Air Pollution Kills as Many People as Cigarettes

Oct. 8, 2019 -- When she turned 62 in 2012, Latifa Moosajee and her husband decided to downsize from their home in small-town Georgia. They moved into a brand-new townhouse in the commercial heart of Atlanta. “It was my dream home … close to my daughter’s family.”

Moosajee was excited to spend more time with her grandchildren and lead an active life in the city. But the very first year in her new home, she began to wheeze and have trouble breathing. At first, she tried allergy pills, thinking it was just a rough ragweed season. Over the next 5 years, she had longer and longer stretches of wheezing with trouble breathing, and she needed more and more medicines. She started short-acting inhalers, then long-acting inhalers, and eventually needed steroids just to keep her airways open.

The winters were the toughest. “For months at a time I had no energy… I could barely breathe,” Moosajee said. Her lung doctor ruled out the usual suspects. She had no history of lung disease. She didn’t smoke. No one around her smoked. She hadn’t changed her diet or started using new products in her home.

The only times she had similar problems were on her rare trips to India, which has some of the highest pollution levels in the world.

Figuring that out helped her zero in on the gridlocked street outside her window in Atlanta. “The cars pack the road from morning to night; only the evening would be clear.” Moosajee and her doctor began to suspect the polluted air she was breathing in for years was taking a toll on her health.

For millions of Americans like Moosajee, every breath brings toxic air deep into the lungs. There, pollutants can get into the bloodstream and cause damage throughout the body. The American Lung Association’s 2019 “State of the Air” report shows that more than 141 million people live in counties with unhealthy air, an increase of 7 million people from the 2018 report.

The science clearly shows that unhealthy air is dangerous. Air pollution, especially invisible, airborne particle pollution -- known as PM2.5 -- increases the risk of serious health problems. And it can kill. Even very low levels play a role in death from heart and lung diseases.

Most of us are not aware of the pollutants we are breathing in. Even fewer are paying attention to the long-term health risks of air pollution.

In the U.S., air monitoring stations collect data on pollutants like particulate matter and ozone so people can be alerted when levels are higher than what is considered acceptable. But these monitors don’t provide neighborhood-level information and may not catch “hot spots” where people like Moosajee live. This is quite true for people living on busy roads. Even on alert days, people who don’t have symptoms may not think they should heed the warnings.

Two young app developers in Paris want to change that.

Amaury Martiny came across Muller’s air pollution-to-cigarette calculation about a year ago and describes it as an “aha” moment.

Martiny and designer Marcelo Coelho created a free app using Muller’s formula and PM2.5 data from hundreds of air quality data stations in cities all around the world. When the app is open, it finds your phone, finds the closest air monitor data for PM2.5, and converts it into the “equivalent” number of health-damaging cigarettes. They found that many of their U.S. downloads happened during the California wildfires in 2018, when the app would have shown a staggering 45 cigarettes per day in the area of the wildfire.

Martiny and Coelho stress that their “main goal is to raise awareness about the risk of air pollution. … What was amazing about the equation was it transformed this very abstract scientific notion of PM2.5 to something that was really tangible to basically everybody. … Everybody knows the effect a cigarette can have on your body.” And everyone knows that there aren’t “safe levels” for cigarette smoking. 

Over the last 20 years, Americans have mostly been protected from high levels of air pollution because EPA programs have greatly improved air quality. The yearly average of fine particles has decreased by 40% since 2000. According to a 2017 Office of Management and Budget (OMB) report to Congress, the EPA’s air rules save tens of billions of dollars.

Most of the savings come from what are known as “co-benefits,” meaning benefits to human health that result in lower health care costs and fewer premature deaths.

 “We’ve done a good job of reducing our air pollution. It’s improved our health, and we’ve done it at a time of rapid economic expansion,” Pope says. “It’s very clear that this isn’t a tradeoff between clean air and jobs. The reality is we can reduce our air pollution while at the same time improving economic activity. So it’s sort of a win-win situation.”

But recent concerning changes at the EPA may affect air quality and health in the not-so-distant future. EPA leadership has moved to replace independent science advisers from important committees, like the Clean Air Scientific Advisory Committee (CASAC), and halted a panel of experts that have been studying the most up-to-date particle pollution science.

But the American Lung Association and other health advocacy groups have raised the alarm about EPA plans to limit or gut many of the programs that have cut air pollution and improved the health of American communities. The organization cites:

  • Plans to roll back fuel efficiency standards for cars and trucks
  • Repeal of the Clean Power Plan and replacement  with a rule that may increase emissions
  • Changes to how the EPA measures benefits to human health when cutting down on pollution from toxic air pollutants, including mercury and PM2.5

According to experts, all of these changes will likely lead to a reversal of the progress in reducing air pollution and preventing related deaths.

Though levels of air pollution are better in most communities in the U.S. than other places in the world, we can still do more to reduce our risk of long-term health problems. “The only thing that makes sense based on the evidence is that we should continue to try to reduce our exposure to air pollution. … It doesn’t come without effort, and it doesn’t come without vigilance,” says Pope.

