A drug used to treat deadly cancers of the colon, pancreas and head and neck may be the next new wrinkle in wrinkle reversal -- if you're willing to put up with several days of unsightly and irritated skin.
For all but one of 20 subjects (aged 56 to 85 years old) at the University of Michigan in Ann Arbor, Fluorouracil, a chemotherapy agent formulated as a topical cream, improved the texture and look of sun-damaged facial skin after subjects applied it twice daily for two weeks, reports a study published in this week's Archives of Dermatology. The subjects' own assessments were seconded by the clinical observations of the study authors, as well as by a committee of dermatologists who reviewed photos of the subjects' faces, as well as by a molecular assessment of the patients' facial skin by researchers.
But make no mistake about it: The 13 men and seven women who underwent the Fluorouracil treatment were having no day at the spa. Twelve of the 19 subjects who completed the skin regimen reported that the treatment was very or moderately uncomfortable, bringing to the skin's surface many more irritated, scaly patches of pre-cancerous skin lesions than had been evident before treatment.
As the subjects endured itch, redness and fiery irritation, however, a biochemical analysis of their skin cells revealed they were mobilizing for an epidermal renewal. The building blocks for new layers of skin, including Type I and Type III pro-collagen, shot up. By Week 6 following the beginning of treatment, fine wrinkles appeared to relax -- a change that continued to progress at 10 and 24 weeks after treatment. By Week 10, subjects' skin was judged to be significantly softer -- and got softer still 24 weeks after treatment. Darkened "age spots" lightened as did the yellow tinge of sun-damaged skin.
"The remodeling of the dermal matrix, which follows the inflammatory phase of wound-healing, is the mechanism for the improved appearance of photo-damaged skin," the authors wrote. By all accounts, the Fluorouracil cream had injured the subjects' skin, calling forth the body's natural defenses to rebuild it.
"The observed biochemical changes are typical of a wound-healing response," wrote the authors.
Flourouracil has been used since the mid-1960s to treat actinic keratoses, the scaly, patchy, rough skin lesions that are a sign of sun damage and considered the earliest stage in the development of skin cancer. For cancer patients taking Flourouracil as systemic chemotherapy, physicians have noted for many years that after an initial outbreak of red, patchy skin, patients' skin texture changes to resemble the skin of someone decades younger.
Despite complaints about skin irritation and redness, 17 of the subjects in the University of Michigan study said they'd try the treatment again for cosmetic improvement of their skin. And 11 even said they'd pay for it out of their own pocket. The study was funded by Valeant Pharmaceuticals International, one of several generic pharmaceutical companies that manufactures Fluorouracil.
The demand for cosmetic surgery fell 12% last year in the United States, according to statistics published this week by the American Society for Aesthetic Plastic Surgery. Nearly every procedure declined in popularity, typically by 10% to 20%. Drops were noted in all groups and genders, but the decline in procedures among men was especially stark.
"Demand for these procedures is still strong and it's still up significantly from 10 years ago," says Dr. Sanjay Grover, a Newport Beach plastic surgeon and past president of the Orange County Society of Plastic Surgeons. "But I think people are being more careful about what they're spending money on."
Locally, Grover says, plastic surgeons are reporting dips in business from 20% to 40% in the first few months of 2009.
Nationwide, even might Botox fell by 8.4% among women in 2008, the ASAPS reported, although surgical procedures declined more than nonsurgical procedures, such as injectables and Botox. That doesn't mean there wasn't a whole lot of fixing going on, however. Overall, 10,258,557 surgical and nonsurgical cosmetic procedures were reported in 2008. And, for the first time, breast augmentation was the most popular surgical procedure, outpacing liposuction for the first time. The increase in breast augmentation is likely due to the return of silicon implants to the market, Grover says. Requests for laser skin resurfacing also soared last year, reflecting the use of fractional lasers that cause patients less recovery time compared with the resurfacing lasers used in the past.
As demand wanes, prices for some procedures are dropping, Grover says. But consumers should still shop cautiously.
"Even though the economy is tougher for everybody, patients still shouldn't let price be the driving factor," he says. "It's important for patients to select a board-certified plastic surgeon who has a particular interest in aesthetic plastic surgery."
The ASAPS consists of plastic surgeons certified by the American Board of Plastic Surgery. The statistics can be accessed on the group's website.
— Shari Roan
Photo credit: Kirk McCoy / Los Angeles Times
Chart: American Society for Aesthetic Plastic Surgery
Voting is a reward unto itself. Since many people around the world can’t vote, or are forced to vote in meaningless elections, it’s something we should never take for granted.
That said, some people in the health realm apparently do want to reward those casting ballots Tuesday with a little something extra. From the bottom of their hearts. Really.
