SCHAUMBURG, Ill., May 5 /PRNewswire/ — While occupational risks are inherent in many jobs, workers who make a living toiling in the sun face an increased threat of skin cancer from repeated overexposure to the sun’s harmful ultraviolet (UV) rays. Now, new research finds that workers who need skin exams the most by nature of their occupation — such as construction, forestry, fishing and farming workers — are the least likely to get them.
In the study published online in the Journal of the American Academy of Dermatology entitled “Reported skin cancer screening of U.S. adult workers,” dermatologist Robert S. Kirsner, MD, PhD, FAAD, professor and vice chairman of the departments of dermatology and cutaneous surgery at the University of Miami Miller School of Medicine in Miami, and his colleagues used the National Health Interview Survey (NHIS) data from 2000 and 2005 to estimate the percentage of U.S. workers who had ever had a thorough skin examination in their lifetime or during an appointment with a primary health care provider in the past 12 months.
“Previous studies have shown that total-body screening examinations are not frequently performed during routine health examinations by primary care physicians, even among potentially high-risk populations,” said Dr. Kirsner. “As dermatologists, we know that the early detection of skin cancer by routine skin examinations is crucial in successfully treating this potentially life-threatening condition — particularly for workers routinely exposed to harmful ultraviolet light. This study shows that workers who need careful monitoring for skin cancer due to the nature of their jobs are less likely to receive skin exams than workers in low-risk occupations.”
Conducted by the National Center for Health Statistics (NCHS), the NHIS is an annual, cross-sectional in-person household survey of U.S. workers. In 2000 and 2005, the Cancer Control Module was included as part of the NHIS and included questions on skin examinations that were administered to 19,702 and 18,422 employed participants, respectively. Questions included “Have you ever had all of your skin from head to toe checked for cancer either by a dermatologist or some other kind of doctor?” and “When did you have your most recent skin exam?”
Dr. Kirsner explained that data of all participants who reported a full-body skin examination were grouped into two categories — those who received a skin exam in the last 12 months and ever in their lifetime. Workers also were asked about their sun-protection behavior, if they reported going out in the sun for an hour or more, and, from their responses, were classified as “sun exposed” for the purposes of the study.
In addition, detailed employment information was coded by occupation and industry for all participants aged 18 years or older employed during the time of the survey. Occupations were grouped into four standard occupational categories — white-collar workers; service workers; farming, fishing, and forestry workers; and blue-collar workers. Workers were then subsequently grouped into eight industrial sector classifications — agriculture, forestry, and fishing; mining; construction; manufacturing; wholesale and retail trade; transportation, warehousing, and utilities; services; and health care and social assistance.
“When we examined the data for the 38,124 total worker participants interviewed from the 2000 and 2005 Cancer Control Supplements, we found that the prevalence of both lifetime and 12-month skin examinations was low,” said Dr. Kirsner. “Only 15 percent of all U.S. workers reported ever receiving a skin examination during their lifetime, and only 8 percent of those who also had seen a health care provider in the past year reported that they had received a skin exam during that time.”
In addition, the data clearly showed that the rate of reporting skin cancer screening was lowest for high-risk occupations most likely to experience increased sun exposure. Specifically, in the 2000 and 2005 Cancer Control Modules, the prevalence of 12-month skin examinations among those who had seen a physician in the past year was lowest among farm workers (5.8 percent and 1.6 percent, respectively) and blue-collar workers (3.9 percent and 4.9 percent, respectively).
“When we analyzed the data by industry sectors, we concluded that agriculture, forestry, fishing, and construction workers reported the lowest rate of skin exams in 2000,” said Dr. Kirsner. “Although the number of agriculture, forestry and fishing workers reporting a skin exam increased from 2000 to 2005 — from 4.2 percent to 13.6 percent — the prevalence of skin exams among construction workers stayed essentially the same, from 5.2 percent to 5.6 percent.”
Dr. Kirsner added that occupational groups at increased risk for exposure to UV light on the job were less likely to have ever received a skin examination in their lifetime than the average U.S. worker (15 percent). This included farm operators and managers (10 percent), farm workers and other agricultural workers (7 percent), forestry and fishing occupations (3 percent), construction and mining trades (8 percent), and construction laborers (8 percent).
“Socioeconomic factors also were significant predictors of having a skin exam in the past year,” said Dr. Kirsner. “Specifically, younger black or Hispanic women with no health insurance, who were service, farm or blue-collar workers, and who did not use sun protection were the least likely to report ever having been screened for skin cancer. All patients, especially those that have occupations where they are exposed to UV light, should request that their physician provide skin exams during their routine exams.”
“In addition, developing and implementing local community health fairs that include screening programs targeting high-risk workers who are reporting low skin examination rates could help reverse this alarming trend,” commented Dr. Kirsner. “One way to receive a free screening is through the Academy’s National Melanoma/Skin Cancer Screening Program, where dermatologists volunteer to provide free skin cancer screenings in their communities. The public can visit http://www.aad.org to find a free skin cancer screening in their area.”