Some of what we know about the health benefits of cleaner air comes from “natural experiments,” where researchers study what happens to people in areas after pollution levels come down, like when large factories shut down or traffic routes change. Most of these studies show improvements to health quickly.

After coal and oil power plants closed in California, there were fewer preterm births in neighboring communities. New electronic tolls (E-ZPass) in New Jersey and Pennsylvania reduced traffic congestion from idling cars, improved birth weights, and lowered early births for mothers living less than 1.5 miles from toll plazas. When air pollution was controlled during the Olympics in Beijing, birth weights for babies in the area improved. And when traffic was rerouted during the Olympics in Atlanta, there were fewer ER visits and hospitalizations for asthma for local children.

Worldwide, research shows that cleaner air from lower emissions leads to less asthma, lungs that work better, and less coughing, congestion, and mucus in young children.

The best way to reduce the risk of health problems is to avoid breathing in polluted air. This is especially true for pregnant women, babies, children, older adults, and those with chronic medical problems. But it’s hard to do if you live in high-traffic areas or close to polluting factories.

Facemasks, specifically those called respirators masks, can filter particle pollution if worn the right way. The main problem is that people have to buy the right mask and wear it with an airtight seal; otherwise, it won’t filter out harmful pollution. Also, most masks don’t filter out certain toxic gases and can still allow harmful lung irritation.

For most people, paying attention to air quality alerts is a good start. Avoiding outdoor activities on “unhealthy air days” is very important. Beyond air quality alert days, doctors recommend walking or exercising in areas far from high-traffic roads and idling cars or buses. High-quality HEPA air filters in the home can lower airborne particles. And eating a healthy diet and exercising can also lower the health risks from air pollution.

As for Moosajee, after years of trying air filters in her home and taking multiple medicines to improve her breathing, she eventually decided to move away. Two years ago, she found a home on a quiet, tree-lined neighborhood in Atlanta. Now 69, she sees a vast improvement in her breathing. “I see a big difference. I don’t use any steroids, no inhalers. I only use allergy pills for a few weeks in the year. I expected these problems when I went to India. … I can’t believe I would have the same problems here.”

But for most people, moving is not an option. Schraufnagel stresses that the most important thing people can do is to learn about the risks of air pollution. “If enough people say ‘we don’t want dirty air, we want clean air, and we’re afraid that it’s affecting our health’ .... then decision-makers will need to step up to make sure that the automobiles are cleaner and power plants are cleaner” so we can all breathe cleaner air.

New medication advances treatment for chronic rhinosinusitis with nasal polyps - Harvard Health Blog

Chronic rhinosinusitis is a long-lasting medical condition, usually caused by infection or exposure to irritants, such as allergies, that affects one in seven American adults. Symptoms include nasal obstruction, nasal congestion, nasal drainage, loss of smell and taste, and facial pain and pressure. Some people with chronic rhinosinusitis also develop additional symptoms, such as asthma and nasal polyps, that are exacerbated by underlying allergies. A nasal polyp is a noncancerous tumor that grows from the lining of the nose or sinuses and affects the drainage system of the sinuses.

While chronic rhinosinusitis is not a life-threatening condition, the chronic nature and progression of the disease can have a significant impact on quality of life, affecting work, productivity, and sleep, and leading to social and emotional consequences, such as depression and anxiety.

Recently, a new medication has been approved in the treatment of chronic rhinosinusitis with nasal polyps.

What is the new medication and how would it be used?

Current treatment includes a combination of therapies that target symptoms. These include medical and surgical treatments, such as antibiotics, short-term oral corticosteroids, steroid nasal sprays, sinus irrigation, and endoscopic sinus surgery. However, many people continue to experience symptoms despite treatment.

Earlier this year, the FDA approved dupilumab (Dupixent) to treat chronic rhinosinusitis with nasal polyps that is not adequately controlled with standard treatment. It is intended to be used together with the other established treatments.

Dupilumab is a human-derived monoclonal antibody, a type of drug that enlists the body’s immune system to help it do its job. It specifically inhibits IL-4 and IL-13 cytokines, chemicals involved in the inflammatory allergic response that leads to symptoms. It is given by injection, under the skin, every other week. It can be administered in a doctor’s office or self-administered at home.

Several clinical trials, including this study published in JAMA (and funded by the drug’s manufacturer), have looked into the effects of dupilumab on chronic rhinosinusitis with nasal polyps. In the JAMA study, participants received either dupilumab plus a steroid nasal spray or a placebo plus a steroid nasal spray, for 16 weeks. Those treated with dupilumab had significant improvements in nasal congestion and obstruction, sense of smell, and overall decreased need for oral corticosteroids and surgery. In those study participants who also had asthma, lung function improved. There were also reductions in nasal polyp size and improved appearance of the sinuses on imaging studies. Patients experienced improvement of symptoms as early as four weeks into treatment, and continued to experience greater improvement than the placebo group for up to one year.

