January 23, 2025 • 43 mins
Centered on Health 1-23-25 - How to treat eczema and 'winter itch' with Dr. Al Knable
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Speaker 1 (00:01):
It's now time for Centered On Help with Baptist's Help
on use Radio.
Speaker 2 (00:05):
Wait for each MEDJS Now, here's doctor Jeff Tubbler.
Speaker 3 (00:11):
Good evening, everyone, and welcome to tonight's episode of Centered
On Health with Baptists Health here on News Radio eight
forty whas. I'm your host, doctor Jeff Tublin. We're joined
from our studio by mister Jim Fenn, who's on standby
to take your calls to talk to our guest this evening.
Our phone number if you want to call in tonight
is five oh two, five seven one, eight four eighty four.
(00:33):
And we hope that you do well. It's still winner
outside and even though we made it through the large
snow of earlier this month, the effects of winter can
affect us much much longer. With winter comes irritation of
the skin, dryness and ezema and all sorts of other
skin conditions. So to help us tonight to stay symptom
free this winter is dermatologist doctor al Canabel. Doctor Canabel
(00:55):
is a dermatologist specializing in the medical and surgical care
of diseases of the skin, hair, and nails. He is
a graduate of the Indiana University School of medicine and
as a member of the Associates in Dermatology with practices
in Louisville and southern Indiana.
Speaker 4 (01:10):
He's been on our show before.
Speaker 3 (01:12):
He always enlightens us and gives us great practical advice.
Welcome back, doctor Canabel.
Speaker 1 (01:18):
Hey, welcome, Thanks, good to be back. Good to be
linked with the word irritation, and that's right, Inex strictly
linked with that. I think it was my third time back.
So at some point I get like the smoking jacket
and all that type of stuff too, right.
Speaker 4 (01:32):
That's right that you get the jacket.
Speaker 3 (01:33):
And obviously we want to stay away from dryness as
well tonight, Right, so we're going to be I know,
you're always very helpful and animation.
Speaker 4 (01:40):
So yeah, the.
Speaker 3 (01:43):
Last time that you were here actually was over the summer,
and we were talking about summer conditions. So just by
way of sort of kicking us off our dermatologic condition
seasonal in general.
Speaker 5 (01:57):
Some are and some aren't.
Speaker 1 (02:00):
I will tell you that some are directly related to weather,
some just kind of kind of behaviorally. One that you
wouldn't think would be is there's probably an uptick in
skin cancer diagnoses in early spring and summer. But it's
kind of because just people start to kind of undress
and look in the mirror I think a little bit
more critically.
Speaker 6 (02:17):
So we always get these runs of people.
Speaker 1 (02:19):
That come in that way, which is not a meteorological season.
It's just more of a culture and climate thing. You
get a financial season because sometimes people come in super
busy late in the year, you know, because they're deductibles
are met. But what you're referring to is more ultraviolet
light and humidity and that type of thing driven. And
there certainly is are people with atopic dermatitis. I would
(02:43):
say probably a good two thirds of those folks get
much worse in the winter better in the summertime. Piatis
is probably ninety percent of people get better in the
ultraviolet rich days of the summer. The ultraviolet light probably
kills some of the immunological cells and the surface of
(03:05):
the skin, which is not really a good thing, but
it also drives up natural vitamin D production, which is
a good thing. So, Uh, there's seasonality with with those
two entities for sure. Uh. And then we always get
this time of year in particular, just a lot of
people to come in with kind of a catchphrase diagnosis
of winter itch, which is just that dry, irritated skin
(03:28):
that comes in with these big.
Speaker 6 (03:29):
Cold air masses. I think w l k y. You
guys are w l k Y.
Speaker 1 (03:34):
I think from what I heard on your break And
you know Jake Cardozi, the chief meteorologist over there, he
was a guest on my podcast a year or so ago,
and I kind of told him we really should have
a dermatological meteorological report with regards to these these air masses.
Speaker 6 (03:49):
That comes through because they really breaks.
Speaker 1 (03:53):
A lag in there. But you know, there's this huge
cold air mass that we had last week. The air
masses are super super dry when they come and just
cold air cannot contain a lot of moisture because the
physics involved in it. So we have these huge dry
air masses outside, we suck them into our house and
(04:16):
superheated with gas. And we do the same thing electrically
in our cars. So you take these super cold dry
air mats, as you bring them into your vehicle or
your car, suddenly they're warm, Suddenly they can hold a
lot of moisture, so that they're basically tries to just
kind of steal that moisture from whatever it can, whether
it be the carpet, the cat, the wood, and our skin,
(04:37):
and you just get progressively more and more dry, and
people do the wrong thing to combat that, which we
can talk about in a minute, and it kind of
just escalates or goes down bill from there.
Speaker 3 (04:50):
So you mentioned earlier the term kind of a catch
all when you were talking about winter itch, But tell
us about ezema. Is that also kind of a term
that people just kind of throw around for skin condition
or what is exzema and what should we be looking for?
Speaker 1 (05:05):
Yeah, you know, egzma is a catch all phrase. It
shares its root word with an old old Greek word
for to boil, and I think it was a descriptive
term because boiling water has that bubbly kind of looks
from the bottom of a pan or whatever. And so
some forms of eggzma have these deep blisters or vesicles
(05:25):
below the skin that people try to kind of instinctively
try to pop and drain out. But eggzma and even
a more generic term dermatitis, which just means inflammation of
the skin, is really a catch all phrase. I might
have mentioned it to you before, but if I tell
you somebody has egzema or dermatitis, it's like sending you
(05:48):
to the store to get me to ice cream.
Speaker 6 (05:50):
You know, I don't tell you what I want.
Speaker 1 (05:51):
You go down that pick up one of one hundred
different things. But dermatitis like to get paid, and we
get paid the kind of site for all that out
into what exact type of ice cream it is, or
what exact type of dermatitis it is. So when you're
talking about winter, which.
Speaker 6 (06:08):
Almost anybody, regardless of their.
Speaker 1 (06:11):
Immunological predisposition, can experience that because it's really not immunologically
driven like psoriasis might be, or atopic dermatitis is, but
it's more just driven by physics. And everybody has kind
of a set number of oil glands when they're born,
and I set the volume of production.
Speaker 6 (06:32):
But as we get older, that.
Speaker 1 (06:34):
Volume goes down and down and down. So winter, which
is one of those things that you get a little
bit more predisposed to the older you get because of
less natural oil production and probably a little bit less
structural integrity of the way that your body builds its
skin as you get older. But classic sign symptoms of
(06:56):
that locations would be the shins and then the lower
back and the for BacT that little triangle between the
shoulder blade, people just kind of go crazy. But it
can be anywhere. But you know that mid ever back
and lower back and the shin bones where people come
in and they're just literally just digging abrasions in themselves
because the itching just feels the scratching just feels so
(07:19):
good when you're in the throes of it.
Speaker 4 (07:22):
So and is that the major symptom of it?
Speaker 6 (07:26):
Is it?
Speaker 4 (07:27):
Is it just itching? Or do these conditions cause pain?
Speaker 1 (07:33):
Uh? It's kind of a though fine line between the
nerve receptors for pain and for itching. They're they're they're
kind of related, but not quite you know, they came
from the end of the same uh baseline before the
embryo became a person, but there's a distinction. And what
people expect that over time is that pain can sometimes
(07:54):
be preferable to the issuing sensation, which is why the
itch and the scratching can cycle down so far, because
it's the replacement that you get with the pain is
preferable to that sensation of the itching.
Speaker 6 (08:11):
And it can almost be.
Speaker 1 (08:12):
Like some people almost almost a wired sensitivity for the
stitching and scratching, almost with sensual pleasure as well. It
sounds weird, and I know you're g rated, so I
won't go too far down this road. But one time
I had a patient and so you just got to
stop this itching, because it's just the scratching when I do,
(08:33):
it is more pleasurable than relationships. And then well, do
you really want me to stop it?
Speaker 6 (08:38):
You know?
Speaker 1 (08:38):
And he had to think twice about it, because when
you in the throes of this scratching, it can be
really really you know, to the point of it's some
kind of macabre or bizarre ecstasy in some places. But anyway,
we don't want people digging hold in themselves to that matter,
you know, we want.
