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Professional and amateur athletes, as well as people who just want to lose weight and add muscle mass, often resort to the illicit “solution” of using anabolic steroids.

Using anabolic steroids can cause all sorts of medical and cosmetic problems, such as impotence and breast growth in men, facial hair and breast shrinkage in women, and acne, liver damage, weakened tendons, heart attacks, strokes, psychiatric disorders (and the invalidation of athletic achievements) in both sexes.

And now, investigators from Massachusetts General Hospital have found that the long-term use of anabolic steroids weakens the heart muscle – to a significant degree – in a majority of the people who use them.

The researchers studied 19 apparently healthy weightlifters – 12 who used anabolic steroids chronically, and seven who did not. (This proportion may reflect the relative difficulty in finding serious weightlifters who do not use steroids.) They found that 10 of the 12 steroid users had left ventricular ejection fractions which were actually below the limits of normal, and in addition displayed other significantly abnormal findings on echocardiography that indicated cardiac muscle weakness. These finding were not seen in the non-steroid-users.

While this is important information, and therefore I feel obligated to report it in the hope that young athletes who may read this site will be discouraged from using these dangerous drugs, one must be realistic.  If the prospect of impotence and big breasts does not scare young men away from anabolic steroids, it would be wishful thinking to expect the additional prospect of mere heart failure to tip the balance.

Sources:

Baggish AL, Weiner RB, Kanayama G, et al. Long term anabolic-androgenic steroid use is associated with left ventricular dysfunction. Circ Heart Fail 2010.

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Have the formulas that you have been using in order to tighten sagging skin been getting the job done, or do you feel as though you have been just spinning your wheels? More than likely you have been made to feel as though you are not making any progress at all in you efforts to return firmness and elasticity to your skin. The truth is that you are not going to accomplish your goals by using the majority of the anti aging skin care formulas.

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Speaking March 1 at the 68th Annual Meeting of the American Academy of Dermatology (Academy), dermatologist Adnan Nasir, MD, PhD, FAAD, clinical assistant professor in the department of dermatology at the University of North Carolina in Chapel Hill, presented an overview of nanotechnology and how nanoparticles may eventually be used in cosmetic products.

“Research in the area of nanotechnology has increased significantly over the years, and I think there will be considerable growth in this area in the near future,” said Dr. Nasir. “The challenge is that a standard has not been set yet to evaluate the safety and efficacy of topical products that contain nanosized particles.”

Nanotechnology: On the Plus Side

Products incorporating nanotechnology are being developed and manufactured at an ever-growing rate, especially among clothing manufacturers that incorporate nanomaterials into fabrics to enhance stain and wrinkle resistance, and water repellence. However, Dr. Nasir explained that a substantial proportion of patents issued for nanotechnology-based discoveries are currently in the realm of cosmetic and consumer skin care products. In fact, the cosmetic industry leads all other industries in the number of patents for nanoparticles, which have the potential to enhance sunscreens, shampoos and conditioners, lipsticks, eye shadows, moisturizers, deodorants, after-shave products and perfumes.

One example of how nanoparticles are being considered for use is to improve some of the undesirable properties of skin care products. Dr. Nasir explained that when certain ingredients are included in micrometer-sized particles, which are considerably larger than nanosized particles, the result is a product than can be cosmetically unappealing.

For example, one common ingredient in broad-spectrum sunscreens, which protect the skin from both UVA and UVB rays, is avobenzone, which can make a sunscreen greasy and very noticeable when applied to the skin. Since titanium, another common sunscreen ingredient, requires an oily mixture to dissolve, a white residue can be apparent on the skin upon application. However, when these active ingredients in sunscreens are converted into nanoparticles, they can be suspended in less greasy formulations — which seem to vanish on the skin and do not leave a residue — while retaining their ability to block UVA and UVB light.

“While widespread use of this technology is currently under evaluation, I think one of the main benefits of nanoparticles used in sunscreens will be that the particles can fit into all the nooks and crannies of the skin, packing more protection and more even coverage on the skin's surface than microsized particles,” said Dr. Nasir. “Since sunscreen formulations using nanoparticles may be more cosmetically appealing and seem to vanish when applied, consumers may be more inclined to use them on a regular basis.”

Nanotechnology also is generating excitement for its potential use in anti-aging products. When properly engineered, nanomaterials may be able to topically deliver retinoids, antioxidants and drugs such as botulinum toxin or growth factors for rejuvenation of the skin in the future.

In anti-aging products, Dr. Nasir added that nanotechnology may allow active ingredients that would not normally penetrate the skin to be delivered to it. For example, vitamin C is an antioxidant that helps fight age-related skin damage which works best below the top layer of skin. In bulk form, vitamin C is not very stable and is difficult to penetrate the skin. However, in future formulations, nanotechnology may increase the stability of vitamin C and enhance its ability to penetrate the skin.

“Since anti-aging products that contain nanoparticles of antioxidants will be harder to make, we expect that these products will cost more than products using traditional formulations,” said Dr. Nasir. “Once these products are determined to be safe, the consumer will have to decide if the increased costs are worth the added benefits.”

Nanotechnology: Future Melanoma Treatment?

Researchers also are reviewing the use of nanomaterials for the treatment of melanoma. In particular, gold, when turned into a nanomaterial called nanoshells, has been shown to be a useful treatment for melanoma in animal studies.