Dupilumab is not a cure for chronic rhinosinusitis with nasal polyps. However, it is an exciting advancement in the treatment of a chronic condition that significantly impacts physical and emotional health.

How do I know if I have chronic rhinosinusitis with nasal polyps and if I am a candidate for dupilumab?

Chronic rhinosinusitis is commonly diagnosed by a primary care physician who can then refer you to an otolaryngologist, or ear, nose, and throat (ENT) physician, for specialty care. The ENT may perform a nasal endoscopy exam and recommend additional testing, such as imaging studies, to make the diagnosis of chronic rhinosinusitis with nasal polyps. Depending on the treatments you have tried, the ENT will assess whether you are an appropriate candidate for dupilumab.

Related Information: Controlling Your Allergies

Give Seniors a Annual Memory Checkup, Experts Say

By Steven Reinberg

MONDAY, Sept. 23, 2019 (HealthDay News) -- Many older people show evidence of mental decline, called mild cognitive impairment, but doctors often miss this sometimes early sign of dementia and Alzheimer's disease.

To help doctors get a better handle on their patients' mental state, the American Academy of Neurology (AAN) is urging physicians to assess patients aged 65 and older at least once a year.

The academy recommends that doctors use a mathematical tool that helps quantify their patients' memory and thinking skills.

"Since thinking skills are the most sensitive indicator of brain function and they can be tested cost-effectively, this creates an enormous opportunity to improve neurologic care," study author Dr. Norman Foster, of the University of Utah in Salt Lake City, said in an AAN news release.

Around the world, nearly 7% of people in their early 60s suffer from mild cognitive impairment, as do 38% of those aged 85 and older, according to the AAN.

Using the new metric can alert doctors so that optimal care can be provided. Although there is no cure for mild cognitive impairment, its presence can help doctors keep watch should the patient progress to dementia.

"We cannot expect people to report their own memory and thinking problems because they may not recognize that they are having problems or they may not share them with their doctors," Foster said.

"Annual assessments will not only help identify mild cognitive impairment early, it will also help physicians more closely monitor possible worsening of the condition," he added.

The report was published online Sept. 18 in the journal .

Pacemakers, Insulin Pumps Could Be Hacking Targets: FDA

By Steven Reinberg

TUESDAY, Oct. 1, 2019 (HealthDay News) -- Medical devices that can connect to the internet might be at risk for hacking, the U.S. Food and Drug Administration warned Tuesday.

"While advanced devices can offer safer, more convenient and timely health care delivery, a medical device connected to a communications network could have cybersecurity vulnerabilities that could be exploited resulting in patient harm," said Dr. Amy Abernethy, the FDA's principal deputy commissioner.

"The FDA urges manufacturers everywhere to remain vigilant about their medical products to monitor and assess cybersecurity vulnerability risks, and to be proactive about disclosing vulnerabilities and mitigations to address them," Abernethy said in an agency news release.

This warning concerns several operating systems that could affect medical devices connected to a network like Wi-Fi and public or home internet, and equipment such as routers, phones and other communications gear, the agency said.

It's possible that an attacker could exploit these vulnerabilities and take control of a medical device, change its function, cause denial of service, or cause information leaks. Logical flaws can also be introduced that could cause the device not to work properly or at all.

So far, the FDA hasn't received any report of a device being hacked.

"While we are not aware of patients who may have been harmed by this particular cybersecurity vulnerability, the risk of patient harm if such a vulnerability were left unaddressed could be significant," said Dr. Suzanne Schwartz, deputy director of the Office of Strategic Partnerships and Technology Innovation in the FDA's Center for Devices and Radiological Health.

"The safety communication issued today contains recommendations for what actions patients, health care providers and manufacturers should take to reduce the risk this vulnerability could pose," Schwartz said in the release. "It's important for manufacturers to be aware that the nature of these vulnerabilities allows the attack to occur undetected and without user interaction."

These vulnerabilities are in software called IPnet that computers use to talk to each other over networks.

Systems that include IPnet are:

  • VxWorks (by Wind River)
  • Operating System Embedded (OSE) (by ENEA)
  • INTEGRITY (by Green Hills)
  • ThreadX (by Microsoft)
  • ITRON (by TRON)
  • ZebOS (by IP Infusion).

The FDA urges patients to talk to their doctors to see if their device could be affected and to get help right away if they notice that the functioning of their device has changed.

The agency is also working with manufacturers to identify products that could be vulnerable and come up with plans to thwart any potential breaches.

