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Good morning and welcome to the Women in Dermatology e-newsletter from Chronicle Companies. We’re pleased to have you join us. This biweekly bulletin will update you on new findings regarding dermatologic issues that affect women and the female dermatologists who care for them. We welcome your feedback and opinions, so let us know if you have any comments, observations, or suggestions. You can email them to us at health@chronicle.org
Cosmetics are part of the daily routine for many people who may not consider the products' ingredients or dermatologic consequences. According to a recent study published in the Journal of Cosmetic Dermatology (Mar. 2023; 00:1- 8), cosmetics can also affect internal health aside from potentially causing multiple dermatologic disorders. In this study, researchers assessed women’s level of awareness about the adverse reactions cosmetics may cause. The researchers note men are less likely to be impacted than women.
The authors conducted a cross-sectional study that involved women who visited the dermatology department of the Kasturba Hospital in India between Dec. 2020 and Mar. 2022. The final sample included 400 participants who answered a self-administered questionnaire. The study excluded participants who had severe facial dermatoses or allergies. Nearly all of the respondents reported using cosmetic products.
The results showed 62 per cent of participants stated they did not consult a dermatologist before using a new cosmetic product. However, 43 per cent did report the habit of reading the labels of cosmetic product contents before using them for the first time. More than 50 per cent of participants were not aware of the presence of heavy metals in cosmetic products. Additionally, 95.75% of women were unaware of “cosmetovigilance” or any other method for reporting the adverse effects of cosmetic products.
The authors also found that 44 per cent of participants experienced negative side effects from cosmetic use. These adverse effects were related to skin, hair, and mucosa. The most common adverse effects were acne and redness of the skin, but 1.25 per cent of respondents reported systemic adverse effects, including nausea and headache. Most women either self-medicated or ceased products used to combat side effects; 15.25 per cent consulted a dermatologist.
Bottom line
The authors concluded that while women are somewhat aware of the potential adverse effects of certain cosmetic products, promoting product use-related safety guidelines is necessary. They add that raising awareness regarding the possibility of adverse side effects caused by cosmetics will reduce incidence. They also note that women should be made aware of the concept of “cosmetovigilance” and other methods for reporting the adverse effects of cosmetic products.
Clinical patterns and frequency of dermatologic manifestations associated with pregnancy
A study published in the Pakistan Journal of Medical & Health Sciences assessed the prevalence of dermatologic issues during pregnancy. The researchers found that 48% of women experienced at least one skin condition during pregnancy. The most common skin manifestations associated with pregnancy were stretch marks, linea nigra, and melasma. Hirsutism, redness of the palms, atopic eruption of pregnancy, acne, urticaria, and scabies had a lower incidence but were also common.
For this cross-sectional study, the authors analyzed the clinical data of 185 pregnant women; those with pre-existing medical conditions such as hypertension and diabetes were not included.
More than 90% of childhood BCG vaccine-induced keloids in Japan occur in women
A study published in Dermatology and Therapy evaluated how sex influences the development of childhood-onset keloids in Japan. The authors found a significant female predominance of childhood-onset keloids and an even more significant female predominance in injection site-induced keloids related to bacille Calmette-Guerin (BCG) vaccination.
For this study, the researchers conducted a retrospective chart review of 131 patients with childhood-onset keloids at a plastic surgery clinic. The study showed that more than 80% of participants were female, nearly 40% had a family history of keloids, and 48.9% had allergies or allergy-related conditions such as asthma or atopic dermatitis. The study also found vaccination was the most common keloid trigger, with the BCG vaccine as the most common trigger.
Hair length in association with hair care regimens and healthy habits in Black women
A study in the Journal of Cosmetic Dermatologyanalyzed whether or not a specific hair care routine influenced hair length in Black women. The authors found that long hair was associated with a hair care regimen that involved frequent moisturization and hair oil application. They concluded that oiling the hair allows hair follicles to retain more moisture and elasticity, which results in stronger hair. They also found that deep conditioning did not affect hair length and that shorter hair was shampooed more frequently.
Does pediatric vulvar lichen sclerosus resolve or persist after the first menstrual period?
A study in the journal Pediatric Dermatology evaluated how pediatric vulvar lichen sclerosus (pVLS) evolves after the patient experiences her first menstrual period and found that pVLS usually persists after menarche.
For this observational retrospective study, the authors analyzed the cases of 31 patients diagnosed with pVLS between 1990 and 2011. The follow-up period was 14 years. The study showed that 58% of participants were still affected by pVLS after menarche, while 26% reported being asymptomatic but still showed persistent clinical signs of VLS. Just 16% of patients experienced complete remission.
VIDEO: Pediatric and adolescent vulvar skin conditions
Drs. Christine Pennesi and Kalyani Marathe review multidisciplinary treatment approaches to complex pediatric and adolescent vulvar skin conditions and discuss how to recognize pediatric and adolescent vulvar skin conditions in patients with varied skin tones. Watch the video here.
Rare association between vulvar Dowling-Degos disease and hidradenitis suppurativa
A case study published in the International Journal of Women’s Dermatology described a 63-year-old woman who presented with multiple reddish-pinkish blisters on her face, neck, chest, arms, and back. The patient was previously diagnosed with chronic lymphocytic leukemia (CLL) and reported the lesions had been present for two months. A physical examination revealed hair loss in the eyebrows and eyelashes, deep skin creases, and infiltrative lesions on the nose. A punch biopsy of one of the lesions on her back revealed viral-associated trichodysplasia spinulosa (VATS).
The patient’s lesions had been previously unsuccessfully treated with corticosteroids, topical metronidazole, and oral cephalexin. After she was diagnosed with VATS, her doctors prescribed 450 mg of valganciclovir twice daily, but her lesions had not improved by the fourth-month follow-up. The physicians added 3% topical cidofovir twice daily to her treatment, and the patient showed significant improvement over nine months.
“I don’t love the term [medical] “gaslighting” because it implies a deliberate, purposeful attempt to mess with another person’s experience of reality. I don’t think that doctors are treating women or people of color differently in a deliberate, conscious manner. This differential treatment is, I believe, an example of System 1 processing. It happens without conscious intent. Doctors are human and have implicit biases like anyone else. With no blame on individual doctors, we have got to get better, and this includes system changes. But to start with, on the individual level, the doctor-patient relationship can be more of a partnership than it’s currently set up to be. Doctors are medical experts, but patients are experts in their own experience. We need to trust each other more and listen to each other more.”
— Dr. Christine Ko, a New Haven, Conn.-based dermatologist and professor at Yale University, in an interview with the Yale School of Medicine.
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