Speaker 3 (08:55):
To try to No, no, we definitely don't. Well we're
definitely staying away from the dryness conversation, right, So that's good.
So what about over the counter over the counter stuff,
What kind of creams work for itching?
Speaker 1 (09:10):
Well, first I would I would go with behavior first
and just behavior modification. So the things that make this
condition worse are things that intuitively people seek out because
they feel good in the moment.
Speaker 6 (09:22):
So really really.
Speaker 1 (09:23):
Hot showers, which you feel like is going to be
great in the moment, and a lot of our people
who have this condition baked under a hot shower. But
if you think about it, if you have a grease
stain on your table or something, which do you use
to get it out?
Speaker 6 (09:37):
Hot water or cold water?
Speaker 1 (09:38):
You go get a hot rag because it's going to
clean that grease off yourn better than cold well under
the shower. That hot water is stripping your whatever natural
oil you have away. The first thing you've got to
do is kind of go lukewarm to cool water. Try
to god with a very very low surfact and soap,
which means something has a little bit of oil in it,
like do scented or oil of ola, and stay away
(10:02):
from things that have really high surfactant stripping values like
zest and irish spring of those that were the classic
ones that had a lot of fragrance and they could
really strip oil away like pearl shampoo strips away from.
Speaker 6 (10:17):
Oil on the air.
Speaker 1 (10:18):
But it's taking away your natural defense. So lukewarm the
cool water rather than hot, dab dry. And then what
works over the counter for itching in large part is water.
If you look at the active ingredient and a lot
of cream's lotions or whatever, the active the first ingredient
is water. In training, we always said only water can
(10:40):
put water in the skin, so you're really trying to
lock that water.
Speaker 6 (10:44):
In with a hueleft.
Speaker 1 (10:45):
And so if you can get out of the shower
and get something that's got a little bit of oil
on it, you get that on top of the skin
while your skin is still a little bit damp in
it's purest form. That could be vacoline, it could be Crisco,
it could be awqua for but those are pretty heavy,
and then you get secondary problems like acne. So I
would look for a thicker type ocean, you know, like
(11:08):
user or nutrigene or something like that.
Speaker 6 (11:12):
The only really.
Speaker 1 (11:13):
Over the counterproduct that has a prescription element to it
or semi prescription element to it is are things that
have hydrid quarter zone and like court a cream and
that type of thing. But the downside of those is
that our people who have this type of sensitivity have
a lot of predisposition towards developing allergies to all the
preservatives and things that are sometimes in some of the
(11:34):
less expensive over the counter products.
Speaker 3 (11:36):
So, doctor Table, I'm gonna pause us for just a
second so we can take a quick break, because I
want to make sure everybody can hear all this. When
we come back, but we're going to take a very
short break. You are listening to Center It on Health
with Baptist Health here on news radio eight forty whas.
I'm your host, doctor Jeff Tavlin, and we're talking tonight
with doctor Alcannabel about the winter Hitch and other dermatologic woes.
(11:58):
Call us at five oh twove seven one eight four
eighty four if you'd like to ask a question and
join us in the conversation, we'll be right back.
Speaker 4 (12:19):
Welcome back to Send.
Speaker 3 (12:20):
It on Health with Baptist Health here on news radio
eight forty whas. I'm your host, doctor Jeff Helvin. We're
talking tonight with dermatologist doctor Al Canabel about Ezemah winter
Itch and other germanologic woes. It's great to get this
information and feel free to call in and ask him
a question. Five oh two five seven one eight four
(12:41):
eighty four. That's five oh two, five seven one eight
four eight four. Our producer mister Jim Fenn is on
standby to take those calls. So doctor Canabel. Right before
we went to break, you were giving us great advice
about kind of Jews and don't and we just kind
of got started with it with the showering, and that
was great practical advice. So talk us through some of
(13:02):
the other maybe does and don'ts about ezema that maybe
we're not thinking all the way through. What are some
of the other triggers and things we should be aware of.
Speaker 1 (13:11):
Sure, So again to the question that you had about
the best cream. You want something bland, The fewer ingredients
the better. And I hate to go into brand names,
but that's what people see on the shelves, right so
you know, you turn a Vino ros pos A. Those
are all pretty good brands that have a nice hypoallergenic
(13:36):
feel to them. In general, I tend to tell my
patience to stay away from the things that have that
say anti itch in them because they tend to throw
in a couple of other things in there, like menthol
and those can feel really good in the moment, but
they're counterproductive. They tend to burn and sting. Probably the
worst of the lot art or anything that's a gel
based or a spray base, because those tend to have
(13:59):
alcohol all bases. And you know, just like when you
put rubbing alcohol in your skin, it evaporates. Again, you're
gonna be stripping away a lot of natural oil. So again,
if you're in that lukewarm cool shower, if you have
to take hot shower trying to dial it back at
the end. I think that's in the in the James
Bond novels, they call those Scotch showers or something like
(14:20):
that Scottish shower. So you turn at the end, bring
that temperature down and then dry off and then greaze up.
So I think the next thing becomes, what what are
you gonna put on for a base layer of clothing,
Because you know, if you're like me, I'm sitting here
as we speak, I'm in an old house that we've
built in the eighteen nineties. I've got two space heaters on.
I mean, I've got three layers of clothes.
Speaker 5 (14:40):
So the.
Speaker 6 (14:43):
Base layer of clothing that.
Speaker 1 (14:44):
Comes into contact with his skin should be as close
to one hundred percent pure cotton as you can get,
preferably one hundred percent cotton. If you get those the
fibers under a scanning electron microscope, which I know.
Speaker 6 (14:58):
Everybody has at home.
Speaker 1 (14:59):
You know the they're smaller fibers, they're flexible, they're more comfortable,
and there's something about the micro environment that they create
with regards to humidity levels near the skin, that's as
closed to ideal as you can get for a bass layer.
The worst of the lot would be pure one hundred
percent wool. I mean everybody probably experienced that with the
(15:19):
scarf when they were a kid. There's a lot of wool,
cotton blends out there, there's poly wool, but if you
look at those fibers under micro they're much more stiff,
much more likely to be prickly on already dry cracked skin.
So the base layer, you want to get close to
one hundred percent pure cotton as you can. And you know,
(15:43):
I don't know about other folks this time of year,
I end up sleeping in one hundred percent pure cotton,
long sleeves, long underwear, and long stockskin because I've got
this cold house.
Speaker 6 (15:54):
But the wolf just.
Speaker 1 (15:55):
Kind of tears you up. So as you're going outside again,
the meteorologists will that that wind as it whipspy creates
that wind show effect because of evaporation. That evaporations, it's
taking moisture from your skin, is also again taking a
little bit of oil and getting down to that base
way and just ripping little micro chears into your skin.
So try to cover up as much as you can,
(16:18):
or if you have to be exposed on the cheap
snary thing, that's where you might want to go with
something ticker. If you're outdoor all day working postal carrier
construction or something trying nice thick layer of fasciline or
a nice thick and mollient type cream on the cheek
bones and the exposed forehead. As much as the dermatologists
harp on sunscreen if you're not out skiing or something
(16:41):
like that this time of year around here, the U
the INDEXI just isn't that high. But if you want
to wear a sunscreen, I would go mineral based again,
with a nice and allient base to.
Speaker 6 (16:52):
It, so.
Speaker 1 (16:55):
Lukewarm, the cool showers, fragrance free stuff, different types of heat.
I mean, if you really really want to experience winter
itch and all the fun that we talked about before,
go take a hot shower, halfway dry off, put on
a gel, and then goes sit in front of a
fireplace where those temperatures can get to seven hundred eight
hundred degrees really really quick, and just flash evaporate all
(17:19):
the moisture and oil from your skin and you can
get the extremest form of this winter itch, which is
called eggs in a crack a lay, which sounds like
it would be fun to have, but it's really not.
It's actually just fissures opening up in the skin. That
can be on the back, that can be on the arms.
The most frequently we see that on the shin bones.
Speaker 4 (17:38):
That sounds that does not sound fun.
Speaker 1 (17:40):
No, what they're kids who kind of have this tendency
because these kids tend to just sit on the hot
air vents sort of the sit next to that dry
air as it comes out of the wall or in
front of the fireplace that they have it.
Speaker 3 (17:55):
What about food, stress, diet, Like do those things matter
when it comes to flaring it or triggering it?
