrics. You can also consider treatments with a diode laser, photodynamic therapy, Intense Pulsed Dye laser, or blue light, which often help to rid the skin of acne gradually over a few sessions.

High heels and pinched shoes may contribute to calluses by causing friction, but Narurkar says the problem can often be alleviated by slipping in a thin insert. One is Foot Petals Tip Toes, a cushion that supports the ball of the foot and is small enough even for open-toe shoes.

To remove existing calluses, take a shower or bath so that skin is soft and pliable, then buff feet with a foot file, a pumice stone, or a pad premoistened with a cleanser. Follow with a cream containing urea, which "eats away at and loosens up the dead skin cells, and makes the skin really smooth and hydrated," says Kathy Fields, an assistant clinical professor of dermatology at the University of CaliforniañSan Francisco.

Stretch is fine for yoga, but not for your skin

When the skin is pulled during pregnancy or weight gain, "the collagen and elastin fibbers in the middle and deeper layers of the skin literally get stretched and probably torn," says Dover. "Microscopically," says Kauvar, "there is no difference between a stretch mark and a scar." Most creams are useless in preventing these scars from forming, but Narurkar is convinced that the cult eye cream Relastin, which contains antioxidants, moisturisers, and a zinc compound, can help by ramping up elastin production in the skin. Likewise, a prescription retinoid applied daily for six months has been shown to shorten and fade pink stretch marks in about 80 percent of women. Lasers that target redness also can drain the colour from an early stretch mark. But once the marks have taken on a silvery colour, pulsed dye lasers and fractional lasers are two of the few things known to help. Multiple sessions may fade marks by about half in some people, Dover says.

Your legs feel stubbly just hours after shaving

The 70 percent of women who are faithful razor users, according to a Schick survey, can eke out an extra half millimeter or so of closeness simply by using a good shaving gel or cream, says Fields. Follow it with a moisturiser that contains a soy extract to slow down hair regrowth and a self-tanner, to decrease the contrast between skin and dark hairs.

A fresh razor blade can make all the difference. "Many people let the same damn razor sit in the bathroom for days, weeks, months," Fields says. "To get a really clean shave, it should be a new blade, so go and buy them in bulk. Shave once with it, and throw it away." Hang a nonfog mirror in the shower so you can see any missed spots. The closest shave comes from drawing the razor against the direction of growth, says Kauvar, which usually means shaving upward on the underarms.

One in ten had 'silent strokes'

Brain scans revealed condition which can raise risk of memory loss

Routine brain scans in a group of middle-aged people showed that 10 percent of them had suffered a stroke without knowing it, raising their risk for further strokes and memory loss, U.S. researchers said.

People with atrial fibrillation, the most common type of irregular heart beat in people over 65, had more than twice the rate of these silent strokes, they said.

Silent cerebral infarctions or SCIs are brain injuries caused by a blood clot that interrupts blood flow to the brain.

"The findings reinforce the need for early detection and treatment of cardiovascular risk factors in midlife," Dr. Sudha Seshadri of Boston University School of Medicine and colleagues wrote in the journal Stroke.

"This is especially true since SCIs have been associated with an increased risk of incident stroke and cognitive impairment," they wrote in the report.

The researchers based their findings on routine magnetic resonance imaging or MRI scans from about 2,000 people with an average age of 62.

They were the children of participants in the long-running Framingham study ó a study of the health and habits of nearly an entire town in Massachusetts. People in this so-called Framingham Offspring Study had medical exams every four to eight years. Brain scans of these people found that 10.7 percent had a stroke even though they showed no stroke symptoms. Of these, 84 percent had only a single lesion in the brain.

Risk profile

The researchers then looked back to their medical records to see if these people had a risk profile that might predict a stroke.

What they found was that atrial fibrillation more than doubled the risk of silent stroke. In atrial fibrillation, the heart's two upper chambers do not pump effectively enough to empty properly, leaving blood to pool and raising the risk of blood clots.

Three percent to 5 percent of people over 65 have this problem.

The study could not determine whether treating atrial fibrillation would reduce the risk of silent stroke, the researchers said.

Other factors that increased the risk of silent stroke included high levels of blood homocysteine, a sulphur-containing amino acid found in the blood; carotid artery disease; high blood pressure and especially high systolic blood pressure ó the top number in the blood pressure reading.

About two-thirds of people over the age of 65 have high blood pressure, according to the National Heart, Lung, and Blood Institute. High blood pressure has long been implicated as a risk factor for silent strokes.

