HEALTHOUGHTS

SEEING SPOTS

Flat, brown splotches appearing on the hands and face are telling proof of years of accumulated sun damage. These permanent discolorations of the skin are known as age spots or sun spots.

Medically known as “solar lentigines,” the spots generally appear after age 40, although some people may experience them in their 30s. Also known as liver spots, their appearance has nothing to do with the liver, but with their color.

“By themselves, they’re totally benign and they don’t lead to skin cancer, but they are an indicator that your skin has accumulated far too much sun exposure,” says Arnold W. Gurevitch, M.D., chief of dermatology at the Keck School of Medicine. “And they make you look old.”

“They’re very common, affecting almost everyone who has fair skin,” he says.

Effective treatments do exist to remove or lighten the spots, but Gurevitch warns that additional sun exposure will cause the spots to return.

Treatment usually consists of a bleaching cream containing hydroquinone applied daily for several months, sometimes in conjunction with Retin-A or other acidic compounds.

For the face, chemical peels using a mild acid can fade the spots. If results are unsatisfactory, treatment with liquid nitrogen can freeze the spot off. This method works quickly, but can be mildly painful and requires several days or weeks of healing before the skin returns to normal, Gurevitch says. Lastly, laser treatments can remove the spots in much the same way that they are used to remove tattoos.

The only way to prevent age spots is to use liberal amounts of sunscreen—especially before age 40—avoid the sun and wear protective clothing, Gurevitch says.

OUTSMART SMOKING

Programs abound to quit smoking, and commercials extol the value of gum and patches that curb the desire to light up a cigarette.

But there is more to kicking the habit than just deciding to quit.

When it comes to women, body image and dieting may be important factors in the effectiveness of smoking cessation programs, according to Donna Spruijt-Metz, Ph.D., assistant professor of research in the Department of Preventive Medicine.

Spruijt-Metz studies lifestyle habits, including physical activity, nutrition and smoking, in young women. In her interviews with college-age women, respondents frequently say they smoke to temper their hunger.

“Smoking is a way people seem to deal with fidgetiness, giving them something to do with their hands, as well as provide an oral outlet that can be used to avoid food,” says Spruijt-Metz. “It also seems to be related to appetite.”

Actually, she says, smoking is linked to having a lower body mass index, which takes into account a person’s weight and height to fairly accurately gauge body fat.

However, the damage caused by smoking—from cancer to heart disease—far outweigh its effects on weight loss, Spruijt-Metz says. Instead, adopting a healthy eating plan and a program of consistent aerobic exercise (even something as easy as walking) can increase energy and relieve stress while fighting off the fat, without the risks of smoking.

Many female smokers fear they will gain weight if they quit, and on average, those who quit smoking do gain about 10 pounds after they stop. In one study, though, women who stopped smoking—and added 45 minutes of walking a day—gained less than 3 pounds.

Obviously, many women need to adopt alternatives to stay at a healthy body weight after smoking, or they risk falling back into the tobacco habit.

“For smoking cessation programs,” Spruijt-Metz says, “it’s critical to provide women with an exercise program—as well as help to stop smoking.”

LONG IN THE TOOTH

Decades of fluoridated water use and improved access to dental care have greatly reduced tooth loss in older Americans, helping dispel the popular belief that tooth loss and the need for dentures is a natural part of aging.

But although many people reach old age with their natural teeth, oral health care for seniors in nursing homes is generally mediocre at best and frequently deplorable, says Harold C. Slavkin, D.D.S., dean of the USC School of Dentistry.

“In 1940, one-third of seniors would have no teeth. Today, less than 7 percent have no teeth,” he says. The problem is that within 10 years of entering a nursing home, most residents have decayed teeth or other problems.

The primary reason is that many of the medications used by seniors reduce saliva production, a condition known as xerostomia. In fact, as many as 700 commonly prescribed drugs cause xerostomia, Slavkin says.

Other factors contributing to poor oral hygiene include:

And although unnecessary tooth loss is a real concern, new evidence also points to a link between poor oral health and heart disease. Studies show that bacteria and yeast microbes usually found only in the mouth can enter the blood stream, a process that is associated with significantly increased heart disease risk—although the exact mechanism for this is unclear, Slavkin says.

“Poor oral health is truly a silent epidemic and it has real health consequences,” Slavkin says. “We need to do a better job educating health care professionals, nursing home staff and the public about it.”

HOT STUFF

Whether it is the jalapeño or the habanero, the chili pepper can truly make the tongue (and eyes, throat and stomach) feel the burn.

The humble pepper also can help relieve the pain of arthritis in some patients.

Capsaicin, the substance that puts the “hot” in hot peppers, has been found to reduce arthritis pain when applied as a cream or gel to the painful area over the course of a few weeks, explains Thomas Susko, M.D., assistant professor of clinical medicine in the division of rheumatology and immunology.

Often found under the commercial name Zostrix, “Capsaicin cream is made from the extract of cayenne chili peppers,” Susko says. “It prompts excessive release of something called ‘substance P.’”

Substance P is found at the body’s nerve endings and is involved in the transmission of pain signals to the brain through the nervous system. It is, in a way, a messenger of pain (a concept familiar to those who have eaten too many chili peppers).

Application of capsaicin can cause increased pain or burning during its first week of use, Susko says. But after this time, it begins to reduce substance P and desensitize the area to pain. It must be used regularly to maintain its effectiveness, and though it can relieve symptoms, it is not a cure.

The capsaicin cream usually comes in two strengths, .025 percent and .075 percent, and may be of help to those with osteoarthritis and rheumatoid arthritis, as well as neuralgia sufferers. Because it is available over the counter and contains natural ingredients, many patients like the cream, Susko says.

But it should be used with care, he notes wryly: “As you’d imagine, it’s a bad thing if you get it in your eyes.”

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