Speaker 1 (18:04):
Well, I think stress is an accelerant for every dermatological
fire out there. It doesn't make anything better. It's really
difficult to tell people don't go get stressed. Yeah, very
few people consciously go out looking for it. Some people
do with lifestyle and seem to be, you know, thrive
(18:27):
on being miserable. We've all met those people. But it's
really ineffective to tell somebody who don't be stressed.
Speaker 6 (18:34):
But the flip side of the coin on stress.
Speaker 1 (18:37):
Is positive energetic outlets, which I think are good for
lots of different conditions in your field and my field,
and that would be exercise, meditation, that type of thing.
Speaker 6 (18:49):
I think there's a.
Speaker 1 (18:50):
Great role to be had in exercise and the release
of endorphins that goes on daily with meditation and kind
of just clearing the mind and trying to get away
from the constant thinking about how miserable one is or
is not. Whether you could meditate yourself to a plane
where there's no itching, you know, who knows. There's a
(19:11):
lot of there's a.
Speaker 6 (19:12):
Lot of mind over matter.
Speaker 1 (19:13):
But I don't think stress is the root cause of
a lot of these things. But it certainly is an
accelerant and a compounding factor. Food that's going to vary
from individual individual, but certainly it can play a part
in it. I think chronic use of alcohol is a
downer for people who have this because I think you
end up with some gastritis and some problems with the
(19:36):
microenvironment of the GI track, and then you're.
Speaker 6 (19:38):
Not going to be absorbing vitamin AD.
Speaker 1 (19:40):
E K and some of the things that can protect
you from this. I mean, I don't know about you,
but the more compelling literature I find about alcohol is
that it's just not much of a place for it
at the table of health. You know these days. Even
that one glass that people talked about, it probably wasn't
such a great thing. There can be just out and
(20:02):
that food triggers that can compound issue, whether it's gluten sensitivity.
Speaker 6 (20:08):
For me personally.
Speaker 1 (20:10):
Just as an example, night shade type foods, you know,
bell peppers, some potasto and stuff like that. If I
have that on a meal, I've got hot spots that
light up on me routinely, and they just make that
it's more problematic. The problem is that there's really no great,
readily available testing where you can come in and give
a vial of blood and then we can tell you, you.
Speaker 6 (20:31):
Know, predictably and reliably.
Speaker 1 (20:33):
You know, if you avoid the ten foods, you're not
gonna have ditch as much. It's kind of trial and error.
But again the problem exists and that there can be
a delay anywhere between a couple of minutes in a
day and a half between the time that this stuff
gets in your system and then has its negative effect.
So even the allergist, you know, you can test for
(20:57):
one type of allergy you know, you can test for
type one hypersensitivity, but we're not going to give you
much of an impact on what that same molecule is
going to do once it passes through your gut, through
your liver and is metabolized and finds its way to
the walls of the vasculature going out to the skin,
which is where a lot of that problem takes place.
So I do talk with people about about diet. I
(21:21):
think the one thing that I think a lot of
people are moving away from in kind of this more
health conscious environment is eliminating some of the food dies
in our system, which I think are shown pretty predictably
to again give you leaky gut, and the leaky gut
and the skin have their relationships too that we're just
starting to kind of plumb the depths of and then
(21:43):
the water.
Speaker 6 (21:44):
If you're going to.
Speaker 1 (21:45):
Seal take food, what are you going to saw pay it?
You know, what kind of fat are you going to
be bringing into your body? And I think there's better
and better literature that say kind of the high olaic
acid type stuff like avocata oil, you know, olive oil,
are much better for us in the law run than
some of the less exclusive vegetable oil and seed oil.
Speaker 4 (22:03):
So for Nabel, we actually we actually have a caller
for you. His name is Darren, and he has a
question for you.
Speaker 3 (22:10):
But I'm actually going to ask Darren to just hold
on while we take a quick break, and we're going
to start with his question after the break. But I
want to remind everybody that you are listening to Senate
on Help with Baptist Help here on news radio eight
forty whas. I'm your host, doctor Jeff Tablin. We're talking
tonight with doctor al Knabel, dermatologists about winter itch and
(22:30):
other dermatolog dermatological woes. We'll be right back after these messages.
Welcome back to Senate on Health with Baptist Help here
(22:53):
on news radio eight forty whas. I'm your host, doctor
Jeff Tablin, and we're talking tonight with doctor Al Nabl,
germatologists with associates in germatology, who is talking to us
tonight about winter itch and other germanologic issues.
Speaker 4 (23:09):
I want to.
Speaker 3 (23:10):
Let everybody know that you can still call in five
oh two, five, seven one, eight four eight four if
you have a question, But we do have a caller
on the line for you, doctor Knabel. We have Darren
on the line, who has a question about some winter issues. So, Darren,
welcome to Center on Health.
Speaker 5 (23:27):
Thank you every renter. I experience splits on the tips
of my fingers. Is that a vitamin or mineral deficiency
or is it just cold weather related?
Speaker 1 (23:42):
Well, it can be a lot of different things. It's
probably not limited to a vitamin deficiency that would rarely
show up in a super isolated area on the body.
MAK question, Darren, how old are you fifty to sixty.
Speaker 5 (23:55):
Ish something like that, yes, or sixty?
Speaker 2 (24:00):
And then what type of work would I do? I
do work outside, But I mean I've had the issue
for years. I'm in the last twenty twenty five years. Yeah,
I mean.
Speaker 1 (24:13):
It's not really an age related thing, except again the
older one gets, the lesser well they produced. But I've
started having these troubles when i was eighteen. So just
kind of literally that was my own curiosity.
Speaker 6 (24:25):
I was just trying to guess your age based off
your voice.
Speaker 1 (24:27):
So, but if you work indoor, outdoor, you're going to
get that cold air exposure this time of year, and
so do you clear up for the most part in
the summertime?
Speaker 5 (24:39):
Yes?
Speaker 1 (24:39):
Yes, yeah, so you know, so you're probably someone who's
really almost literally just driven primarily by the amount of.
Speaker 6 (24:47):
Moisture that's in the air.
Speaker 1 (24:48):
You know, humidity levels or two points around sixtyre where
people are most comfortable because of the amount of moisture
in there. You get heavier than higher than that, and
you end up with a lot of mugging, and you know,
people it's not feeling good because of too much humidity.
You get down low, it just drives us out. What
I would tell you a couple of things would be,
and we see this all the time. First, avoid things
(25:13):
that will make this worse. So as much as possible,
avoid a lot of hot water hand washing. Avoid any
instant hand sanitizer gel. Even if you use that.
Speaker 6 (25:23):
In the summertime.
Speaker 1 (25:24):
In the winter, you're probably just breaking over a threshold
where you can't really deal with that type of dryness
from the gel. So Blue formed the cool Water dove
soap for us, one of these little dial pump soaks.
In terms of foam rents off with cold water. Drive
very very thoroughly. If you're indoor outdoor, try to at
least always have a light glove on, like a jersey
(25:46):
glove or something like that. Some people's work does not
allowed for them to use a lot of heavy hand
cream and moisturizer during the day because of what they're
dealing with. They can't have tools slipping or whatever, or
they can't be touching screens and getting them greased. So
I get that, but if you could start the morning
with a good cream. My favorite hand cream is a
(26:07):
Nutrigena Norwegian formula hand cream, and you can put that
on as much as you can tolerate during the day,
in the night or when you're getting ready to bed
down if you're a third shifter, when you're done with
your day's activities.
Speaker 6 (26:22):
Washed with cold water.
Speaker 1 (26:23):
That's where a prescription medication, like a good topical steroid
ointment would come in.
Speaker 6 (26:29):
And you want an ointment.
Speaker 1 (26:31):
They're a little bit crazier, but they're more potent, and
you can put that on before you bed down. I
have some of my patients do hypoallergenic white cotton gloves
that they can put over their hands before.
Speaker 6 (26:41):
They go to bed.
Speaker 1 (26:42):
So you've got a good six to ten hours that
you depend on how much you sleep, where you've got
a good micro environment there for those to heal up.
Speaker 6 (26:50):
What I'm about to say it.
Speaker 1 (26:51):
Sounds really really weird, but if you have a kind
of a deep fissure in your hand, they can be
incredibly painful, and so a lot of people that with
new skin. Over the counter, what I do is I
buy a bunch of crazy glue.