"Although previous studies have also reported a significant association of hypertension and tHcy (total homocysteine), ours is the first study to our knowledge to demonstrate a significant relationship between atrial fibrillation and SCI," the researchers wrote.

Warning signs of a stroke include changes in balance, slurred speech or a droopy face, weakness in one side, partial vision loss and severe headache, according to the American Stroke Association.

--www.scienceblog.com

Enriched cocoa improves blood flow in diabetics

Natural compounds called flavanols may be responsible for the benefit

By Ed Edelson

All the talk about chocolate being good for your health is starting to get serious. Mars Inc., of chocolate bar fame, has established a scientific division.

And a group of researchers, some in Germany, others with the new Mars division known as Symbioscience, has just published a report showing that an enriched hot cocoa beverage can improve blood flow in people with type 2 diabetes.

"The study is the first of its kind in terms of its rigor, as well as the population studied," said Harold Schmitz, chief science officer of Mars. "Diabetics treated as well as they could be treated with pharmaceutical intervention did see, on average, a 30 percent improvement in vascular function."

The study had 41 adults with type 2 diabetes drink cocoa enriched with flavanols, which are natural compounds found in some fruits and vegetables and in chocolate -- especially the dark kind. Flavanols are believed to improve blood flow by increasing the production of nitric oxide, which causes arteries to relax.

After an initial trial of cocoa containing various amounts of flavanols, the participants were assigned to drink cocoa with either 321 milligrams or 25 milligrams of flavanols per serving three times a day for 30 days. The researchers then tested the participants for "flow-mediated dilation," the ability of the arteries to expand in response to the body's demand for more blood and oxygen. Before the study began, the brachial artery in the upper arms of the participants expanded only 3.3 percent on average. After 30 days of the high-flavanol cocoa, the expansion was 5.8 percent after the beverage was drunk. No increase was seen in the people who consumed low-flavanol cocoa.

"This is a nice study, confirming and extending previous work that cocoa compounds can enhance vasodilation in humans to diabetes patients," said Henriette van Praag, an investigator in the U.S. National Institute on Aging's Neuroplasticity and Behaviour Unit.

It wasn't a perfect study, she added. "The study would have been better if they had tested the individual flavanols they suggest are responsible for the effect separately," van Praag said.

Angela Kurtz, a nutritionist at New York University Medical Center, also had some mild criticism of the study, centring on the caloric content of cocoa. "Those 170 extra calories in the cocoa would promote obesity," she said. "You would have to omit some other calorie sources that match that amount to prevent weight gain."

Still, Kurtz said, "the bottom line is that diabetics who have a poor vascular system can benefit from something that gives pleasure at the same time it helps health. Cocoa increases the amount of endorphins, the feel-good chemicals."

Schmitz said that more research is needed to substantiate the findings. "Clearly, the next step is a long study with enough subjects to clearly demonstrate there is a benefit of flavanol-enriched beverages for diabetics," he said. Mars has been sponsoring research on the health benefits of chocolate products for years, Schmitz said. "We've published a lot of peer-reviewed papers, well over 100," he said.

The commercial possibilities aren't being overlooked, Schmitz said. "We have a number of products in development," he said. "Symbiosciences has been working on some. I'm not at liberty to discuss what is in our pipeline."

Health update
Topical oral syrup prevents early childhood tooth decay



Dental researchers at the University of Washington have reported a significant reduction of tooth decay in toddlers who were treated with the topical syrup xylitol, a naturally occurring non-cavity-causing sweetener. Their results were presented today during the 86th General Session of the International Association for Dental Research. In a recent clinical trial in the Republic of the Marshall Islands, children 6 to 15 months old were given oral doses of xylitol in fruit-flavoured syrup daily to determine whether the substance can prevent early-childhood tooth decay, or caries. Researchers reported that nearly 76 percent of the children in the group who received xylitol were free of tooth decay by the end of the study, compared with 48 percent of the children in the group that did not receive the substance.

Talking therapy plans under fire

A multi-million pound strategy to increase access to psychological therapies in England is flawed, a group of therapists has warned. The British government has earmarked £173m to increase the number of cognitive behavioural therapists in the NHS. But delegates at an international counselling conference heard it was a "myth" that CBT was more effective than other types of therapy. NHS advisors recommended CBT for depression and anxiety in 2004. When resources are limited, surely the NHS should focus on treatments that have established efficacy. The National Institute of Health and Clinical Excellence (NICE) said the evidence supported its use ahead of antidepressants in mild to moderate cases. The Scottish Executive is also planning to train more therapists to improve patient access to CBT, which aims to help patients to pinpoint - and then change - thoughts and actions that cause emotional problems.

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