Gail Saltz, MD, is a psychiatrist and television commentator in New York City who specializes in health, sex, and relationships.
Double Up on Acne Treatments, New Guidelines Say
TUESDAY, Feb. 23, 2016 (HealthDay News) — Combining treatments is the best way to combat acne, new guidelines from the American Academy of Dermatology state.
“There are a variety of effective treatments available for acne, and dermatologists have found that combining two or more treatments is the best option for the majority of patients,” Dr. Andrea Zaenglein, co-chair of the guidelines committee, said in an academy news release.
“Recommended treatments include topical [skin] therapy, antibiotics, isotretinoin [Accutane is one brand] and oral contraceptives,” she added.
Acne affects up to 50 million Americans a year, according to the academy.
When using antibiotics to treat moderate to severe acne, prescription skin medications should be used at the same time. After patients complete a course of antibiotics, they should continue using topical, or skin, therapy to manage their acne, according to the guidelines.
Topical medications such as retinoids and benzoyl peroxide can also be used together, the guidelines say.
Also, girls and women with acne may benefit from taking birth control pills, which can be combined with other treatments, the experts noted.
Oral isotretinoin can be used for severe acne that does not respond to other treatments. However, the medication carries a high risk of birth defects, so females must be extra vigilant about preventing pregnancy while taking the drug, the guidelines authors pointed out.
Some research has suggested a link between oral Accutane and inflammatory bowel disease or depression, but the evidence is not conclusive. However, patients should be aware of this and follow their doctor’s advice, the guidelines say.
There is not enough evidence to recommend in-office procedures such as laser treatments and chemical peels, alternative therapies such as tea tree oil, or dietary changes, according to the guidelines.
The guidelines were published recently in the Journal of the American Academy of Dermatology.
More information
The American Academy of Family Physicians has more about acne treatment.
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‘Mindfulness’ Might Help Older Adults With Back Pain
By Alan Mozes
HealthDay Reporter
TUESDAY, Feb. 23, 2016 (HealthDay News) — Mindful meditation may offer a measure of pain relief to seniors suffering from chronic lower back pain, new research suggests.
The study involved nearly 300 older adults with long-term lower back pain, half of whom were assigned to a two-month mindful meditation course.
“Mindfulness meditation is a method to learn how to be fully engaged in the present moment and not let the mind get so easily distracted,” explained study lead author Dr. Natalia Morone. She is an associate professor of medicine at the University of Pittsburgh.
As patients practiced mindfulness meditation and tried to stay more focused on the present moment, “participants found they experienced less pain,” Morone said. They also saw short-term benefits in physical function, the study found.
More than half of adults older than 65 suffer from chronic pain, most commonly in the back, according to background notes with the study. Because medication side effects are more common in old age, many doctors and patients seek nonpharmaceutical treatments, the researchers said.
“There is no magic bullet for pain,” said Dr. John Mafi, an assistant professor of medicine with the David Geffen School of Medicine at the University of California, Los Angeles.
“The closest we have is time, as 75 percent of pain will get better within two months, and 90 percent within three months. But simply telling patients to be patient can be frustrating,” he said.
“So, although this is a small study, and the results are modest, it’s still a first of its kind,” said Mafi, who wasn’t involved in the research. “That’s exciting, because it offers some new movement in the realm of possible therapies. It’s definitely worthy of continued study with a larger group of patients,” he added.
For the study, published online Feb. 22 in JAMA Internal Medicine, 282 Pittsburgh residents over age 65 were recruited between 2011 and 2014. All had experienced at least three months of ongoing, “moderate” back pain that reduced their functioning. All were mindfulness first-timers.
About half were assigned to engage in weekly 90-minute sessions of mindful meditation for eight weeks. Sessions centered on “directed breathing” and greater thought- and sensation-awareness, designed to help them redirect their attention.
The others participated in an eight-week healthy aging education program, which touched on issues such as blood pressure management and stretching, though not pain management specifically.
At completion, both groups returned for six monthly one-hour “booster” sessions.
The result: While both groups improved in terms of mobility and pain, by some measures the mindfulness group improved significantly more.
For example, while 37 percent of the healthy living group said their back pain had eased after the two-month program, that figure was more than 80 percent among the mindfulness participants. Six months later, 42 percent of the healthy living group said their pain had at least “minimally” improved, compared with more than 76 percent among the meditation group, the findings showed.