Luxury Spa Treatments To Try At Home

A busy lifestyle leaves little opportunity to relax, unwind and carve out much-needed “me” time. Yet, when you’re always on the go, stress can spin out of control. If dedicating time to self-care seems daunting, start small. To set you on the path to wellness, we’ve compiled seven mini spa treatments to try at home. Practice one of these rituals a day - or mix and match - to enhance your overall health and well-being:

  • ?Fruit-Infused Water & Herbal Tea
  • Hand Massage
  • Aromatherapy Shower
  • Body Scrub
  • Mask & Milk Bath
  • Dry Brushing
  • Meditation
  • Fruit-Infused Water & Herbal Tea

    There’s a reason your favorite spa serves fruit-infused water and herbal tea. Both beverages encourage you to slow down and savor the moment. Plus, their ingredients boast plenty of benefits for mind and body health. Sip them morning and night to experience a taste of the spa from the comfort of your own home.

    Spa Water

    Spa water - or “detox” water - is water that has been infused with fresh fruits, vegetables or herbs, usually overnight. While it won’t necessarily detoxify your system, it will provide the hydration your body needs to function at its best (plus, it’s delicious). Here are a few of our favorite fruit-infused water combinations:

  • Cucumber + Mint
  • Strawberry + Basil
  • Grapefruit + Rosemary
  • Berry + Green Tea
  • Herbal Tea

    Herbal tea, on the other hand, is well-known for its lengthy list of health benefits. These brews, which have been used in traditional medicine for centuries, are brimming with antioxidants, vitamins and minerals. Herbal teas have the potential to relieve stress, calm your mind and body, support brain health and boost your immune system. Here are two of our favorite blends:

  • Chamomile + Lavender (soothes and relaxes the mind and body)
  • Peppermint + Lemon (promotes focus and boosts mental performance)
  • Hand Massage

    No time for a full body massage? No worries. An easy way to unwind is to give yourself a five-minute hand massage. This type of massage not only releases tension after a day spent typing and texting but also calms the nervous system and enhances circulation. Here’s how to perform one at home:

  • Warm a few drops of your favorite body oil or lotion between your palms. Our pick: Stone Crop Body Oil, which is infused with stone crop and arnica and is ideal for massage treatments.
  • Begin with your palm facing up and firmly press the tip of each finger.
  • Use the thumb of the opposite hand to rub the muscles surrounding your palm with gentle, circular motions. Pay particular attention to the fleshy area between your thumb and wrist as well as at the base of your fingers.
  • Slowly knead the center of your palm.
  • Slide your thumb down your palm in long, straight strokes. Focus on the space between each tendon, starting at the base of your fingers and ending at your wrist.
  • Flip your hand over and repeat step four along the back of your hand.
  • Palm up, rub each individual finger using small, counter-clockwise motions and moving from the base of the finger to the tip.
  • Switch hands.
  • Aromatherapy Shower

    Bring the spa home by adding an aromatherapy element to your daily shower. According to Healthline: “Inhaling the aromas from essential oils can stimulate areas of your limbic system, which is a part of your brain that plays a role in emotions, behaviors, sense of smell and long-term memory.” Creating an at-home aromatherapy shower is simple:

  • Spray your favorite essential oil blend onto a washcloth
  • Tuck it into a corner of your shower
  • Let the water run for 5-10 minutes
  • Step into the oil-infused steam
  • Take a deep breath and relax into the present moment
  • Not sure which essential oil to choose? Try these selections for a relaxing, stimulating or balancing soak:

  • Relaxing: neroli, jasmine, ylang ylang
  • Stimulating: citrus oils, rosemary, eucalyptus
  • Balancing: lavender, clary sage, bergamot
  • Body Scrub

    Elevate your at-home spa treatment with a body scrub. These are physical exfoliants that use salt and/or sugar to mechanically slough away dead skin cells, draw out impurities and smooth rough, dry skin. But, which to choose? Try a product like our Stone Crop Revitalizing Body Scrub which blends both hydrating sugar and invigorating salt to provide long-lasting, luxurious exfoliation. 

    Applying a body scrub has plenty of benefits for the skin:

  • Promotes efficient circulation and skin cell turnover
  • Removes dead cells from the skin’s surface
  • Smooths and softens rough, dry skin
  • Draws out impurities and clears congestion
  • Frees ingrown hairs and smooths razor bumps
  • Mask & Milk Bath

    If a bath is more your style, follow Cleopatra’s lead and sink into a soothing milk bath. Adding milk to your bath water has plenty of benefits. Milk is packed with healthy fats, proteins, lactic acid, vitamins and minerals which help to soften and soothe dry, itchy skin. 

    To make a milk bath:

  • Add 1-2 cups of milk to a full tub of warm water
  • Mix in your favorite body oil (we recommend our ultra-hydrating Apricot Body Oil)
  • Add extras like rose petals, herbs, honey and/or oats
  • Let ingredients soak for 15 minutes
  • Step in, sit back and relax
  • To truly indulge, apply your favorite Eminence Organics face mask. Our Rosehip & Maize Exfoliating Masque combines rosehips, lemon juice, maize flour and honey to smooth and revitalize your skin’s appearance. Apply a thin layer with your fingertips and leave on while you soak into your milk bath. Afterward, remove the mask with a damp cloth to reveal a radiant-looking complexion.