Let’s start with O!burger. O!burger bills itself as "the first organic fast-food burger joint in Los Angeles," (even though it’s in West Hollywood) and is offering free 100% organic fries or fresh organic cookies with any burger order to everyone who votes, no matter who’s elected. That’s right — you could secretly back the Stay Puft Marshmallow Man and still get the healthy stuff free, between 11:30 a.m. and 9:30 p.m. on election day, providing you have that little sticker.
But that’s not all! What could be better than free food? How about discounted injectibles? Yes, a Beverly Hills plastic surgeon is offering 50% off Botox and $100 off Juvederm treatments through Nov. 15 to those who show an "I Voted" sticker. Is this a great country or what?
Dr. Payman Simoni, the doctor who’s offering the deal, says this is his way of saying thanks "to people who take this seriously."
Simoni, who became a U.S. citizen in 1997, says that in his native Iran, "We didn’t have the freedom that a person really needs," and adds that he’s always appreciated his right to vote.
This being Los Angeles, we told Simoni that he might have people lined up around the block waiting for those marked-down procedures. Maybe he should have considered free doughnuts instead.
"This is too precious to do it with doughnuts," he says.
Krispy Kreme doesn’t think so. It's offering a free star-shaped doughnut with patriotic sprinkles (i.e. red, white and blue) on Tuesday to customers with a sticker (at participating locations). Not that Krispy Kremes are the healthiest things around, but hey, they are cooked in "zero grams trans fat shortening," according to the company’s website. Not so sure about those sprinkles, though.
Several years after Botox parties raised eyebrows, a San Diego County bar has begun holding a spa night in which patrons can order up a shot of Botox. One doctor calls it the "next not-quite-so-logical step" in society's embrace of Botoxed faces.
NBCSanDiego.com reported last week that WineStyles Bar in Coronado has invited a doctor to deliver Botox shots one evening per week. According to the website article, the doctor will not drink during the visit and will refuse to treat patrons who have had too much to drink. These stipulations are unlikely to impress medical societies, such as the American Society of Plastic Surgeons, which warned consumers against receiving Botox treatments in nonmedical settings in a 2002 statement.
"Botox injections should be performed in a setting with appropriate medical personnel and necessary equipment to safely observe patients and deal with potential complications, as well as provide for the disposal of medical waste as required by Occupational Safety," the organization's statement says.
New York plastic surgeon Kevin Tehrani told the Los Angeles Times that Botox should be administered in a confidential setting, where a patient's complete health history is recorded; by a qualified health professional and where record-keeping, including photographs, and emergency care is available. Those medical and ethical considerations, he says, should deter most doctors from setting up shop in bars, adding a final objection: "This is not even entertaining the idea of BWI (Botox While Intoxicated)."
Tami Dennis, who takes the word "skeptic" to previously uncharted territory, is the Times' Health and Science editor. She's adamant that pitches promoting awareness days, weeks or months are, by their nature, non-stories. And, because she's an adult, she refuses to use words like "veggies," "tummy" and "yummy."
Rosie Mestel, deputy Health and Science editor, studied genetics before abandoning flies, fungi and DNA for health/medical writing. Her hero is the biologist Ernst Haeckel, whose jellyfish paintings inspired snazzy chandeliers. Her favorite toast-spread is Marmite, a British delicacy made of yeast extract. Her least-favorite word is "millenniums."
Melissa Healy is a staff writer for the Health section reporting from Washington D.C. Healy's a veteran of The Times' National staff, having covered the Pentagon, Congress, poverty and social welfare, the environment, and the White House before shifting to Health in 2003. She writes frequently about mental health and human behavior, about federal health policy, prescription medication and ethics in medicine. More wonk than wellness freak, Healy chooses to believe in the health benefits of coffee and wine, and considers water a better work-out medium than beverage.
Karen Kaplan covers genetics, stem cells and cloning. She and colleague Thomas H. Maugh II comprise about 25% of the unofficial MIT-Alumni-in-Journalism Club, and she is proud to have taken more math (5) than English (0) courses in college. Her contributions to Booster Shots will, she hopes, appear more frequently than postings to her mommy blog.
Thomas H. Maugh II has been a science and medical writer at the Times for 23 years. Before that, he was on the staff of the journal Science for 13 years.
He has bachelor's degrees in English and chemistry from MIT and a doctorate in chemistry from UC Santa Barbara.
After a brief stint as a sports writer, Shari Roan turned to health journalism and has covered the topic for The Times for 18 years. She is the author of three books and the mother of two daughters, both teenagers who refer to her as a "health freak." She likes to jog, watch baseball and is very happy that dark chocolate contains some health benefit.
Jeannine Stein writes about fitness, sports medicine and obesity for the Health section. She’s a gym rat from way back and never met an elliptical trainer she didn’t like. Well, maybe one or two. She tempers exercise with a steady diet of reality television because she believes it’s all about balance.