With respect to “pain self-efficacy,” a standard measurement of pain control, the meditation group was ahead at the two-month mark, but six months later that difference had all but disappeared, the investigators found.
Similarly, the greater physical function improvements observed in the mindfulness group at the program’s end had also dropped off by the six-month mark, ultimately matching gains achieved by the nonmeditation group.
On that score, Morone theorized that the functional gains seen in both groups might be due to the emphasis both interventions placed on healthy living. She suggested that a meditation program supplemented by exercise — such as brisk walking — might result in even greater and longer-lasting benefits.
More information
There’s more on chronic lower back pain at the U.S. National Institute of Neurological Disorders and Stroke.
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Could You Have ADD, Or Is It Anxiety? Here’s How to Tell
Photo: Getty Images
Lately, I can never really relax—my brain is going a mile a minute. When I try to read a book, I check my texts or jump up to do chores. Do I have ADD?
If this has only recently started happening, it most likely isn’t attention deficit disorder, which doesn’t just suddenly strike in adulthood. The condition—in which difficulty regulating attention creates issues with distractibility and impulsivity—typically crops up at school age. It sounds like you’re dealing with anxiety, which can interfere with pretty much anything that requires concerted attention.
RELATED: 12 Signs You May Have an Anxiety Disorder
It’s not unusual for worry to grow over the course of the day and feel more present and disruptive in the evening, when you’re tired. Getting up to do things may be your mind’s way of distracting you from unpleasant thoughts. Before you settle down to read, do something physically soothing (gentle stretching, say). Calming your body can go a long way toward relaxing your mind. Also, try to write down as many worries as you can in five minutes, then put the list aside. There—you’ve downloaded.
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This Is Chrissy Teigen’s Go-To Healthy Meal
Photo: Getty Images
It’s no secret that Chrissy Teigen has a seriously impressive kitchen game. But now the model is sharing all her best meals and tips in her new cookbook, Cravings: Recipes for All the Food You Want to Eat ($30, amazon.com). We couldn’t resist these mouthwatering, low-carb Chicken Lettuce Wraps, and neither apparently can Chrissy: “Every single time I make this dish, I find myself burying my head in the fridge all night, scooping and scraping for every chicken bit possible with my bare hands,” she wrote in her book. “Filling and healthy and freaking yummy.”
RELATED: 7 Insider Secrets I Learned from Chrissy Teigen’s Makeup Artist
Chicken Lettuce Wraps
Photo: Aubrie Pick
Serves: 6
Prep time: 15 minutes
Total time: 30 minutes
Sauce
3 Tbsp. Thai sweet chili sauce
3 Tbsp. hoisin sauce
3 Tbsp. light soy sauce
2 Tbsp. Sriracha
2 Tbsp. vegetable oil
1 tsp. sesame oil
1½ Tbsp. unseasoned rice vinegar
2 Tbsp. minced garlic (about 4 cloves)
1 Tbsp. minced fresh ginger
Filling
1 lb. ground chicken
3 Tbsp. vegetable oil
8 scallions, thinly sliced, whites and greens kept separate
1 Tbsp. minced garlic (about 2 cloves)
1 Tbsp. minced fresh ginger
½ pound white mushrooms, trimmed, cleaned, and finely chopped
½ cup finely diced canned water chestnuts
1 small red bell pepper, finely chopped
2 heads butter lettuce, leaves separated
- Make the sauce: In a bowl, combine the chili sauce, hoisin, soy sauce, Sriracha, vegetable oil, sesame oil, vinegar, garlic, and ginger.
- In a bowl, mix 2 Tbsp. of the sauce into the ground chicken.
- In a large skillet, heat 2 Tbsp. of the vegetable oil over medium-high heat. When shimmering-hot, add the chicken and cook, breaking up the meat with a wooden spoon, until browned, 5 to 6 minutes. Transfer the meat to a plate and set aside.
- Add the remaining 1 Tbsp. oil to the skillet, then add the scallion whites, garlic, and ginger and cook, stirring, for 1 minute.
- Add the mushrooms and cook, stirring, until they release their liquid, 3 to 4 minutes. Return the chicken to the pan, then add the water chestnuts, bell pepper, and the rest of the sauce and cook, stirring, until cooked through and the liquid has reduced and thickened slightly, 3 to 4 minutes. Stir in the scallion greens.