Speaker 6 (27:08):
On Amazon and it averages.
Speaker 1 (27:10):
Out to the eighty nine cents the tube, and I
put a little doll up on that out of a
piece of paper, and then I take a toothpick and
I just dip it in there and I paint those
cracked shut with the clean seas and glue like it's
like you're calking around the bathroom or something like that.
Things transiently, and then it gets you one to three
days of good relief as it seals those up. So
(27:31):
you don't put it all over the fingers of the hand.
You just put it in the little crack itself, and
then you know, be careful with it not to shut
your glue, your eyes shut and stuff like that while
it's feeling up.
Speaker 6 (27:41):
But unfortunately, on this.
Speaker 1 (27:43):
One, you're gonna probably need to see someone to give
you a nice prescription. Ointments used in the evening hours.
We have some people who get this every single year,
and if they only have for like six weeks out
of the year. Sometimes we can give them a steroid
shot once a year or something like this. Of course,
if it's more than just winter and it goes to season,
the season, and sometimes you have to investigate it further
(28:05):
to see if there's an immiological cause or an allergic cause,
or some people who work in a motor pool or
warehouse environment might have some hydraulic food or petroleum based
products that they get into their tool. Well around here
in the Louisville metro area, the people that work in
the big distribution warehouse is Amazon Ups and they're handling
(28:28):
a lot of cardboard that's.
Speaker 6 (28:29):
A very very drying agent.
Speaker 1 (28:30):
Every time you touch a piece of cardboard, it's stripping
some of your boisture and water away. So a lot
of our patients who experiences they're doing some sort.
Speaker 6 (28:38):
Of warehouse type of work too.
Speaker 1 (28:41):
And one final thought, even when you're just driving to
and from work, crossing a parking lot, if it's below
thirty five degrees, put some jersey gloves on or something.
Any wind that's coming around your fingers is going to
again set this process into motion. So you want to
try to control that micro environment around your hands as
best you can.
Speaker 3 (29:00):
Well, Darren, I don't know if you have ever tried
to get a new patient dermatology appointment, but this is
amazing because you know, it could take a year to
get into ze A dermatologists. So I hope that this
helps you, Darren. So I really want to thank you
for calling in and joining us today.
Speaker 5 (29:18):
Yes, sir, it was very helpful. Thank you very much
for all that information.
Speaker 4 (29:22):
Yeah, you have a good night.
Speaker 3 (29:24):
So doctor Cannabel, I think you might have kind of
addressed this just by sort of talking about the age
a little bit. But do people outgrow this condition or
does it just you've got it?
Speaker 4 (29:36):
You got it?
Speaker 1 (29:38):
Nah? Probably it probably ends about a year after you've
passed away.
Speaker 6 (29:44):
I don't know more.
Speaker 5 (29:47):
You know, you're really And the other thing is that.
Speaker 1 (29:50):
Sometimes we medicate people with things that can kind of
dry them out right diuretics or as dermatologists. Sometimes if
we have people on acting medications, you know is knowing
the generic tracking team, we're drying their oil lands up
and it doesn't happen just preferentially on the face. It
just so happens that you have a lot more of
them on the face. So if you do have someone
(30:12):
who's predisposed towards ex amount, you know, and we're treating
with some of those things.
Speaker 6 (30:17):
We have to warn them about that in advance.
Speaker 1 (30:19):
And no, I think the problem becomes worse with age.
I think at some point maybe your other problems catch
up with you so that you're not as fixated on these.
Speaker 6 (30:29):
But this is an.
Speaker 1 (30:30):
Absolutely real number one, number two issue for white people.
Snowbird and go south for the winter. This and rheumati
the joint aate some things and skin itching and that's
why everybody gets the hell out of town after Christmas
and they don't come back till, you know, after Saint
Patrick's Day or Easter time.
Speaker 3 (30:52):
And I think you you also started to talk a
little bit about this, which I think would be really helpful.
So somebody's trying all these things that you're recommending at home,
what's the mental trigger for them to think, you know,
maybe maybe a doctor has something more to offer me here,
Like what should they think about coming in to be
seen instead of trying just home remedies.
Speaker 1 (31:15):
Yeah, and that's a very good question. And there's two
things that happen in this situation. That the first thing
is that people will try anything. They will listen to
me tonight, they'll try what I say. They'll listen to
their grandmother down the street, they'll listen to the mailman.
And you'll try one thing for two days, and then
another and then another, and you can really, really, through
(31:36):
no fault of your own, because you're so desperate, you'll
throw the kitchen think at it, and you sink up
a secondary activity. I would say that if you have
tried some common sense type remedies that we've.
Speaker 6 (31:48):
Talked about tonight for.
Speaker 1 (31:52):
One and a half to three weeks and you're not
getting anywhere, particularly if you're losing sleep and or quality
of sleep is being disturbed, you can't focus at work
because of it, or it's school, or if it's putting
a damper on your relationships social, sexual, whatever those relationships are,
(32:13):
then I think it would be whoovi you to go
in and get some help. You know, it's difficult under
any circumstances for single people to meet, but if you're
seeing there scratching, you know, sores into your skin, it
becomes very, very difficult. If you're the kid at school
who can't focus and listen to the teacher because you're
so preoccupied scratching holes in your elbows.
Speaker 6 (32:37):
It's a problem.
Speaker 1 (32:37):
I mean, the job of a child is to eat, sleep,
and play. So if it's interfering with any of those things,
you know, take your child into see a physician dermatologist.
You know, if you're an adult again and you can't
sleep and you can't focus, and you're dwelling on this
and you've ordered more than let's say, three different products
and you're not getting anywhere, I think it's time to
(32:59):
get in and get some help.
Speaker 3 (33:02):
You know, if the job of a child is to eat, sleep,
and play, then I should.
Speaker 4 (33:07):
Be Father of the Year. So I feel like that.
Speaker 3 (33:10):
I feel like I'm doing a really really good job there.
So we're going to take our final break here, but
we're going to come back and talk a little bit
more with doctor Cannabel about winter itches or other derminologic issues.
Doctor Jeff Tublin, you're listening to Senate on Health with
Baptist Health here on news Radio eight forty whas And
(33:30):
if you missed any part of tonight or you could
keep up with all the great information and want to
hear it back, this will be a podcast.
Speaker 4 (33:37):
You can download the iHeartRadio app. It's free it's easy
to use. We'll be right back after this.
Speaker 3 (33:55):
Welcome back to Center It On Health with Baptist Health
here on News Radio eight whas I'm your host, doctor
Jeff Tublin, and tonight we're talking with doctor al Kanabel,
dermatologists and we've been talking a lot about the winter
itch and ezema and all really great practical advice as
we always get with Doctor Cannabel. Remember to download the
iHeartRadio app. It's free, it's easy to use, and you
(34:18):
can re listen to this or any of our previous
segments and have access to all the other features that
the app has to offer. So Doctor Cannabel, and the
time that we have left, I wanted to just ask
if we get to them a few different things throughout
the dermatology world. And the first one is I get
a lot of questions about these TV commercials that are
(34:39):
for these new medications, these biologics that are for all
of these different dermatologic diagnoses.
Speaker 4 (34:46):
Can you just.
Speaker 3 (34:47):
Kind of give us a very small primer on what
we're seeing on TV and what these drugs are and
who they might be right for.
Speaker 1 (34:56):
I thought I was the only one that was getting
those I thought.
Speaker 6 (35:00):
You kind of.
Speaker 4 (35:03):
Figured out the right algorithm for you.
Speaker 6 (35:05):
Yeah, they did.
Speaker 1 (35:06):
You know, if you've ever seen you know, mad Men,
which my wife and I are watching for the first
time right now and love it. You know, advertisers are
good at what they do, and they're good at name recognition,
and a lot of these products are are phenomenal. They
really are a gateway to a new quality of life
for people who've been miserable for a very very long time.
Speaker 6 (35:29):
You know, five, ten, fifteen years ago, there were really
only one or two of each of these.