    Dry Brushing

    Another body treatment to try at home is dry brushing. This ancient technique has gained popularity over the years for its ability to boost circulation, detoxify the skin and reduce the appearance of cellulite. And, it’s incredibly easy to do at home! Here’s how:

  • Step into the shower (but don’t turn on the water)
  • Reach for a body brush with stiff, natural bristles
  • Brush your body using long, sweeping motions
  • Begin at your feet and move upward, toward the direction of your heart
  • Brush each area several times; overlap as you go
  • Rinse away dead skin and debris
  • Follow your dry brush with a toning body cream that will continue to target areas of concern. The Stone Crop Contouring Body Cream contains extracts of microalgae and coffee to smooth skin and improve the look of cellulite. Massage it into cleansed skin, focusing on problem areas, and leave on. 

    Meditation

    It’s no secret that meditation is incredibly beneficial for mind and body health. For thousands of years, it has been celebrated for its ability to train the mind to focus, stay in the present moment and gain a deeper awareness of self and surroundings. With regular practice, meditation has been shown to impart the following benefits: 

  • Relaxes the mind and body
  • Lowers cortisol levels and relieves stress
  • Increases feelings of positivity and happiness
  • Enhances communication and decision-making
  • Improves memory and focus
  • Unsure how to start a meditation practice? Try adding five minutes of mindful breathing to your daily routine:

  • Sit comfortably
  • Close your eyes and relax your body
  • Slowly inhale through your nose and out your mouth
  • Breathe deeply, filling your lungs and expanding your diaphragm
  • Focus on the sensation of breath entering and leaving your body
  • Follow your breath in and out for five minutes
  • When your mind wanders, return to your breath
  • What wellness rituals do you practice at home? Share them with us in the comments below and join the conversation on social media.

    $8 Billion Award in Risperdal Lawsuit

    A lawsuit over the antipsychotic drug Risperdal has led to an $8 billion punitive damages award against Johnson & Johnson and one of its subsidiaries.

    The award was handed out Tuesday by a Philadelphia jury. The plaintiff's attorneys argued that the drug is linked to abnormal growth of female breast tissue in boys, the reported.

    In a statement, attorneys Tom Kline and Jason Itkin said Johnson & Johnson used an organized scheme to make billions of dollars while illegally marketing and promoting the drug.

    Johnson & Johnson said the award is "excessive and unfounded" and that it would take immediate action to overturn it, the reported.

    Dense breasts on a mammogram? What to know and do - Harvard Health Blog

    You’re staring at a letter from your mammography facility. Your breast exam was normal, great. But then you see a note on the bottom: you have high breast density, which could put you at higher risk for breast cancer in the future. Now what?

    “The finding of dense breasts on a mammogram can be stressful and confusing for patients,” says Dr. Toni Golen, acting editor in chief of Harvard Women’s Health Watch. It’s information that may concern them, but they don’t know what to do about it.

    What is breast density?

    Breasts are composed of:

    • lobules, which produce milk
    • ducts, tubes that carry milk to the nipple
    • fatty tissue, similar to fat in other parts of your body
    • fibrous connective tissue, which gives the breast its characteristic shape.

    Dense breasts have more active tissues — lobules, ducts — and less fat. The only way to tell if you have high breast density is by having a mammogram. Dense breasts don’t feel or look any different from breasts that have a larger proportion of fatty tissue.

    Density is typically gauged by the radiologist who reads the mammograms. It is classified on a scale of 1 to 4, with 1 being the least dense and 4 being the most. Women who score a 3 or a 4 are typically said to have high density.

    Breast density often changes over time. Younger women typically have higher density than older women, and density typically declines after menopause. But this is not always the case. Some older women still have dense breast tissue. Taking hormone therapy may also increase breast density.

    How much does high breast density affect cancer risk?

    Estimates vary, but a 2011 study in the Journal of the National Cancer Institute found that women with breasts composed of 50% or more dense tissue were three times more likely to be diagnosed with breast cancer over a 15-year period than women who had less than 10% dense tissue in their breasts.

    What are experts saying about breast density?

    Experts want women to know that high breast density

    • means you have more active breast tissue, and it is a risk factor for breast cancer
    • can make it more difficult for a radiologist to see a cancer on a mammogram.

    “Right now, we have a risk factor without a plan to manage it,” says Dr. Kathryn M. Rexrode, associate professor of medicine at Harvard Medical School and chief of the Division of Women’s Health at Brigham and Women’s Hospital. While doctors know that women with high density are slightly more likely to develop breast cancer, there is no consensus yet on how to respond to that risk. Should women with high density be screened at a younger age, more often, or using different technology? There’s no official plan.

    “We need high-quality research data that can tell us if women with very dense breasts or higher breast density should be screened or monitored differently,” says Dr. Rexrode.

    What actions can you take?