- Transfer the mixture to a bowl and set out with the lettuce leaves.
Reprinted from Cravings: Recipes for All the Food You Want to Eat. Copyright © 2016 by Chrissy Teigen. Photographs copyright © 2016 by Aubrie Pick. Published by Clarkson Potter/Publishers, an imprint of Penguin Random House LLC.
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The 5 Top-Rated Waterproof iPhone Cases on Amazon
When you lead an active lifestyle, your iPhone will inevitably wind up in a precarious situation—caught in the rain during a bike ride, tossed in a snowbank on a rough ski run, floating in a river after a failed kayaking selfie. Protect your phone and the photos, music, and contacts within with one of these iPhone cases that rank high on Amazon.
JOTO Universal Waterproof Case for Apple iPhone 6S, 6, 6S Plus, 5S, 5 ($20; amazon.com)
If you’re hitting the beach, scoring one of these dry bags can keep your phone, credit cards, and money safe from water, sand, and crumbs.
SmartSpeed iPhone 6 Case ($25; amazon.com)
This case won’t protect you from a full submerge, but it does guard against rain and splashes. It also features extreme shock protection, so if you tend to drop your phone a lot, then this might be the case for you.
Easylife Waterproof Case for iPhone 6/6s ($70; amazon.com)
Take your phone surfing and snorkeling (underwater pictures!) up to 6 feet below the surface with this case. When you first get the phone you’ll perform a waterproof test on a piece of paper so you’ll be sure to install it correctly on your phone.
Fully Sealed Underwater Shockproof Snowproof Dirt proof Protective Luxury Cover for Apple iPhone 6 / 6s ($100; amazon.com)
Your phone can stay submerged for more than three hours in this case. It also takes crystal-clear photos.
Maxdara iPhone 6S Waterproof Case ($100; amazon.com)
Sometimes when you put a big, bulky waterproof case on your phone, you lose a lot of its features, like the sound and camera. With this case, you’re still able to use your phone at its full potential while also keeping it protected from the elements.
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Prenatal Use of HIV Drug May Slow Child’s Development Slightly
TUESDAY, Feb. 23, 2016 (HealthDay News) — A drug used to prevent mother-to-child HIV transmission during pregnancy may slow language development slightly in children, a new study suggests.
Researchers followed more than 900 infants who were born to HIV-positive mothers but were not infected by the AIDS-causing virus. All of the mothers took antiretroviral drugs during pregnancy. Some of the treatment regimens included a drug called atazanavir (Reyataz), while others did not.
The infants underwent a standard test of development at 1 year of age. The 167 infants whose mothers took atazanavir during pregnancy had slightly lower language and social development scores than the 750 infants whose mothers did not take the drug.
But the study only showed an association between atazanavir and language delays in children, and did not prove a cause-and-effect link.
And the difference in social development scores was significant only among infants whose mothers started antiretroviral therapy during the second or third trimester of pregnancy. This may be because women who started taking atazanavir during the first trimester switched to a different antiviral drug regimen later in pregnancy, the researchers suggested.
Scores in mental, physical and behavioral development were similar for infants whose mothers took atazanavir and those whose mothers did not, added lead researcher Ellen Caniglia, from Harvard’s T.H. Chan School of Public Health in Boston.
The study was published online recently in the journal AIDS.
Previous research has suggested language development delays in infants whose mothers took atazanavir during pregnancy, and these findings add to those concerns, the researchers said in a journal news release.
Further studies are needed to determine whether these language and social development delays last beyond the age of 1, how atazanavir might cause these delays, and whether the delays might be linked to another drug called tenofovir (Viread), which is typically used alongside atazanavir.
The results of the study “may be useful in treatment planning for women with HIV infection,” the researchers concluded.
More information
The U.S. Office on Women’s Health has more on pregnancy and HIV/AIDS.
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CDC Researchers Join Hunt for Zika Clues in Brazil
TUESDAY, Feb. 23, 2016 (HealthDay News) — Teams of American and Brazilian scientists will travel on Tuesday to areas of Brazil hit hard by the Zika virus, in hopes of confirming a link between Zika and a severe infant birth defect.
