Doctor's Blog, Education, & Dermatology News

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Cannabinoids:  their role in dermatology therapeutics---a summary of my files.

 

As more and more states decriminalize cannabis, the list of potential medical benefits continues to grow.  Cannabinoids are hydrophobic (fat-soluble)  compounds that can be divided into three broad categories: a) endogenous (made in our bodies), 2) plant made, and 3) synthetically made.  The Cannabis sativa plant contains more than 120 compounds called phytocannabinoids.

In dermatology, a few clinical trials are showing the efficacy for a broad spectrum of inflammatory skin conditions such as atopic dermatitis, psoriasis, acne, scleroderma, cutaneous lupus, as well as cancers of the skin (though many of the skin cancer studies are contradictory). The most commonly studied cannabinoids are THC (tetrahydrocannabinol) and CBD. However, it is THC that elicits a psychotropic effect, thus, not considered an ideal therapeutic agent. CBD (cannabidiol) is one of the major non-psychogenic compounds of the plant. Both have shown potential for treating skin diseases to reduce inflammatory response within the skin, but more emphasis has been applied on CBD due to it being a non-psychogenic compound. 

 

Cannabinoid cell receptors are found in human skin on keratinocytes, hair follicle cells, sebaceous glands, immune cells, and sensory neurons.  Activation of these receptors in these cells reduces pain and itch sensation, and regulates cell differentiation and proliferation (cell maturation, specialization and turnover).

 

The most probable role for cannabinoids is in the attempt to control the symptom of ITCH with or without inflammation. Cannabinoid studies have shown potential for the treatment of complex inflammatory conditions such as hidradenitis suppurativa and bullous pemphigoid, as well as chronic neurologic itching conditions like lichen simplex chronicus and prurigo nodularis. In addition, these substances may also have properties useful for the treatment of more common eczematous conditions like allergic contact dermatitis and atopic dermatitis as anti-inflammatory agents.

 

Questions remain around many aspects of cannabis therapeutics for the skin. There is the need to select the type or ratio of TCH to CBD (to balance the beneficial effects of both, while reducing the adverse events), how to administer (topical, oral, or inhaled), and the dosage. For the topical therapies, the concern may center around the chemistry of the highly lipophilic (fat-soluble) nature of the compounds.

 

The retail health market has experienced a deluge of products labeled “CBD”. The key will lie in the details of each product. For example, often the product either doesn’t contain CBD or it is present in such small percentage that it may be ineffective.  It will be important to READ THE LABEL of the product you are considering buying. Bear in mind, if the label states the product is hemp seed oil, there is no CBD. These may have a slight moisturizing effect on the skin but, in general, topical oils do not make ideal emollients. If you are considering CBD, Hemp, or Hemp oil and the product does not specify the amount of CBD, then buyer beware, it is likely to contain negligible quantities of CBD. According to a 2019 review in the Chicago Tribune, it is recommended to look for topical oils that deliver 10-120 milligrams of CBD per dose (topically).Consider how the CBD was extracted and avoid products that used industrial solvents, as they be harmful to your skin. It is recommended that the product derive from the whole plant, and not just an isolate to provide better predictable benefit. Even the lay-press agrees (Chicago Tribune 8/2019), avoid the ‘scientific catch phrases‘ intending to impress the consumer into a purchase. Words like ‘nano-extracted’ and ‘phytocannabinoids’ on the label do not necessarily mean the CBD oil described is actually effective. 

 

My recommendations?  This is a very exciting topic with tremendous potential. Tread carefully in this new therapeutic arena, do your research, and ask advice from trusted medical professionals.     One more thought,winter really is coming, so use your moisturizers now. -------Dr.Berne

  

SKIN HEALTH TIPS & DERMATOLOGY NEWS

10 Great Ways to Help Prevent Skin Cancer

(American Society for Dermatologic Surgery)

  • Avoid sun burns-Apply SPF before you go in the sun; and re-apply every 2 hours.

  • Wear sun-protective clothing

  • Wear a shade-producing hat

  • Wear sun glasses (UV rated)

  • Use SPF  on your lips too !!

  • Be aware of reflected sunlight

  • Reapply, reapply, reapply-Use SPF every 3-4 hours

  • Avoid excessive sun between 10am and 2 pm

  • Avoid tanning beds

  • Have your skin examined regularly

 

Questions? Want to learn more? See your board-certified dermatologist soon, and regularly

 Dry Skin Care

Not all moisturizers are created equal.

Chemistry matters !!