    If you do receive this notification:

    Talk to your doctor about how your density affects your overall risk of breast cancer. If you have additional risk factors for breast cancer, your doctor may recommend changes to your breast cancer screening regimen.

    “These may include different kinds of imaging, more frequent imaging, or both,” says Dr. Golen. Doctors sometimes recommend that women at high risk for breast cancer be screened using breast ultrasound or magnetic resonance imaging (MRI) in addition to mammography to help find cancers that can’t be seen on a mammogram.

    Consider different screening technology. In the June issue of Harvard Women’s Health Watch, we highlighted a recent study that showed that digital breast tomosynthesis (DBT), sometimes referred to as 3D mammography, might be better at detecting cancers in younger women and those with dense breast tissue.

    DBT is a relatively new technology, approved by the FDA in 2011. It works by taking a series of images, which a computer then assembles into a 3D-like image of breast slices. In the study, which was published online February 28 by JAMA Oncology, researchers compared more than 50,000 breast screenings performed with DBT and 129,369 performed with digital mammography. Their analysis found that DBT identified 1.7 more cancers than digital mammography for every 1,000 exams of women with normal breast tissue. For younger women with dense breasts, the advantage of DBT was even greater: 2.27 more cancers were found for every 1,000 women screened.

    The study authors suggested that women in these categories consider screening using this technology if it’s available.

    Related Information: Harvard Women’s Health Watch

    Adult acne: Understanding underlying causes and banishing breakouts - Harvard Health Blog

    “I’m not a teenager anymore, why do I still have acne?!” This is a question we hear from patients on a daily basis. The truth is, it is quite common to see acne persist into adulthood. Although acne is commonly thought of as a problem of adolescence, it can occur in people of all ages.

    Adult acne has many similarities to adolescent acne with regard to both causes and treatments. But there are some unique qualities to adult acne as well.

    What causes adult acne?

    Adult acne, or post-adolescent acne, is acne that occurs after age 25. For the most part, the same factors that cause acne in adolescents are at play in adult acne. The four factors that directly contribute to acne are: excess oil production, pores becoming clogged by “sticky” skin cells, bacteria, and inflammation.

    There are also some indirect factors that influence the aforementioned direct factors, including

    • hormones, stress, and the menstrual cycle in women, all of which can influence oil production
    • hair products, skin care products, and makeup, which can clog pores
    • diet, which can influence inflammation throughout the body.

    Some medications, including corticosteroids, anabolic steroids, and lithium, can also cause acne.

    Many skin disorders, including acne, can be a window into a systemic condition. For example, hair loss, excess hair growth, irregular menstrual cycles, or rapid weight gain or loss in addition to acne, or rapid onset of acne with no prior history of acne, can all be red flags of an underlying disease, such as polycystic ovarian syndrome, or other endocrine disorders. Tell your doctor if you are experiencing additional symptoms; he or she may recommend further evaluation.

    How can I prevent breakouts?

    Like most things in life, acne is not always completely in one’s control. There are, however, some key tips we offer to help prevent breakouts:

    • Never go to bed with makeup on.
    • Check labels: when purchasing cosmetic and skincare products, always look for the terms “non-comedogenic,” “oil-free,” or “won’t clog pores.”
    • Avoid facial oils and hair products that contain oil.
    • Some acne spots are not actually acne but are post-inflammatory pigment changes from previous acne lesions or from picking at acne or pimples. Wear sunscreen with SPF 30+ daily, rain or shine, to prevent darkening of these spots.

    There is some evidence that specific dietary changes may help reduce the risk of acne. For example, one meta-analysis of 14 observational studies that included nearly 80,000 children, adolescents, and young adults showed a link between dairy products and increased risk of acne. And some studies have linked high-glycemic-index foods (those that cause blood sugar levels to rise more quickly) and acne.

    With that said, it’s important to be wary of misinformation about nutrition and skin. As physicians, we seek scientifically sound and data-driven information; the evidence on the relationship between diet and acne is just starting to bloom. In the future, the effect of diet on acne may be better understood.

    What are the most effective treatment options?

    The arsenal of treatment options for acne treatment is robust and depends on the type and severity of acne. Topical tretinoin, which works by turning over skin cells faster to prevent clogged pores, is a mainstay in any acne treatment regimen, and has the added bonus of treating fine wrinkles and evening and brightening skin tone. Isotretinoin (Accutane, other brands), taken by mouth, is the closest thing to a “cure” for acne that exists and is used to treat severe acne. Women who can become pregnant need to take special precautions when taking isotretinoin, as it can cause significant harm to the fetus.

    For women with hormonally driven acne that flares with the menstrual cycle, a medication called spironolactone, which keeps testosterone in check, can be prescribed. Oral birth control pills can also help regulate hormones that contribute to acne.

    In-office light-based treatments, such as photodynamic therapy, can sometimes help. Chemical peels, also done in-office, may help to treat acne and fade post-inflammatory pigment changes.