For more information about skin cancer, please visit the SkinCancerNet section on http://www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.
SCHAUMBURG, Ill., Oct. 18 /PRNewswire/ — While acne is oftentimes as much a part of being a teenager as dating and Friday night football games, a new study examining the prevalence of acne in adults age 20 and older confirms that a significant proportion of adults continue to be plagued by acne well beyond the teenage years. In particular, women experience acne at higher rates than their male counterparts across all age groups 20 years and older.
In the study entitled, “The prevalence of acne in adults 20 years and older,” published online in the Journal of the American Academy of Dermatology, dermatologist Julie C. Harper, MD, FAAD, associate professor of dermatology at the University of Alabama in Birmingham, Ala., and her colleagues at the University of Alabama at Birmingham School of Medicine, surveyed a random sample of men and women aged 20 and older to determine the prevalence of persistent acne that continued after adolescence or new adult-onset acne.
“Although acne is one of the most common skin diseases, there is a general misconception that it only affects teenagers,” explained Dr. Harper. “As dermatologists, we treat acne patients of all ages — from those who have experienced acne since they were teenagers to others who have developed the condition for the first time as adults. Our study set out to determine just how common acne is among adult men and women.” A total of 1,013 men and women aged 20 years and older at the University of Alabama at Birmingham campus and medical complex were asked to complete a one-page questionnaire designed to evaluate the prevalence of acne in adults across various age groups. Survey questions gauged whether the participant had ever had acne or pimples, including during their teens or later in life (in their 20s, 30s, 40s, and 50s or older). The survey also asked participants to judge whether their acne had become better, worse or stayed the same since their teenage years.
When asked whether they had ever had a pimple or acne, the vast majority (73.3 percent) of participants responded that at one time or another they had dealt with acne. The majority also reported that they had experienced acne as teenagers, with the number of men and women affected by the condition nearly identical (68.5 percent of male participants and 66.8 percent of female participants).
Interestingly, the survey found that for every age group following the teenage group, the reported incidence of acne was significantly higher among women than men. Specifically,
— During their 20s, 50.9 percent of women and 42.5 percent of men
reported experiencing acne.
— During their 30s, 35.2 percent of women and 20.1 percent of men
reported experiencing acne.
— During their 40s, 26.3 percent of women and 12 percent of men reported
experiencing acne.
— During their 50s or older, 15.3 percent of women and 7.3 percent of men
reported experiencing acne.
A separate section of the survey, which included questions assessing aspects of acne specific to women, asked female participants to note changes in acne around the time of their menstrual period, their pre-menopausal or post-menopausal status, and the effect of any treatments for symptoms of menopause on acne. Of the pre-menopausal women surveyed, 62.2 percent noted that their acne gets worse around the time of menstruation. In addition, of the 86 women who reported using either hormone replacement therapy or over-the-counter medications for the side effects of menopause, nine women (10.5 percent) reported improvement in their acne with the use of these therapies. However, 75 of the women (87.2 percent) reported no change with these menopausal therapies, and two women (2.3 percent) reported that their acne symptoms worsened.
“Our findings demonstrate that acne is a persistent problem for people of all ages, but clearly women seem to be affected by this medical condition more than men when we examined the 20-plus age groups,” said Dr. Harper. “Research examining the role hormones play in the development of acne may hold the key to explaining why more adult women are affected by acne and could lead to future treatments to control this condition.”
Dr. Harper added that the majority of study participants reported that the severity of their acne improved after their teenage years, which is consistent with previous studies suggesting that post-adolescent acne is generally mild or moderate. For example, 63 percent of men and 53.3 percent of women stated that their acne improved after their teenage years, while only 3.6 percent of men and 13.3 percent of women reported that their acne worsened post- adolescence.
“Despite the fact that adult acne tends to be generally milder than teenage acne, this common medical condition can have a significant impact on a person’s overall quality of life — regardless of when it occurs,” explained Dr. Harper. “Involving a dermatologist in the diagnosis and treatment of acne is vital to managing this difficult condition.”
The American Academy of Dermatology recommends the following tips for the proper care and treatment of acne:
— To prevent scars, do not pop, squeeze or pick at acne; seek treatment
early for acne that does not respond to over-the-counter medications.
— Gently wash affected areas twice a day with mild soap and warm water.
Vigorous washing and scrubbing can irritate your skin and make acne
worse.
— Use “noncomedogenic” (does not clog pores) cosmetics and toiletries.
— Use oil-free cosmetics and sunscreens.
— Avoid alcohol-based astringents, which strip your skin of natural
moisture.
— Shampoo hair often, daily if it is oily, though African-Americans may
prefer to wash it weekly.
— Use medication as directed and allow enough time for acne products to
take effect.