The goal of a skin  moisturizer is to keep the skin hydrated and healthy. Hydrated skin feels better, functions more effectively, and is a better barrier against irritants and disease. Choose a product that fits your budget, and is not unpleasant to touch and fragrance.  Cream-based products are prefered over lotions in the winter-time  as they tend to seal in the moisture better.

ASK YOUR DERMATOLOGIST WHICH EMOLLIENT MIGHT BE BEST FOR YOUR DRY SKIN

 

Tips:

  • Humidify your home

  • Apply moisturizer (emollient cream) often, especially after washing or bathing

  • Avoid long HOT showers, and use soapless fragrance-free skin cleansers.

  • Use gentle, clothing detergent products. Be sure laundry cleaning chemicals are rinsed out completely

 

Springtime brings flowers, rain, warm weather, and Poison Plants...

    Poison ivy, poison oak , and poison sumac are plants   that may cause an irritating skin rash on some people. It is an oil, URUSHIOL, present in the sap of these plants that can cause the allergic reaction.  You may also get a rash through indirect contact with the oil, perhaps from clothing, tools, or pets that may have the oil on them. Poison Ivy is by far the most common in our area. Sumac and Oak  can be found, but tend to be more shrub-like and the leaves look different.  Learn to recognize these plants and avoid contact. If uncertain, call a qulaified landscaper or horticulturist to look at your garden or yard.

 

If you suspect a allergic plant rash, call your dermatologist ASAP, as these rashes, which tend to cause blistering, can become very red, itchy, blistered, and easily infected.

 

Dermatologists can diagnose your irritating rash, and offer treatments to relieve itch, rash, and possible secondary infection.

Helpful Links to Learning

American Academy of Dermatology:  www.AAD.org

 

National Psoriasis Foundation: www.psoriasis.org

 

National Rosacea Society:

www.rosacea.org

 

Skin Cancer Foundation:

www.skincancer.org

 

National Eczema Foundation: www.nationaleczema.org

Do You Work Outside in the Summer?

Here's a few things to consider to help keep your skin safe:

  • Clothing: consider wearing a hat long sleeves, and protective gloves. Cotton fibers are comfortable and cool; but fibers that are tightly woven provide more protection from ultraviolet .Bright and dark colors (rather than white) protect you better because the dyes absorb the UV rays.

  • Seek shade: Find covered areas for as much of your work as possible. Adjust your work schedule, if possible, to allow for more to be done during off-peak sun hours.

  • Hats: Remember, you need to protect your ears and neck as well as your face. A tightly woven canvas hat provided better protection than a loose straw one.There are bandanas that are rated with ultraviolet protection factor (UPF).

  • Sunglasses: Protect your eyes and eyelids. Find lenses that block 99-100% of UV rays. The larger, the better. Polarized lenses help by reducing glare from reflected surfaces.

  • Sunscreen: Use a broad-spectrum sunscreen with at least a SPF rating of 30, SPFs up to 50 offer extra protection. You must re-apply every 3-4 hours, and even more frequently if you are perspiring. There are so many varieties of UV protective products, find one you like and use it properly. THERE IS NO EXCUSE NOT TO USE A SUNBLOCK.  Ask your dermatologist if you have questions or special issues like allergy or sensitive skin.

  • Skin Exams: see a dermatologist at least once a year for a skin cancer screening. Most skin cancers can be cured IF detected early.

 

      The above are highlights from the 2016 Skin Cancer Foundation Journal. Please visit SKINCANCER.ORG for more information

Preventative Skin Care

--BE AWARE--

  • Be Sun Smart

  • Protect your kids, Teach sun safety

  • Get Vitamin D safely through a healthy diet that may include vitamin supplements. Don't seek the sun.

  • Get a physical exam of your skin regularly

  • Check your skin at home too for new, changing or          non-healing lesions

 

  • Know the ABCDE's of moles

  • Avoid tanning beds

  • Apply sunblock properly

  • Seek shade

  • Early detection can be the best prevention

 

  • SEE YOUR DERMATOLOGIST REGULARLY, AT LEAST EVERY 12 MONTHS--- SOONER IF YOU SEE A NEW, CHANGED, OR UNFAMILIAR SKIN LESION

 

  One more thought...

If there is a topic you'd like to see discussed here, please call our office and add your suggestion. We'll do our best to address your idea. 

 

Call: 773-237-SKIN  (7546)

Call today and schedule an appointment

A & G Dermatology Associates

1733 N Harlem Avenue

Chicago, IL 60707

773.237.7546 (SKIN)

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