According to Dr. Nasir, gold nanoshells can be engineered to absorb specific wavelengths of light. If the wavelength of light unique to a particular type of gold nanoshell is used on it, the particle generates heat. In one animal study done at MD Anderson Cancer Center in Houston, investigators joined gold nanoshells with a molecule which homes to melanoma. When these gold nanoshells are injected into mice harboring melanoma, the nanoshells accumulate in the cancerous tissue. When mice are illuminated with the proper wavelength of light, their tumors, laden with gold nanoshells, heat up and are effectively killed. The surrounding tissue, which lacks targeted gold nanoshells, is unharmed.

“Nanotechnology holds promise for new non-invasive treatment methods, particularly for challenging dermatologic conditions, such as atopic dermatitis and ichthyosis,” said Dr. Nasir.

Nanotechnology: More Consumer Information Needed

Because the skin is the first point of contact and the first line of defense for newly manufactured nanomaterials, Dr. Nasir noted that many dermatologists have concerns about the potential health risks posed by nanotechnology. “Although nanotechnology is an exciting area that holds enormous potential,” said Dr. Nasir, “we anxiously await the FDA's review of the safety of nanoparticles which will determine their future role in skin cancer products.”

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Speaking March 1 at the 68th Annual Meeting of the American Academy of Dermatology (Academy), dermatologist Alan Menter, MD, FAAD, chair of the Psoriasis Research Unit at Baylor Research Institute in Dallas, addressed the need for psoriasis to be viewed as a serious disease affecting the whole body with significant quality of life issues.

“In the past, psoriasis was viewed primarily as a cosmetic nuisance that was not thought to extend beyond the obvious plaques apparent on the skin,” said Dr. Menter. “With the discovery of multiple genes related to psoriasis, a better understanding of the immune system responses involved in this disease, and the frequent associations with other serious diseases, we know that psoriasis is a much more complex disease that demands continual monitoring and evaluation by a dermatologist and, if necessary, other medical professionals to address related health issues.”

Link between Psoriasis and Other Serious Medical Conditions

Over the years, multiple studies have found that psoriasis is associated with a number of potentially serious medical conditions, including cardiovascular disease, cancer and lymphoma, obesity and metabolic syndrome (also known as “Syndrome X”), autoimmune diseases (Crohn's disease and diabetes mellitus I and II, for example), psychiatric diseases (such as depression and sexual dysfunction), psoriatic arthritis, sleep apnea, personal behavior issues, chronic obstructive pulmonary disease (COPD) and even increased mortality. Dr. Menter explained that the majority of these diseases can have a significant impact on a patient's overall health and affect psoriasis patients in different degrees of severity.

“It is important to note that while we are unsure whether psoriasis causes other diseases or that these other diseases cause psoriasis, the fact that an association exists at all is critically important in treating psoriasis patients,” said Dr. Menter.

One recent observational study of 3,236 patients with psoriasis and 2,500 patients without psoriasis who served as the controls concluded that patients with psoriasis experienced an increased incidence of ischemic heart disease (where the blood vessels are blocked leading to the heart), cerebrovascular disease (where the blood vessels are blocked leading to the brain), and peripheral vascular disease (the obstruction of arteries in the arms and legs), and mortality.1

Another study examining the increased risk of mortality in psoriasis patients suggests that patients with severe psoriasis may have shorter life expectancies by an average of three to five years than individuals who are not affected by psoriasis. 2

In addition, other studies have shown that psoriasis patients are more likely to consume excessive amounts of alcohol and cigarettes, both of which can negatively impact a psoriasis patient's health. These detrimental behaviors can further aggravate other conditions associated with psoriasis, such as heart disease and COPD.

Impact on Quality of Life from Psoriasis Cannot be Underestimated

Since psoriasis is a chronic lifelong disease that needs to be controlled with a customized treatment regimen, the constant presence of psoriatic lesions or unexpected flare-ups — at times when patients least expect it — can cause a considerable amount of stress and anxiety. In fact, psoriasis has long been known to cause considerable emotional stress for patients, including low self-esteem and feelings of rejection, introspection, weight gain, increased use of alcohol and tobacco, and depression (which in some cases can be severe).

Another study conducted by the National Psoriasis Foundation examining attitudes and beliefs about contagious diseases among the general population of young adults found that approximately one-third (36 percent) of those surveyed were unsure whether psoriasis was contagious. In addition, when asked their attitudes about dating and skin conditions, more than half (62 percent) of the respondents reported that they take the condition of a person's skin into consideration when first asking someone out on a date.

Dr. Menter added that the findings of this survey lend credence to the belief held by many psoriasis patients that their disease can have a negative impact on their personal lives and affect their interpersonal relationships.

“We cannot underestimate the complexity of psoriasis, particularly the psychological impact the disease can have on young people,” said Dr. Menter. “Even at a young age, psoriasis can affect a person's relationships at home, work or school, and the disease can contribute to an overall poor body image that can be hard to reverse throughout life.”

Dr. Menter added that studies conducted regarding the effect of newer biologic medications, such as adalimumab, etanercept and infliximab, on psychiatric symptoms have shown that psoriasis patients may experience significant improvement in fatigue and other symptoms of depression. The newest biologic agent recently approved by the Food and Drug Administration (FDA), ustekinumab, also has been shown to improve sexual dysfunction in patients with moderate to severe psoriasis up to 10 fold.

“Although psoriasis is an incurable disease, it is controllable in the majority of cases with proper treatment,” said Dr. Menter. “Over the past several years, there have been a number of newer therapies introduced that are effective in managing psoriasis, and a patient's dermatologist can determine which therapy would work best to control each patient's disease.”

1Archives of Dermatology: Vol 145 (NO. 6), June 2009, Pages 700-703

2Archives of Dermatology: Vol 147 (NO. 12), December 2007, Pages 1,493-1,499.

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