Judy Hu

The role of antioxidants in photoprotection: A critical review

Free radicals have long been studied as a contributor to aging and disease processes. Endogenous production of radicals from cellular metabolism and exogenous sources from ultraviolet radiation and pollution can damage the skin on the cellular and tissue levels. Although the body possesses an elegant defense system to prevent radical damage, this innate system can be overwhelmed and lead to a state of oxidative stress or immunosuppression, and can even trigger carcinogenesis. Topical supplementation of antioxidants can provide additional protection to neutralize reactive oxygen species from both endogenous and exogenous sources. This review will discuss our current understanding of the mechanisms of free radical damage and evaluate the potential benefit of topical antioxidants in sunscreens and skin care products.

Correlates of health-related quality of life in women with severe facial blemishes.

Background  Facial appearance plays a large role in self‐perception and interaction with others. Visible facial skin lesions are a common condition.

Sunscreens: a review of health benefits, regulations, and controversies.

Ultraviolet radiation plays a major role in the development of nonmelanoma and melanoma skin cancers. Photoprotection by sunscreens has been shown to prevent the development of actinic keratosis, squamous cell carcinoma, melanoma, and photoaging. However, these benefits are only derived if the users apply sunscreen appropriately and practice other sun protection measures. This review discusses the health benefits provided by sunscreen use, updates the latest regulatory landscape on sunscreen, and addresses the controversies and limitations associated with sunscreen use.

Class I topical corticosteroid use by psoriasis patients in an academic practice

BACKGROUND: Psoriasis is a chronic skin disorder that can have a profound impact on the quality of life of patients. The treatment of psoriasis is complicated by the availability of numerous topical agents, systemic agents, and phototherapy. Of the topical preparations available, the ultra‐high potency, or Class I steroids, have an important role in treating psoriasis. Their use is most appropriate for the treatment of plaques in regions excluding the face, axilla, groin and genitals. OBJECTIVE: The purpose of this study was to examine the prescribing patterns of Class I topical corticosteroids within a large academic dermatology practice for patients with all types of psoriasis. METHODS: A retrospective chart review of 650 patients with psoriasis from an academic dermatology practice was performed. Class I steroid use was defined as those patients who were observed to be currently using clobetasol propionate, halobetasol propionate, diflorasone, or augmented betamethasone dipropionate. RESULTS: A total of 79% of patients were prescribed topical steroids of any class while 46% of patients were prescribed a Class I steroid. In all, 58% of patients who received topical steroid therapy received a Class I agent; 11% of patients prescribed Class I steroids also received systemic therapy for their psoriasis. Conversely, 35% of patients who received systemic therapy were also receiving Class I topical therapy. DISCUSSION: In our department, Class I topical steroids are commonly used in the treatment of psoriasis. The superpotent topicals are often used as an adjunct to systemic therapy and will likely remain a mainstay of psoriasis therapy.

Improving compliance of daily sunscreen application by changing accessibility.

Sunscreens are effective in preventing sunburn, skin cancers and signs of photoaging (1). Over the past decades, a sustained effort to educate the public on the benefit of sunscreen use and proper application techniques has been carried out by dermatologists, academia, industry and nonprofit organizations (2). Although the public understands the benefits of sunscreen use (3, 4), the vast majority do not use sunscreen on a routine basis due to a variety of reasons (5). The aim of this study was to investigate whether sunscreen compliance can be improved by changing accessibility and storage location. The study took place from February 2016 to May 2016. All eligible participants were randomized into two groups: group A (sunscreen only) and group B (sunscreen + toothpaste/storage unit). On the initial visit, all participants were educated regarding the benefits of daily sunscreen application and received a 2-month supply of broad-spectrum, SPF-30 sunscreen (Neutrogena Ultra-Sheer Dry-Touch Lotion – 3 fl oz) with instructions to apply it each morning to their face, neck, and hands. In addition, participants in group B received a storage unit and were instructed to place the sunscreen with their current toothpaste in the same storage unit in their bathroom. Participants also completed baseline questionnaires regarding demographics and skin characteristics. After 6 weeks, participants returned for followup, and the weight of each participant’s sunscreen was measured before and after the study. Descriptive statistics and graphical methods were used to describe the study population and intervention results. The outcome measure was the difference in weight of sunscreen preminus postintervention for each participant. Least squares regression was used to assess differences between intervention group, while controlling for participant age and skin type. All analyses were performed with Stata v.14.1, Stata Corporation, College Station, TX, USA. A total of 62 Caucasian women took part in the study. Overall mean age of the participants was 38.1 years (SD = 10.7), and no difference in age was observed between the groups. Of the participants, 16% (n = 10) were skin type I, 32% (n = 20) were skin type II, and 52% (n = 32) were skin type III. No appreciable difference in skin types was observed between intervention groups. The mean preweight of sunscreens was 112.2 g for all study participants. Overall sunscreen usage was 40.7 g (SD = 17.8), reflecting a 36.2% change from baseline, P < 0.001. Participants with skin type I used significantly more sunscreen (53.4 g, SD = 13.0) than type II (40.7 g, SD = 15.9) and type III (36.4 g, SD = 18.8) participants, P-values 0.05 and 0.009, respectively.