To learn more about acne, visit http://www.skincarephysicians.com/acnenet. The American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or http://www.aad.org.
NEW YORK, Aug. 1 /PRNewswire/ — If sagging skin is getting you down, recent advances in skin-tightening technologies can lift your spirits — and your skin — in a matter of a few office visits to your dermatologist. The beauty of these non-invasive procedures is their ability to treat loose skin virtually anywhere on the body without the risks and downtime associated with surgery.
Speaking today at the American Academy of Dermatology’s Summer Academy Meeting 2007, dermatologist David J. Goldberg, MD, JD, FAAD, clinical professor of dermatology and director of laser research at the Mount Sinai School of Medicine in New York, N.Y., discussed the rapidly expanding area of skin-tightening techniques and how they can safely and effectively treat sagging skin on the jowls, neck, arms, and stomach, as well as cellulite.
“The monopolar radiofrequency (RF) technology, which was introduced five years ago and which is credited as the first non-surgical skin-tightening device, has been the catalyst for what is now an explosion in non-invasive skin tightening with different technologies and areas of the body that we can treat,” said Dr. Goldberg. “Originally used to lift the eyebrows, monopolar RF was found to be effective in tightening the jowls and neck area with its unique approach of cooling the outer layer of skin while heating the deeper layers to cause tightening. This basic principle is what shaped many of the latest skin-tightening technologies.”
Broad-Spectrum Light Sources
Dermatologists now have their pick of several broad-spectrum light sources to treat loose skin on areas of the face and body. Using a broad band of infrared light ranging in wavelength from 850 to 1800 nanometers (nm), the new devices produce deep heating in the middle layer of skin which spurs new collagen formation over time. As with monopolar RF, the outer layer of skin is kept intact with a continuous cooling device.
“The delivery systems that these devices employ and the varying depths to which the heat is delivered are what set them apart from each other, which is what dermatologists evaluate when selecting a technology for the area of skin they’re treating,” said Dr. Goldberg. “For example, the broad-spectrum light sources and monopolar RF use different size treatment tips to deliver energy to the skin. Larger tips are better for bigger surfaces of skin, whereas the smaller tips are used for more confined areas of loose skin that require a concentrated delivery of energy.”
In some patients, skin tightening is visible following the initial treatment, while others will notice the improvement gradually over time. Dr. Goldberg added that while results vary, studies show that skin tightening with the broad-spectrum light sources typically last at least 12 months.
“These new technologies allow us to treat younger and older patients with equal degrees of success,” said Dr. Goldberg. “As long as the area being treated involves only superficial loose skin — not loose fat or muscle — no area of the body should be off limits for a skin-tightening procedure.”
Unipolar Radiofrequency for Cellulite
Dr. Goldberg spearheaded a recent study that is pending publication and was designed to determine the results of a new unipolar, volumetric radiofrequency (RF) device to treat cellulite. With its characteristic “orange peel” skin irregularity and dimpling of the buttocks and thighs, cellulite affects more than 85 percent of post-pubescent women.
Unipolar RF is different from other previously described RF devices in that this device does not produce electrical currents within skin tissue. Instead, high-frequency electromagnetic radiation is produced by this non-laser technology.
“The best way to describe how this treatment works is to think of it as a blender-like effect on the skin, involving the ultra-rapid rotation of molecules through the skin that generates heat,” said Dr. Goldberg. “The heat is dispersed to the surrounding tissue, allowing the deeper skin structures — where cellulite forms — to be effectively heated.”
In the study, Dr. Goldberg evaluated whether deep unipolar RF-induced heating could tighten the skin irregularities of cellulite when administered in six treatment sessions every two weeks. Of the 30 patients treated, 27 showed evidence of clinical improvement in their cellulite as measured by an independent evaluator. The mean decrease in leg circumference was 2.45 cm (1.2 inches), and the graded improvement on a 1 to 4 scale (4 is the highest) was noted to be 2.9. Biopsies taken of skin samples showed tightening of the dermis, and blood tests as well as magnetic resonance imaging of the areas treated showed no abnormalities.
“The improvement we saw with the unipolar radiofrequency device in tightening cellulite was greater than the results previously reported with bipolar and low-energy laser systems,” explained Dr. Goldberg. “In fact, fewer treatments were needed and better results were noted with this new approach. What remains to be seen is how long treatment results last and whether combined approaches with other modalities will lead to even better results.”
Although the latest skin-tightening technologies offer patients a range of treatment options, Dr. Goldberg stressed that it is vital for patients to seek a consultation with a physician experienced in the latest procedures.
“When deciding on what technology to use for each individual patient, I make the decision based on the findings of clinical studies using the various technologies, which of the devices’ delivery systems will work best for the treatment area, and my own personal experience with the technology,” said Dr. Goldberg. “In the right hands, these new skin tightening techniques can produce noticeable improvements.”
To learn more about aging skin, visit http://www.skincarephysicians.com.
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or http://www.aad.org.
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