What is hair effluvium?
dients: tretinoin, hydroquinone and fluocinolone, a cortisone drug. All are prescription items. None works overnight.
Doctors can remove those brown spots by freezing them off. It’s an immediate treatment. Lasers also can get rid of them. So can dermabrasion, the sandpapering of skin, often used for acne scars.
These treatments are considered cosmetic procedures and might not be covered by insurance.
TO READERS: The booklet on stroke explains this common and tragic condition and its rehabilitation. Readers can order a copy by writing: Dr. Donohue — No. 902, Box 536475, Orlando, FL 328536475. Enclose a cheque or money order (no cash) for $6 Cdn with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Will you please give me some information on Reglan? I would like to know what it’s used for and what side effects it has. — J.T
ANSWER: Reglan (metoclopramide) speeds the passage of food through the stomach and the first parts of the small intestine. It also enables the esophageal sphincter to close more tightly. The sphincter is an encircling muscle at the bottom of the esophagus that prevents stomach acid from squirting upward into the esophagus.
Reglan is used for GERD, gastroesophageal reflux disease (heartburn) because of its effect on the sphincter muscle. It’s also prescribed for gastroparesis, a stomach condition in which it takes an inordinately long time for food to pass through the stomach. This condition often is due to diabetes.
It also has “off-label” uses. One is to control nausea and vomiting. Another is control of Tourette’s syndrome.
Involuntary muscle contractions, facial grimacing, signs suggestive of Parkinson’s disease and grogginess are some of its possible side effects. It can raise blood pressure and have some ill effects on the liver. TORONTO — The spot was very dark, almost black, barely the size of a pencil eraser, and would bleed when Jackie Connors shaved her legs.
She initially chose to ignore it. But at age 20 while in nursing school and learning about the signs and symptoms of skin cancer, it soon would become a cause for concern.
“I still remember sitting at my desk thinking, ‘Wow, this is what I have,’ and still trying to put it in the back of my mind of not wanting to think that it could be that,” Connors recalled in a telephone interview from St. John’s, N.L.
Her family doctor thought she was too young to have skin cancer, but referred her to a surgeon to have the spot removed.
About a week after he’d taken it off, the surgeon called her and confirmed her initial fears — she had melanoma.
“I was devastated, I was, for a lot of reasons,” Connors recalled of her reaction. “(Not) just for the diagnosis of cancer but also knowing I couldn’t tan anymore.”
“As scary as it sounds, that was one of the things that went through my mind was: ‘Oh my gosh, I’m not going to be able to tan anymore.”’
From around age 16, Connors had frequented tanning salons, paying visits three times a week. She started out first using lie-down tanning beds which took 20 minutes then switched to the stand-up booths which took about half the time.
“I felt better, I thought I looked better with a tan, but just the feeling too, the heat, the warmth, knowing that you were tanning was one of the things I enjoyed, too.”
Now 36, Connors is part of a new campaign by the Canadian Dermatology Association which features melanoma survivors encouraging young women to learn the facts about indoor tanning.
The CDA has long advocated against indoor tanning use. But with its “Indoor Tanning is Out” campaign, launched Monday, the organization representing Canada’s dermatologists is targeting its message toward young women.
The association says melanoma has become the third most common form of cancer among young Canadian women.
Connors and three other melanoma survivors in their 20s will be among those featured in posters sharing their experiences. TV and radio PSAs will be aired until June, including March Break and pre-prom, when the CDA says many young people seeking tans use indoor tanning equipment.
Dr. Cheryl Rosen, national director of the CDA’s Sun Awareness Program, said it seemed most logical to focus on young women in their teens and 20s as they seemed to be among those who most frequently use indoor tanning facilities.
Part of the issue is that for many people, having a tan is correlated to beauty, she said.
“We did focus groups a while ago that showed people felt a tan made them look sexier, made them look more beautiful,” Rosen said.
“The tan is certainly valued by many people and our message is be happy with the colour skin you’re born with because tanning is a response to the skin of being injured. Tanning is a way our skin protects itself.”
Rosen said dermatological groups have been working toward having tanning devices banned for those 18 years of age and under. New Brunswick is currently the only jurisdiction in Canada that prohibits those under 18 from using tanning beds.
Last year, a working group of the WHO’s International Agency of Research on Cancer classified ultraviolet-emitting tanning devices as “carcinogenic to humans.” Tanning beds and UV radiation were moved into the highest cancer risk category.
Analysis of more than 20 epi- demiological studies revealed the risk of skin cancer increased by 75 per cent when the use of tanning devices starts before the age of 30, the working group found.
The group said the findings reinforced current WHO recommendations to avoid sunlamps and tanning parlours as well as to steer clear of sun overexposure.
But the president of Canada’s largest indoor tanning company disputes the links made between melanoma and UV exposure.
“As it relates to melanoma and UV light, there is correlative evidence but correlation does not mean causation,” Doug McNabb of Fabutan Sun Tan Studios said in a phone interview from Calgary on Monday.
“There are studies that show correlation, just as there would be if you did swimming and drowning, but that does not mean causation.”
Shortly after the removal of the cancerous spot on her leg, Connors had to have a wider section of skin around the lesion removed.
In the years since, she has had treatment for two other melanomas — one each on her neck and back— and continues to go for routine followups.
While she has stopped indoor tanning, the spots still continue to surface. She just recently had another mole removed and is awaiting diagnosis.
Connors now ensures when she’s outside that she protects herself, using self-tanners along with sunscreen.