Speaker 1 (35:35):
In the market for each mechanism of action, and now
what you're seeing is multiple medications with the same are
very similar mechanisms of action, all vying for patient FaceTime,
if you will, because they know that if you go
to your doctor, all else being equal, and that includes
insurance coverage and accessibility on tiered medications, if a patient
(36:01):
asks or something by name, all else being equal, a
physician is going to more often than not, you know,
be accepting of that because we like to please our
patients too, So if we know it's a good medicine
for that patient, we've got two and they asked for
chocolate instead of vanilla, and they're both going to work
equal in our eyes, We're going to give them what
they ask for so they break down thermatologically. Most of
(36:26):
those are going to be an FDA approved medication for
either a topic dermatitis which is a form of exemma
or psoriatis, or storiatic arthritis, which we're breaking into more
and more in that realm of treatment. And now with
a totally different medication which might be a great topic
for our next conversation, which is hindrat andite is superativa
(36:49):
an underdiagnosed, underappreciated cause of a lot of misery, and
there are now three FDA approved treatments available for that,
all of which are these biologic medications which is zero
in on key elements of the commune dysregulation that goes
on to produce the disease that we see. And then
(37:09):
hydrad night is super at tiva. We see large boils
and the armpits around the neck beneath the breast in
the growing area, and they are an extreme cause of misery.
But those are the four main things that the dermatologists
is going to be using these medications for. So I
would say, as an example, in the realm of atopic
(37:31):
dermatitis or egzima, since that was our main topic tonight.
Where with all the topical medications and steroids that we
might have used in the past, and then new different
types of creams that we might have used. To use
a baseball analogy, we traditionally hit a lot of singles,
a lot of doubles, We fouled off a lot, we
strike out a lot. It was pretty rare for us
(37:51):
to get triples and home runs. With the new medications
that are out there, the injectable biologics, which of which
there are or two and possibly a third that I'm
not thinking of out there now. Not to mention trade
names just because they'll confuse the conversation. And there are a
couple of types of pills that are out there that
are these Janus kind as inhibitors. We now have have
(38:14):
four or five real options where we can pretty predictably
hit a trip our home run for our most severe
patients who had this to a degree where it's really debilitating.
I mean I mentioned it to you in the past,
the people who have this, the level of itching on
a scale that some of our patients have, you know,
(38:35):
we're suicidal. In the past, you could care whatever antim
you wanted to. At the US bout anti histories earlier,
and I rarely use them anymore. You almost had to
crank them up to a level of sedation that you know,
people would kind of pass out or have brain fog
chronically to get them to that level. I mean, yeah,
(38:56):
if they work for the issuing looking to sleep, he's
been asleep for fifteen hours, Well that's not really what
we want.
Speaker 5 (39:03):
Oh yeah.
Speaker 1 (39:05):
So the biologics are just it's an incredibly brave new
world with regards to that. That the overwhelming downside to
those that I see because most of the potential downsids
are kind of manageable. You tell people this is the risk, right,
one out of one hundred people is going to get
a B or C, and people will either take those
or they won't. You know, you can talk about air travel,
(39:28):
people will either get on the plane or they won't.
The big downside to these that I see is that
with the new players to market, one would hope through
capitalism that the cost on these medicines will come down,
and I've seen that yet they seem to be at
an elevated plateau. And even though some of them are
getting biosimilars, which is similar to a generic. The cost
(39:51):
savings has not been what one would hope in a
free market. So I don't know if these things become
more and more and more routine and a greater percentage
of a population are using them. You know, that's why
employees see their insurance rates going up every year because
some of the costs of some of these medications. The
same things is for procedures too, right, I mean, you
(40:13):
and I both went to medical school at about the same
time when people going into oncology might as well have
been you know, more titians that they just didn't have
a lot of wins. And right now the oncologists are
are hitting lots of triples and home runs and extending
life and curing illness to a degree that I thought
imaginable as a medical student. But who pays for all this,
(40:36):
you know, and the answers we collectively at this point
in time. But as the even as our population kind
of steadies, longevity goes up. I mean, except for this
mild aberration with COVID, but you know, demographically people are
living longer. They're living longer through better medicine. A lot
of these cases, but there are also more expensive medications,
(40:58):
so I don't know where that line is, but yeah,
the commercials are great because I think they do create
an awareness and they do get people into the discussion.
And I don't mean that's selfish like like oh, Craig,
you're coming into my office and I'm going to make
money off in office?
Speaker 5 (41:12):
Is it?
Speaker 1 (41:12):
I mean, right right, commercial has told you that there
is a better way of life and you don't necessarily
have to sit there in your own misery watching television
shows from twenty years ago like how Canabel is well?
Speaker 4 (41:30):
And you know we use we use these.
Speaker 3 (41:34):
NGI a lot as well, so you know, obviously we've
seen just how amazing you know, these drugs improve people's
quality of life.
Speaker 4 (41:42):
One of the side effects they do.
Speaker 3 (41:44):
Talk about with some of these biologics just you know, interestingly,
given having you tonight, is you know the kind of
the risk of skin cancer and I know we have
to have you back to have a whole hour on
skin cancer alone, but in general in general, like what
do you what do you how do you tell your
patients to protect themselves against skin cancer with these biologics?
Speaker 1 (42:05):
Which about thirty Yeah, I'll be very quick a lot
of the increased risk of skin cancer on those of
squamo cell skin cancers. So it's a non milium of
skin cancer and a certain per percentage of squaymo self
skin cancers are promoted by human papilloma virus HPV virus
that can lay dormant in the skin. So when you're
putting people on some of these medications that decrease iim
(42:28):
you know policing right, you're getting some APV breakthrough. It's
producing more DNA, and it's producing a little bit more
square my cell and that whole thing can be promoted
by ultraviolet light as well. So that's kind of gid
in a nutshell.
Speaker 4 (42:43):
Perfect.
Speaker 3 (42:44):
Well, we definitely need an hour on hydrat and itis.
Speaker 4 (42:47):
We need an hour on pirias's acting and skin cancer.
So you'll be back. So that's going to do.
Speaker 3 (42:52):
It for tonight's segment centered on health with Baptist Health,
I'm your host, doctor Jeff Talblin. I really want to
thank our guest doctor alf Dinabel. You always give us
such practical advice which we are all looking for. Join
us every Thursday night for another segment. I want to
thank our caller Darren, and I want to think mister
Jim Finn, our producer, and you the listener. I hope
(43:12):
everybody has a great warm rest of the weekend.
Speaker 1 (43:26):
This program is for informational purposes only and should not
be relied upon as medical advice. The content of this
program is not intended to be a substitute for professional
medical advice, diagnosis, or treatment. This show is not designed
to replace a physician's medical assessment and medical judgment. Always
seek the advice of your physician with any questions or
concerns you may have related to your personal health or
(43:49):
regarding specific medical conditions. To find a Baptist health provider,
please visit Baptistealth dot com.
It's now time for Centered On Help with Baptist's Help
on use Radio.
Speaker 2 (00:05):
Wait for each MEDJS Now, here's doctor Jeff Tubbler.
Speaker 3 (00:11):
Good evening, everyone, and welcome to tonight's episode of Centered
On Health with Baptists Health here on News Radio eight
forty whas. I'm your host, doctor Jeff Tublin. We're joined
from our studio by mister Jim Fenn, who's on standby
to take your calls to talk to our guest this evening.
Our phone number if you want to call in tonight
is five oh two, five seven one, eight four eighty four.
(00:33):
And we hope that you do well. It's still winner
outside and even though we made it through the large
snow of earlier this month, the effects of winter can
affect us much much longer. With winter comes irritation of
the skin, dryness and ezema and all sorts of other
skin conditions. So to help us tonight to stay symptom
free this winter is dermatologist doctor al Canabel. Doctor Canabel
(00:55):
is a dermatologist specializing in the medical and surgical care
of diseases of the skin, hair, and nails. He is
a graduate of the Indiana University School of medicine and
as a member of the Associates in Dermatology with practices
in Louisville and southern Indiana.
Speaker 4 (01:10):
He's been on our show before.
Speaker 3 (01:12):
He always enlightens us and gives us great practical advice.
Welcome back, doctor Canabel.
Speaker 1 (01:18):
Hey, welcome, Thanks, good to be back. Good to be
linked with the word irritation, and that's right, Inex strictly
linked with that. I think it was my third time back.
So at some point I get like the smoking jacket
and all that type of stuff too, right.
Speaker 4 (01:32):
That's right that you get the jacket.