    Simple, non-irritating skin care products are important for anyone with acne. Choose products that are gentle and safe for skin with acne, and eliminate products that are harsh and can make matters worse. It’s also important not to squeeze or pick at acne lesions, as that can worsen discoloration and scarring.

    With proper evaluation by a board-certified dermatologist and commitment to a treatment regimen, almost all cases of acne can be successfully treated. After all, adulthood is stressful enough without breakouts!

    Follow us on Twitter @KristinaLiuMD and @JanelleNassim

    Related Information: Skin Care and Repair

    Sleeping In Makeup: Why It's A No-No & How To Remove Makeup Properly

    One of the biggest beauty blunders is forgetting to remove your makeup before bed. Sleeping in cosmetics can cause countless problems including dullness, congestion and inflammation. That’s why it’s crucial to remove your makeup thoroughly before your head hits the pillow. We have all the tips you need to learn how to properly remove your makeup.

    What Happens When You Don’t Remove Makeup?

    Is it really so bad to sleep in your makeup? While one slip up won’t ruin your complexion, consistently skipping this skin care step can cause cumulative damage over time. Here’s a breakdown of what happens to your skin when you don’t give it a thorough cleanse before bed.

    Free Radical Damage

    During the day, your skin accumulates oxidative stress through contact with pollution, blue light and UV rays. These environmental stressors expose your skin to free radicals - highly unstable molecules that attack otherwise healthy cells, causing dullness, inflammation and premature aging. Silicone primers, foundations and powders may be key to your beauty routine, but these occlusive cosmetics can exacerbate free radical damage.

    “Free radicals cling to makeup, causing a number of skin issues - including collagen breakdown.”

    Makeup traps free radicals against your skin and, when left on, prevents it from repairing overnight. Eminence Organics Product Support Representative Alicia Hawthorne tells us: “Free radicals cling to makeup, causing a number of skin issues - including collagen breakdown.” When you sleep in your makeup, you deprive your skin of the opportunity to recover from the day’s oxidative stress. As a result, damage to structural proteins like collagen and elastin continues, and your skin takes on the visible signs of aging more quickly.

    Dull Skin

    There’s truth to the term “beauty sleep”: Your skin performs its most important regenerative functions overnight. While you sleep, growth hormone kicks into gear and stimulates skin cell renewal. This triggers the skin’s natural turnover process whereby dead and damaged skin cells are shed from the surface and replaced by new, healthy cells. Makeup interferes with this cycle by trapping dead skin and preventing it from sloughing away. 

    We naturally shed close to 50 million skin cells a day. When skin cell turnover is interrupted, dead cells aren’t efficiently removed and accumulate on the skin’s surface. This contributes to a dull, dry and lackluster complexion. Dendy Engelman, MD tells SELF: “When we’re not exfoliating or removing those top surface cells as quickly, the light doesn’t reflect off the skin as nicely as it does when it’s very clean and properly exfoliated. Even if your skin doesn’t break out, it is going to look older, rougher and less radiant.”

    Clogged Pores & Breakouts

    The fact that comedogenic products lead to breakouts is a no-brainer - and the potential for acne is amplified when these types of cosmetics are left on overnight. Acne occurs when oil, debris and bacteria combine, causing infection and inflammation. Wearing makeup to bed traps these impurities under the skin, increasing the risk of a breakout. 

    In fact, there’s a type of acne that is caused specifically by makeup. Acne cosmetica is caused by pore-clogging makeup and displays as tiny bumps and whiteheads on the cheeks, chin and forehead. If you’re going to sleep with a full face of makeup on, you’re not only preventing these breakouts from clearing but also contributing to their emergence in the first place. 

    Irritation & inflammation

    Makeup’s occlusive effect also contributes to skin irritation and inflammation. Heavy cosmetics form a barrier overtop of the skin that locks in environmental irritants such as chemical agents, allergens and pollution. Cosmetics themselves often include synthetic ingredients and fragrances that are irritating to the skin - especially when left on for a prolonged time. When these irritants are left to fester, they can cause an inflammatory response.

    Inflammation is the skin’s first line of defense against external stress. When faced with harmful stimuli, the skin issues an immune response that rushes blood to the area. While this is meant to speed up healing, it also results in uncomfortable symptoms such as heat, swelling and redness. For some skin types, this can be temporary but for others - especially sensitive - it can cause ongoing discomfort in the form of blotchy, itchy and dry skin.

    How To Remove Your Makeup

    You have a handle on the importance of removing your makeup before bed, but how do you do it properly? If you’ve ever detected a trace of mascara smeared under your eye or a smudge of foundation on your pillowcase - even after you’ve washed your face - you’re probably not making the most of your cleansing routine. Follow these tips to ensure you clear every last bit of makeup from your complexion.