Babies born to mothers infected with the mosquito-borne virus can have microcephaly, a condition where infants have smaller heads and the potential for long-term developmental issues.
Brazil has already recorded more than 4,100 such cases, and while links to prenatal exposure to the Zika virus are strong, they have yet to be confirmed.
According to the Associated Press, the new research initiative is a partnership between Brazil’s Health Ministry and the U.S. Centers for Disease Control and Prevention. Researchers plan to compare infants born with microcephaly and their mothers against infants born without the birth defect.
Eight teams, comprised of one CDC expert plus three Brazilian health workers, will go door to door to randomly selected families with new babies living in Paraiba, a state on Brazil’s northeast coast. They hope to recruit at least 130 babies with microcephaly and compare them to almost triple that number of infants without the condition, the AP said. All will undergo blood tests looking for infection with Zika and another mosquito-borne virus, dengue.
“If we can provide some basic information or show a potential association [between a virus and microcephaly], that will allow us another avenue of how do we prevent this and what do we need to do next,” Erin Staples, a Colorado-based epidemiologist who heads the CDC contingent in Paraiba, told the AP.
The study’s launch comes a day after President Barack Obama asked Congress for $1.9 billion to help stem the spread of the Zika virus.
Since it first surfaced last spring, the virus has spread to 30 countries and territories in Latin America and the Caribbean. The World Health Organization now estimates there could be up to 4 million cases of Zika in the Americas in the next year.
Meeting Monday with the nation’s governors, Obama said he hoped to work with them in guarding against an outbreak of the disease in this country.
Obama said the money he is requesting would be used for research into new vaccines and better diagnostic tools, the Associated Press reported. He added that the money would also go toward more support for Puerto Rico and territories where there are confirmed cases, and to help pay for mosquito-control programs in southern states such as Florida and Texas at risk for the Zika virus.
Obama also asked for the flexibility to use some of $2.7 million that was approved to fight the 2014 Ebola outbreak in West Africa but was never used. House Republicans have said that would be the best way to fund a fight against Zika, the AP said.
Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, and Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, appeared before a Congressional panel earlier this month to lobby for Zika funding.
Although first discovered in Uganda in 1947, the Zika virus was not thought to pose serious health risks until last year. In fact, approximately 80 percent of people who become infected never experience symptoms.
But the recent increase in both cases and severe brain birth defects among thousands of newborns in Brazil has prompted health officials to reassess their thinking about Zika and pregnant women.
Last Friday, the CDC advised that healthy newborns of women who traveled in an area affected by the Zika virus within two weeks of delivery, or whose mothers show signs of Zika infection, be checked for infection.
According to the U.S. Food and Drug Administration, people considered at risk for Zika infection include those who have:
- Traveled to areas during the past four weeks where there’s active transmission of Zika virus. The CDC now lists 30 countries and territories in Latin America and the Caribbean as places with active Zika infection.
- Engaged in sexual contact with a person who has traveled to, or resided in, an area with active Zika virus transmission during the prior three months.
- Developed symptoms suggestive of Zika virus infection during the past four weeks.
There have been no reports to date of Zika virus entering the U.S. blood supply, the FDA has said. But, the risk of blood transmission is considered likely based on the most current scientific evidence of how Zika and similar viruses are spread.
The American Red Cross has also asked potential blood donors who have traveled to Zika-affected areas to wait 28 days before giving blood.
More information
For more on Zika virus, and where the virus is endemic, head to the U.S. Centers for Disease Control and Prevention.
To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.
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Could Adults’ Expectations Drive Up ADHD Diagnoses in Kids?
By Amy Norton
HealthDay Reporter
TUESDAY, Feb. 23, 2016 (HealthDay News) — Rates of attention deficit hyperactivity disorder (ADHD) have risen globally, and adults’ unreasonable expectations of young children could be one reason why, researchers suggest.
Reporting in the Feb. 22 issue of JAMA Pediatrics, researchers from the University of Miami point to evidence that the rise in ADHD diagnoses coincided with ever-growing demands on young children’s attention and focus.
Since the 1970s, the researchers said, elementary school children have been getting more and more homework, while preschoolers have spent more time in full-day programs — and getting coached in reading and numbers by mom and dad.
During those same years, the prevalence of ADHD doubled in the United States.