Speaker 3 (01:33):
And obviously we want to stay away from dryness as
well tonight, Right, so we're going to be I know,
you're always very helpful and animation.
Speaker 4 (01:40):
So yeah, the.
Speaker 3 (01:43):
Last time that you were here actually was over the summer,
and we were talking about summer conditions. So just by
way of sort of kicking us off our dermatologic condition
seasonal in general.
Speaker 5 (01:57):
Some are and some aren't.
Speaker 1 (02:00):
I will tell you that some are directly related to weather,
some just kind of kind of behaviorally. One that you
wouldn't think would be is there's probably an uptick in
skin cancer diagnoses in early spring and summer. But it's
kind of because just people start to kind of undress
and look in the mirror I think a little bit
more critically.
Speaker 6 (02:17):
So we always get these runs of people.
Speaker 1 (02:19):
That come in that way, which is not a meteorological season.
It's just more of a culture and climate thing. You
get a financial season because sometimes people come in super
busy late in the year, you know, because they're deductibles
are met. But what you're referring to is more ultraviolet
light and humidity and that type of thing driven. And
there certainly is are people with atopic dermatitis. I would
(02:43):
say probably a good two thirds of those folks get
much worse in the winter better in the summertime. Piatis
is probably ninety percent of people get better in the
ultraviolet rich days of the summer. The ultraviolet light probably
kills some of the immunological cells and the surface of
(03:05):
the skin, which is not really a good thing, but
it also drives up natural vitamin D production, which is
a good thing. So, Uh, there's seasonality with with those
two entities for sure. Uh. And then we always get
this time of year in particular, just a lot of
people to come in with kind of a catchphrase diagnosis
of winter itch, which is just that dry, irritated skin
(03:28):
that comes in with these big.
Speaker 6 (03:29):
Cold air masses. I think w l k y. You
guys are w l k Y.
Speaker 1 (03:34):
I think from what I heard on your break And
you know Jake Cardozi, the chief meteorologist over there, he
was a guest on my podcast a year or so ago,
and I kind of told him we really should have
a dermatological meteorological report with regards to these these air masses.
Speaker 6 (03:49):
That comes through because they really breaks.
Speaker 1 (03:53):
A lag in there. But you know, there's this huge
cold air mass that we had last week. The air
masses are super super dry when they come and just
cold air cannot contain a lot of moisture because the
physics involved in it. So we have these huge dry
air masses outside, we suck them into our house and
(04:16):
superheated with gas. And we do the same thing electrically
in our cars. So you take these super cold dry
air mats, as you bring them into your vehicle or
your car, suddenly they're warm, Suddenly they can hold a
lot of moisture, so that they're basically tries to just
kind of steal that moisture from whatever it can, whether
it be the carpet, the cat, the wood, and our skin,
(04:37):
and you just get progressively more and more dry, and
people do the wrong thing to combat that, which we
can talk about in a minute, and it kind of
just escalates or goes down bill from there.
Speaker 3 (04:50):
So you mentioned earlier the term kind of a catch
all when you were talking about winter itch, But tell
us about ezema. Is that also kind of a term
that people just kind of throw around for skin condition
or what is exzema and what should we be looking for?
Speaker 1 (05:05):
Yeah, you know, egzma is a catch all phrase. It
shares its root word with an old old Greek word
for to boil, and I think it was a descriptive
term because boiling water has that bubbly kind of looks
from the bottom of a pan or whatever. And so
some forms of eggzma have these deep blisters or vesicles
(05:25):
below the skin that people try to kind of instinctively
try to pop and drain out. But eggzma and even
a more generic term dermatitis, which just means inflammation of
the skin, is really a catch all phrase. I might
have mentioned it to you before, but if I tell
you somebody has egzema or dermatitis, it's like sending you
(05:48):
to the store to get me to ice cream.
Speaker 6 (05:50):
You know, I don't tell you what I want.
Speaker 1 (05:51):
You go down that pick up one of one hundred
different things. But dermatitis like to get paid, and we
get paid the kind of site for all that out
into what exact type of ice cream it is, or
what exact type of dermatitis it is. So when you're
talking about winter, which.
Speaker 6 (06:08):
Almost anybody, regardless of their.
Speaker 1 (06:11):
Immunological predisposition, can experience that because it's really not immunologically
driven like psoriasis might be, or atopic dermatitis is, but
it's more just driven by physics. And everybody has kind
of a set number of oil glands when they're born,
and I set the volume of production.
Speaker 6 (06:32):
But as we get older, that.
Speaker 1 (06:34):
Volume goes down and down and down. So winter, which
is one of those things that you get a little
bit more predisposed to the older you get because of
less natural oil production and probably a little bit less
structural integrity of the way that your body builds its
skin as you get older. But classic sign symptoms of
(06:56):
that locations would be the shins and then the lower
back and the for BacT that little triangle between the
shoulder blade, people just kind of go crazy. But it
can be anywhere. But you know that mid ever back
and lower back and the shin bones where people come
in and they're just literally just digging abrasions in themselves
because the itching just feels the scratching just feels so
(07:19):
good when you're in the throes of it.
Speaker 4 (07:22):
So and is that the major symptom of it?
Speaker 6 (07:26):
Is it?
Speaker 4 (07:27):
Is it just itching? Or do these conditions cause pain?
Speaker 1 (07:33):
Uh? It's kind of a though fine line between the
nerve receptors for pain and for itching. They're they're they're
kind of related, but not quite you know, they came
from the end of the same uh baseline before the
embryo became a person, but there's a distinction. And what
people expect that over time is that pain can sometimes
(07:54):
be preferable to the issuing sensation, which is why the
itch and the scratching can cycle down so far, because
it's the replacement that you get with the pain is
preferable to that sensation of the itching.
Speaker 6 (08:11):
And it can almost be.
Speaker 1 (08:12):
Like some people almost almost a wired sensitivity for the
stitching and scratching, almost with sensual pleasure as well. It
sounds weird, and I know you're g rated, so I
won't go too far down this road. But one time
I had a patient and so you just got to
stop this itching, because it's just the scratching when I do,
(08:33):
it is more pleasurable than relationships. And then well, do
you really want me to stop it?
Speaker 6 (08:38):
You know?
Speaker 1 (08:38):
And he had to think twice about it, because when
you in the throes of this scratching, it can be
really really you know, to the point of it's some
kind of macabre or bizarre ecstasy in some places. But anyway,
we don't want people digging hold in themselves to that matter,
you know, we want.
Speaker 3 (08:55):
To try to No, no, we definitely don't. Well we're
definitely staying away from the dryness conversation, right, So that's good.
So what about over the counter over the counter stuff,
What kind of creams work for itching?
Speaker 1 (09:10):
Well, first I would I would go with behavior first
and just behavior modification. So the things that make this
condition worse are things that intuitively people seek out because
they feel good in the moment.
Speaker 6 (09:22):
So really really.
Speaker 1 (09:23):
Hot showers, which you feel like is going to be
great in the moment, and a lot of our people
who have this condition baked under a hot shower. But
if you think about it, if you have a grease
stain on your table or something, which do you use
to get it out?
Speaker 6 (09:37):
Hot water or cold water?
Speaker 1 (09:38):
You go get a hot rag because it's going to
clean that grease off yourn better than cold well under
the shower. That hot water is stripping your whatever natural
oil you have away. The first thing you've got to
do is kind of go lukewarm to cool water. Try
to god with a very very low surfact and soap,
which means something has a little bit of oil in it,
like do scented or oil of ola, and stay away
(10:02):
from things that have really high surfactant stripping values like
zest and irish spring of those that were the classic
ones that had a lot of fragrance and they could
really strip oil away like pearl shampoo strips away from.
Speaker 6 (10:17):
Oil on the air.
Speaker 1 (10:18):
But it's taking away your natural defense. So lukewarm the
cool water rather than hot, dab dry. And then what
works over the counter for itching in large part is water.
If you look at the active ingredient and a lot
of cream's lotions or whatever, the active the first ingredient
is water. In training, we always said only water can
(10:40):
put water in the skin, so you're really trying to
lock that water.
Speaker 6 (10:44):
In with a hueleft.