    Avoid Cleansing Wipes

    First, skip the cleansing wipes. While they may be convenient, most makeup wipes won’t fully remove your makeup. As James C. Marotta, MD tells Good Housekeeping, “Very few makeup wipes contain ingredients that can actually break down all of your face oils, makeup and gunk on your skin, so you’re really just rubbing bacteria, irritants and makeup wipe residue around your skin.” Plus, many cleansing wipes contain chemical ingredients and preservatives that can irritate the skin and cause dryness.   

    Double Cleanse

    The best way to remove makeup is to double cleanse. This cleansing technique uses an oil-based cleanser to break up and lift makeup, followed by a second cleanser of your choice (we suggest a gel-based option like our Stone Crop Gel Wash) to sweep away impurities. If you have an oily skin type, don’t let the “oil” in “cleansing oil” scare you: Like attracts like, and natural oils will not only clear makeup, but also lift excess sebum from your skin’s surface. 

    These are the steps to perform a double cleanse:

  • Break down makeup with a cleansing oil or balm: The oil in the cleanser will solubilize oil-based products like foundation and mascara so they lift easily from your skin’s surface. Warm a small bit of cleansing oil or balm in your hand. Then, use your fingers to swipe it across your eyelids and lips and use circular motions to lightly massage it over your face. Rinse clean with lukewarm water. 

  • Remove impurities with a second cleanser: Now that you’ve loosened and lifted your makeup, you need to sweep away stubborn dirt, grime and bacteria that are left on the skin. Simply apply your favorite cleanser to wash your skin more deeply and target specific skin concerns such as acne or aging. With this two-step process, you clear both types of impurities that can clog pores, dull your skin and contribute to premature aging. 

  • Ready to start double cleansing? Watch this video for tips and product recommendations from Eminence Organics Lead Skin Care Trainer Natalie Pergar:

    Don’t Forget Your Neck & Hairline

    You may have removed an inch of foundation from your face, but be sure you haven’t skipped your neck and hairline. If you stop short of these easy-to-miss areas, you can accumulate makeup residue that clogs pores and leads to breakouts. Pull back your hair with a headband and extend your face wash past your jaw to ensure you catch every last bit of makeup.

    Remove Eye Makeup - Gently

    Waterproof mascara and eyeliner can be notoriously difficult to remove. If you’ve done a double cleanse, you’ve probably removed most of your eye makeup, but it’s worth touching up the area with a natural and organic makeup remover. 

    Before you tackle your eye area, remember that the skin there is thinner and more delicate, so it’s important to be gentle. Rather than rub vigorously, saturate a cotton pad with remover and hold it over each eye for ten seconds. This will give it time to break up and dissolve the product before you gently wipe it off. Tackle the eye line and inner corners with a cotton bud to complete your cleanse.

    Use Steam

    Still not feeling quite clean? You can give your skin a facial steam to deepen your cleanse. Steam softens surface debris and releases any leftover grime and makeup that is still trapped in your pores after cleansing. Follow these steps for a facial steam at home:

  • Fill your sink or a bowl with hot water.
  • Place a large towel over your head.
  • Hover your face five to ten inches away from the steam. Lower or raise your head for more or less heat.
  • Steam for five to ten minutes (we recommend two minute intervals so you don’t overheat).
  • What To Do After You’ve Removed Your Makeup

    Makeup removal gives your skin a clean slate - but it needs to be followed with proper care to maintain your skin’s health and resilience. After cleansing, continue your skin care routine with these essential steps:

  • Apply a toner or facial mist to hydrate your skin and prep it for the skin care products that follow.
  • Use a serum, oil or concentrate to target specific skin concerns and conditions. 
  • Moisturize to lock in hydration and protect your skin’s lipid barrier. 
  • Tap on an eye cream for a bright and smooth eye area. 
  • Apply SPF to protect your skin from the drying and aging effects of UV rays. 
  • Which products are part of your cleansing routine? Visit an Eminence Organics partner spa for skin care recommendations from a licensed esthetician! Use our Spa Locator to find a spa near you. 

    Sundays With Tabs the Cat, Makeup and Beauty Blog Mascot, Vol. 574 - Makeup and Beauty Blog

    Tabs’s relationship with birds was complicated. On one hand, he deeply believed, to the core of his being, that he was a birder.

    Not a mouser, but a birder 100%.

    This, of course, was all fine and good till he actually had to work with birds. I can’t imagine how challenging it must have been to pose alongside a coworker, while also wanting to gobble them up.

    But Tabs was a consummate professional. He never actually ate a bird on set…that we know of.

    I’ve been thinking about him a little more than usual today because we have a woodpecker issue. The exterior walls of our condo are being pecked into Swiss cheese by a gang of angry woodpeckers!

    OK…I don’t actually know if they’re angry, but I think they are.

    I don’t think Tabs would have viewed them as his enemy though. During his golden years, he was kind of like the cat equivalent of the Dalai Lama, and he was all about zen and living peacefully with other creatures, including ones you want to eat.

    Oh, how I wish I could evolve to that state of enlightenment with these woodpeckers…

    Your friendly neighborhood beauty addict,

    Karen

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