Everybody who lives in NE Montana knows the burden of fighting dry skin especially in the winter given our very dry air. This author is no exception and speaks from both professional and personal experience. This time of year I almost daily see folks coming into my office asking about rashes that turn out to be dry skin and do not need a prescription as must as proper skin care.
To begin our discussion we must first understand that we cannot actually "moisturize" our skin effectively but can only effectively do things that trap our body's natural moisture in. Our body was designed to do this with our skin oils. We are all big on trying to get the proper soaps and body/face washed to help remove as much oil from our skin as we can but this is the worst things we can do for dry skin. Since we don't want to be oily we need to come up with the balance of keeping our skin lubricated without being a "grease ball."
The advice I give patients in my office is a combination of:
1) Shower no more than once a day unless absolutely necessary. Showering, especially with hot water, is one of the worst things we can do for drying out our skin. The only thing that dries us our more is soaking in a hot tub. When it comes to babies I recommend bathing no more than two or three times a week.
2) After showering pat dry with a towel, don't rub. Rubbing removes more of those natural oils that help hydrate our skin and further irritates already irritated skin.
3) Before you open the bathroom door and let the steam out apply lotion everywhere. The best moisturizer is Vaseline but it's obvious why most people do not want to use this one. I recommend Cetaphil, Eucerin or CeraVe. These are a little more expensive but are engineered to moisturize without increasing acne. All three are available locally and the first two are available in large sizes at Costco in Billings. Cheaper moisturizers often are more silky smooth but that is because they are water based rather than oil based so they do not trap in any of your body's moisture and their effects wear off after an hour or so. Many people will need to moisturize twice a day but with a good moisturizer few people need to do more than that.
I have found that these things will take care of most dry skin and prevent eczema from returning. If this does not work for you or you have questions I would be happy to discuss your individually situation. Just cal the Glasgow Clinic to schedule.
Saturday, December 8, 2007
Who Really Needs A PAP Smear Anyway
One question we often get ask at the Glasgow clinic is, "Do I really need a pap smear?" So to answer that question I wanted to start with talking about why anybody needs a PAP smear. The purpose as most people know is to screen for cervical cancer. Most cervical caner is related to HPV (Human Papiloma Virus) which is sexually transmitted. This virus causes irritation that leads to cancer so we try to screen to detect it early while it's at a very treatable stage. This leads to three questions:
1) Who needs to be screened?
2) How often do we need to screen?
3) When can we stop?
Today I am not going to address what an abnormal PAP means as this varies quite a bit and should always be discussed in the office with your doctor on a case by case basis.
To answer the first question, who needs to be screened. There are three different professional organizations who weight in on this topic including the American Cancer Society (ACS), the American College of Obstetrics and Gynecology (ACOG), and the US Preventative Services Task Force (USPSTF). All three recommend that we start PAP smear screenings three years after the onset of sexual activity or at the age of at the age of 21, whichever is first.
When it comes to how often women need screened the answer is a little more complex. For most women the answer is every year until you have had three negative PAPs and then every two to three years after that. For women at high risk screening may need to be more frequent. High risk means usually includes having multiple sexual partners or having a history of positive PAPs in the past.
The third question that women want to know is when can I stop getting these tests. The answer is not very well defined. The three above mentioned organizations all pose slightly different opinions. In general they say that women who meet all three criteria below NEVER need to be tested again.
1) Age 65-70
2) Have had at least three negative PAPs in the last 10 years.
3) Are not at high risk.
For this purpose not at high risk means sexually active only within a long term mutually monogamous relationship without a history of cervical or related cancers. We can also stop all PAP smears for women who have had a complete hysterectomy who do not have a history of cervical or uterine cancer.
The final word that I would like to add is the new vaccine Gardasil. This is a vaccine created to prevent HPV infection. It is available for women and girls ages nine to 26. It is a series of three shots that prevent the most common types of HPV and therefor prevent the majority of cervical cancer. It does not prevent all cervical cancer. This is heavily recommended for girls age 13-16 because to be most effective girls need to receive the vaccine before sexual activity. Currently most insurance companies in our area cover this vaccine and it is available through the Glasgow clinic so feel free to ask about it. More information about this vaccine is available at www.gardasil.com.
As always if you have any questions about any of the above material pleas schedule a visit with us at the Glasgow Clinic and we will be happy to discuss these things with you.
1) Who needs to be screened?
2) How often do we need to screen?
3) When can we stop?
Today I am not going to address what an abnormal PAP means as this varies quite a bit and should always be discussed in the office with your doctor on a case by case basis.
To answer the first question, who needs to be screened. There are three different professional organizations who weight in on this topic including the American Cancer Society (ACS), the American College of Obstetrics and Gynecology (ACOG), and the US Preventative Services Task Force (USPSTF). All three recommend that we start PAP smear screenings three years after the onset of sexual activity or at the age of at the age of 21, whichever is first.
When it comes to how often women need screened the answer is a little more complex. For most women the answer is every year until you have had three negative PAPs and then every two to three years after that. For women at high risk screening may need to be more frequent. High risk means usually includes having multiple sexual partners or having a history of positive PAPs in the past.
The third question that women want to know is when can I stop getting these tests. The answer is not very well defined. The three above mentioned organizations all pose slightly different opinions. In general they say that women who meet all three criteria below NEVER need to be tested again.
1) Age 65-70
2) Have had at least three negative PAPs in the last 10 years.
3) Are not at high risk.
For this purpose not at high risk means sexually active only within a long term mutually monogamous relationship without a history of cervical or related cancers. We can also stop all PAP smears for women who have had a complete hysterectomy who do not have a history of cervical or uterine cancer.
The final word that I would like to add is the new vaccine Gardasil. This is a vaccine created to prevent HPV infection. It is available for women and girls ages nine to 26. It is a series of three shots that prevent the most common types of HPV and therefor prevent the majority of cervical cancer. It does not prevent all cervical cancer. This is heavily recommended for girls age 13-16 because to be most effective girls need to receive the vaccine before sexual activity. Currently most insurance companies in our area cover this vaccine and it is available through the Glasgow clinic so feel free to ask about it. More information about this vaccine is available at www.gardasil.com.
As always if you have any questions about any of the above material pleas schedule a visit with us at the Glasgow Clinic and we will be happy to discuss these things with you.
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