Speaker 1 (10:45):
And so if you can get out of the shower
and get something that's got a little bit of oil
on it, you get that on top of the skin
while your skin is still a little bit damp in
it's purest form. That could be vacoline, it could be Crisco,
it could be awqua for but those are pretty heavy,
and then you get secondary problems like acne. So I
would look for a thicker type ocean, you know, like
(11:08):
user or nutrigene or something like that.
Speaker 6 (11:12):
The only really.
Speaker 1 (11:13):
Over the counterproduct that has a prescription element to it
or semi prescription element to it is are things that
have hydrid quarter zone and like court a cream and
that type of thing. But the downside of those is
that our people who have this type of sensitivity have
a lot of predisposition towards developing allergies to all the
preservatives and things that are sometimes in some of the
(11:34):
less expensive over the counter products.
Speaker 3 (11:36):
So, doctor Table, I'm gonna pause us for just a
second so we can take a quick break, because I
want to make sure everybody can hear all this. When
we come back, but we're going to take a very
short break. You are listening to Center It on Health
with Baptist Health here on news radio eight forty whas.
I'm your host, doctor Jeff Tavlin, and we're talking tonight
with doctor Alcannabel about the winter Hitch and other dermatologic woes.
(11:58):
Call us at five oh twove seven one eight four
eighty four if you'd like to ask a question and
join us in the conversation, we'll be right back.
Speaker 4 (12:19):
Welcome back to Send.
Speaker 3 (12:20):
It on Health with Baptist Health here on news radio
eight forty whas. I'm your host, doctor Jeff Helvin. We're
talking tonight with dermatologist doctor Al Canabel about Ezemah winter
Itch and other germanologic woes. It's great to get this
information and feel free to call in and ask him
a question. Five oh two five seven one eight four
(12:41):
eighty four. That's five oh two, five seven one eight
four eight four. Our producer mister Jim Fenn is on
standby to take those calls. So doctor Canabel. Right before
we went to break, you were giving us great advice
about kind of Jews and don't and we just kind
of got started with it with the showering, and that
was great practical advice. So talk us through some of
(13:02):
the other maybe does and don'ts about ezema that maybe
we're not thinking all the way through. What are some
of the other triggers and things we should be aware of.
Speaker 1 (13:11):
Sure, So again to the question that you had about
the best cream. You want something bland, The fewer ingredients
the better. And I hate to go into brand names,
but that's what people see on the shelves, right so
you know, you turn a Vino ros pos A. Those
are all pretty good brands that have a nice hypoallergenic
(13:36):
feel to them. In general, I tend to tell my
patience to stay away from the things that have that
say anti itch in them because they tend to throw
in a couple of other things in there, like menthol
and those can feel really good in the moment, but
they're counterproductive. They tend to burn and sting. Probably the
worst of the lot art or anything that's a gel
based or a spray base, because those tend to have
(13:59):
alcohol all bases. And you know, just like when you
put rubbing alcohol in your skin, it evaporates. Again, you're
gonna be stripping away a lot of natural oil. So again,
if you're in that lukewarm cool shower, if you have
to take hot shower trying to dial it back at
the end. I think that's in the in the James
Bond novels, they call those Scotch showers or something like
(14:20):
that Scottish shower. So you turn at the end, bring
that temperature down and then dry off and then greaze up.
So I think the next thing becomes, what what are
you gonna put on for a base layer of clothing,
Because you know, if you're like me, I'm sitting here
as we speak, I'm in an old house that we've
built in the eighteen nineties. I've got two space heaters on.
I mean, I've got three layers of clothes.
Speaker 5 (14:40):
So the.
Speaker 6 (14:43):
Base layer of clothing that.
Speaker 1 (14:44):
Comes into contact with his skin should be as close
to one hundred percent pure cotton as you can get,
preferably one hundred percent cotton. If you get those the
fibers under a scanning electron microscope, which I know.
Speaker 6 (14:58):
Everybody has at home.
Speaker 1 (14:59):
You know the they're smaller fibers, they're flexible, they're more comfortable,
and there's something about the micro environment that they create
with regards to humidity levels near the skin, that's as
closed to ideal as you can get for a bass layer.
The worst of the lot would be pure one hundred
percent wool. I mean everybody probably experienced that with the
(15:19):
scarf when they were a kid. There's a lot of wool,
cotton blends out there, there's poly wool, but if you
look at those fibers under micro they're much more stiff,
much more likely to be prickly on already dry cracked skin.
So the base layer, you want to get close to
one hundred percent pure cotton as you can. And you know,
(15:43):
I don't know about other folks this time of year,
I end up sleeping in one hundred percent pure cotton,
long sleeves, long underwear, and long stockskin because I've got
this cold house.
Speaker 6 (15:54):
But the wolf just.
Speaker 1 (15:55):
Kind of tears you up. So as you're going outside again,
the meteorologists will that that wind as it whipspy creates
that wind show effect because of evaporation. That evaporations, it's
taking moisture from your skin, is also again taking a
little bit of oil and getting down to that base
way and just ripping little micro chears into your skin.
So try to cover up as much as you can,
(16:18):
or if you have to be exposed on the cheap
snary thing, that's where you might want to go with
something ticker. If you're outdoor all day working postal carrier
construction or something trying nice thick layer of fasciline or
a nice thick and mollient type cream on the cheek
bones and the exposed forehead. As much as the dermatologists
harp on sunscreen if you're not out skiing or something
(16:41):
like that this time of year around here, the U
the INDEXI just isn't that high. But if you want
to wear a sunscreen, I would go mineral based again,
with a nice and allient base to.
Speaker 6 (16:52):
It, so.
Speaker 1 (16:55):
Lukewarm, the cool showers, fragrance free stuff, different types of heat.
I mean, if you really really want to experience winter
itch and all the fun that we talked about before,
go take a hot shower, halfway dry off, put on
a gel, and then goes sit in front of a
fireplace where those temperatures can get to seven hundred eight
hundred degrees really really quick, and just flash evaporate all
(17:19):
the moisture and oil from your skin and you can
get the extremest form of this winter itch, which is
called eggs in a crack a lay, which sounds like
it would be fun to have, but it's really not.
It's actually just fissures opening up in the skin. That
can be on the back, that can be on the arms.
The most frequently we see that on the shin bones.
Speaker 4 (17:38):
That sounds that does not sound fun.
Speaker 1 (17:40):
No, what they're kids who kind of have this tendency
because these kids tend to just sit on the hot
air vents sort of the sit next to that dry
air as it comes out of the wall or in
front of the fireplace that they have it.
Speaker 3 (17:55):
What about food, stress, diet, Like do those things matter
when it comes to flaring it or triggering it?
Speaker 1 (18:04):
Well, I think stress is an accelerant for every dermatological
fire out there. It doesn't make anything better. It's really
difficult to tell people don't go get stressed. Yeah, very
few people consciously go out looking for it. Some people
do with lifestyle and seem to be, you know, thrive
(18:27):
on being miserable. We've all met those people. But it's
really ineffective to tell somebody who don't be stressed.
Speaker 6 (18:34):
But the flip side of the coin on stress.
Speaker 1 (18:37):
Is positive energetic outlets, which I think are good for
lots of different conditions in your field and my field,
and that would be exercise, meditation, that type of thing.
Speaker 6 (18:49):
I think there's a.
Speaker 1 (18:50):
Great role to be had in exercise and the release
of endorphins that goes on daily with meditation and kind
of just clearing the mind and trying to get away
from the constant thinking about how miserable one is or
is not. Whether you could meditate yourself to a plane
where there's no itching, you know, who knows. There's a
(19:11):
lot of there's a.
Speaker 6 (19:12):
Lot of mind over matter.
Speaker 1 (19:13):
But I don't think stress is the root cause of
a lot of these things. But it certainly is an
accelerant and a compounding factor. Food that's going to vary
from individual individual, but certainly it can play a part
in it. I think chronic use of alcohol is a
downer for people who have this because I think you
end up with some gastritis and some problems with the
(19:36):
microenvironment of the GI track, and then you're.
Speaker 6 (19:38):
Not going to be absorbing vitamin AD.
Speaker 1 (19:40):
E K and some of the things that can protect
you from this. I mean, I don't know about you,
but the more compelling literature I find about alcohol is
that it's just not much of a place for it
at the table of health. You know these days. Even
that one glass that people talked about, it probably wasn't
such a great thing. There can be just out and
(20:02):
that food triggers that can compound issue, whether it's gluten sensitivity.