Of course, many other things have also changed since the 1970s, and it’s not possible to pin the rise of ADHD on any one trend, said lead researcher Dr. Jeffrey Brosco, associate director of the university’s Mailman Center for Child Development. His research letter only points to an association and not cause-and-effect.
But, Brosco said, it makes sense that greater academic pressure would set the stage for more ADHD diagnoses.
“You may have a young child who has difficulty paying attention to boring things,” Brosco said. “That’s only a problem if you’re trying to force that child to pay attention to boring things.”
“In the U.S.,” he added, “we’ve decided that increasing children’s academic demands is a good thing. But we haven’t really considered the potential negative effects.”
A child psychologist not involved in the study agreed there’s a “plausible” connection between academic expectations and ADHD diagnoses.
It’s not that homework is causing ADHD, said Stephanie Wagner, an assistant professor of child and adolescent psychiatry at NYU Langone’s Child Study Center in New York City.
ADHD is a “neurobiological” disorder, Wagner said, which means it’s brain-based, and not caused by environmental factors.
“But we do know that the environment can exacerbate symptoms,” she added.
So the more time that children with ADHD have to sit, do homework and have no freedom for play, Wagner said, the more difficulty they’ll have — and the more apparent that will be to adults.
According to Wagner, children with ADHD typically do best in environments where there are clear rules, plenty of hands-on lessons, and less “down time.”
In the United States, about 11 percent of children ages 4 to 17 have ever been diagnosed with ADHD, according to the U.S. Centers for Disease Control and Prevention. Mental health experts believe genetics might play a role in its development, as well as lifestyle behaviors like smoking or drinking during pregnancy.
Critics have long charged that some children diagnosed with ADHD are wrongly labeled as having a “disease” and given drugs they don’t need.
Recent decades have seen a number of trends that could feed the rise in ADHD diagnoses, Brosco said. Those include changes in how the disorder is diagnosed and aggressive marketing of ADHD drugs, Also, kids with ADHD are sometimes eligible for special education services that were not available in the 1970s, Wagner said. “So there likely are families who seek a diagnosis for their child, in order to help him or her receive appropriate services in school,” she said.
But, Brosco said, there has also been a shift in academic demands. Looking at government statistics and previous research, Brosco’s team found that between 1981 and 1997, U.S. children dedicated more and more hours per week to studying.
The biggest change was seen among 6- to 8-year-olds. By 1997, they were spending over two hours a week on homework, versus less than one hour in 1981.
Even preschoolers were feeling the pressure. By 2005, 77 percent of parents said they “frequently” taught their 3- to 5-year-olds letters, words and numbers. That was up from 58 percent in 1993.
It’s not that parents shouldn’t engage their preschoolers’ minds, Brosco stressed. But it should be done through play and connection, rather than lessons, he said.
“Parents should read to their children,” Brosco said. “That’s social interaction and storytelling.” The problem, he added, arises when parents use flashcards and other ways of pushing young children to “get it right.”
Another change, the study found, is that many more preschoolers are in full-day programs now — 58 percent in the mid-2000s, compared with just 17 percent in 1970.
Brosco said there’s nothing wrong with full-day preschool, if children are playing and learning things that are developmentally appropriate — like how to get along with other kids. But some programs get into academics, he noted.
“At that age,” Brosco said, “what’s most important is free play, social interactions, using your imagination. We need to be careful that our demands aren’t making children feel like they’re getting it ‘wrong.’ We want them to love learning.”
More information
The U.S. Centers for Disease Control and Prevention has more on ADHD.
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Move of the Week: Straight Arm Plank
We know what you’re thinking: Everyone knows how to do a plank. But the trouble is, not everybody does it correctly! And if you’re not executing this move with perfect form, you’re missing out on its sculpting benefits. Watch Health’s contributing fitness editor Kristin McGee demonstrate how to properly perform the straight arm plank to tone your arms to core.
Here’s how to do it: Come onto your hands and knees, making sure your hands are directly beneath your shoulders. Then extend one leg back at a time to form a straight line from your heels to your head. Hollow out your lower abs and pull your shoulders down from your ears. Hold here and breathe for one to two minutes. Repeat three to four times, dropping back to your knees between sets.
Trainer tip: To tighten up your lower abs, imagine you’re cinching a seat belt around your waist.
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