Speaker 6 (20:08):
For me personally.
Speaker 1 (20:10):
Just as an example, night shade type foods, you know,
bell peppers, some potasto and stuff like that. If I
have that on a meal, I've got hot spots that
light up on me routinely, and they just make that
it's more problematic. The problem is that there's really no great,
readily available testing where you can come in and give
a vial of blood and then we can tell you, you.
Speaker 6 (20:31):
Know, predictably and reliably.
Speaker 1 (20:33):
You know, if you avoid the ten foods, you're not
gonna have ditch as much. It's kind of trial and error.
But again the problem exists and that there can be
a delay anywhere between a couple of minutes in a
day and a half between the time that this stuff
gets in your system and then has its negative effect.
So even the allergist, you know, you can test for
(20:57):
one type of allergy you know, you can test for
type one hypersensitivity, but we're not going to give you
much of an impact on what that same molecule is
going to do once it passes through your gut, through
your liver and is metabolized and finds its way to
the walls of the vasculature going out to the skin,
which is where a lot of that problem takes place.
So I do talk with people about about diet. I
(21:21):
think the one thing that I think a lot of
people are moving away from in kind of this more
health conscious environment is eliminating some of the food dies
in our system, which I think are shown pretty predictably
to again give you leaky gut, and the leaky gut
and the skin have their relationships too that we're just
starting to kind of plumb the depths of and then
(21:43):
the water.
Speaker 6 (21:44):
If you're going to.
Speaker 1 (21:45):
Seal take food, what are you going to saw pay it?
You know, what kind of fat are you going to
be bringing into your body? And I think there's better
and better literature that say kind of the high olaic
acid type stuff like avocata oil, you know, olive oil,
are much better for us in the law run than
some of the less exclusive vegetable oil and seed oil.
Speaker 4 (22:03):
So for Nabel, we actually we actually have a caller
for you. His name is Darren, and he has a
question for you.
Speaker 3 (22:10):
But I'm actually going to ask Darren to just hold
on while we take a quick break, and we're going
to start with his question after the break. But I
want to remind everybody that you are listening to Senate
on Help with Baptist Help here on news radio eight
forty whas. I'm your host, doctor Jeff Tablin. We're talking
tonight with doctor al Knabel, dermatologists about winter itch and
(22:30):
other dermatolog dermatological woes. We'll be right back after these messages.
Welcome back to Senate on Health with Baptist Help here
(22:53):
on news radio eight forty whas. I'm your host, doctor
Jeff Tablin, and we're talking tonight with doctor Al Nabl,
germatologists with associates in germatology, who is talking to us
tonight about winter itch and other germanologic issues.
Speaker 4 (23:09):
I want to.
Speaker 3 (23:10):
Let everybody know that you can still call in five
oh two, five, seven one, eight four eight four if
you have a question, But we do have a caller
on the line for you, doctor Knabel. We have Darren
on the line, who has a question about some winter issues. So, Darren,
welcome to Center on Health.
Speaker 5 (23:27):
Thank you every renter. I experience splits on the tips
of my fingers. Is that a vitamin or mineral deficiency
or is it just cold weather related?
Speaker 1 (23:42):
Well, it can be a lot of different things. It's
probably not limited to a vitamin deficiency that would rarely
show up in a super isolated area on the body.
MAK question, Darren, how old are you fifty to sixty.
Speaker 5 (23:55):
Ish something like that, yes, or sixty?
Speaker 2 (24:00):
And then what type of work would I do? I
do work outside, But I mean I've had the issue
for years. I'm in the last twenty twenty five years. Yeah,
I mean.
Speaker 1 (24:13):
It's not really an age related thing, except again the
older one gets, the lesser well they produced. But I've
started having these troubles when i was eighteen. So just
kind of literally that was my own curiosity.
Speaker 6 (24:25):
I was just trying to guess your age based off
your voice.
Speaker 1 (24:27):
So, but if you work indoor, outdoor, you're going to
get that cold air exposure this time of year, and
so do you clear up for the most part in
the summertime?
Speaker 5 (24:39):
Yes?
Speaker 1 (24:39):
Yes, yeah, so you know, so you're probably someone who's
really almost literally just driven primarily by the amount of.
Speaker 6 (24:47):
Moisture that's in the air.
Speaker 1 (24:48):
You know, humidity levels or two points around sixtyre where
people are most comfortable because of the amount of moisture
in there. You get heavier than higher than that, and
you end up with a lot of mugging, and you know,
people it's not feeling good because of too much humidity.
You get down low, it just drives us out. What
I would tell you a couple of things would be,
and we see this all the time. First, avoid things
(25:13):
that will make this worse. So as much as possible,
avoid a lot of hot water hand washing. Avoid any
instant hand sanitizer gel. Even if you use that.
Speaker 6 (25:23):
In the summertime.
Speaker 1 (25:24):
In the winter, you're probably just breaking over a threshold
where you can't really deal with that type of dryness
from the gel. So Blue formed the cool Water dove
soap for us, one of these little dial pump soaks.
In terms of foam rents off with cold water. Drive
very very thoroughly. If you're indoor outdoor, try to at
least always have a light glove on, like a jersey
(25:46):
glove or something like that. Some people's work does not
allowed for them to use a lot of heavy hand
cream and moisturizer during the day because of what they're
dealing with. They can't have tools slipping or whatever, or
they can't be touching screens and getting them greased. So
I get that, but if you could start the morning
with a good cream. My favorite hand cream is a
(26:07):
Nutrigena Norwegian formula hand cream, and you can put that
on as much as you can tolerate during the day,
in the night or when you're getting ready to bed
down if you're a third shifter, when you're done with
your day's activities.
Speaker 6 (26:22):
Washed with cold water.
Speaker 1 (26:23):
That's where a prescription medication, like a good topical steroid
ointment would come in.
Speaker 6 (26:29):
And you want an ointment.
Speaker 1 (26:31):
They're a little bit crazier, but they're more potent, and
you can put that on before you bed down. I
have some of my patients do hypoallergenic white cotton gloves
that they can put over their hands before.
Speaker 6 (26:41):
They go to bed.
Speaker 1 (26:42):
So you've got a good six to ten hours that
you depend on how much you sleep, where you've got
a good micro environment there for those to heal up.
Speaker 6 (26:50):
What I'm about to say it.
Speaker 1 (26:51):
Sounds really really weird, but if you have a kind
of a deep fissure in your hand, they can be
incredibly painful, and so a lot of people that with
new skin. Over the counter, what I do is I
buy a bunch of crazy glue.
Speaker 6 (27:08):
On Amazon and it averages.
Speaker 1 (27:10):
Out to the eighty nine cents the tube, and I
put a little doll up on that out of a
piece of paper, and then I take a toothpick and
I just dip it in there and I paint those
cracked shut with the clean seas and glue like it's
like you're calking around the bathroom or something like that.
Things transiently, and then it gets you one to three
days of good relief as it seals those up. So
(27:31):
you don't put it all over the fingers of the hand.
You just put it in the little crack itself, and
then you know, be careful with it not to shut
your glue, your eyes shut and stuff like that while
it's feeling up.
Speaker 6 (27:41):
But unfortunately, on this.
Speaker 1 (27:43):
One, you're gonna probably need to see someone to give
you a nice prescription. Ointments used in the evening hours.
We have some people who get this every single year,
and if they only have for like six weeks out
of the year. Sometimes we can give them a steroid
shot once a year or something like this. Of course,
if it's more than just winter and it goes to season,
the season, and sometimes you have to investigate it further
(28:05):
to see if there's an immiological cause or an allergic cause,
or some people who work in a motor pool or
warehouse environment might have some hydraulic food or petroleum based
products that they get into their tool. Well around here
in the Louisville metro area, the people that work in
the big distribution warehouse is Amazon Ups and they're handling
(28:28):
a lot of cardboard that's.
Speaker 6 (28:29):
A very very drying agent.
Speaker 1 (28:30):
Every time you touch a piece of cardboard, it's stripping
some of your boisture and water away. So a lot
of our patients who experiences they're doing some sort.
Speaker 6 (28:38):
Of warehouse type of work too.
Speaker 1 (28:41):
And one final thought, even when you're just driving to
and from work, crossing a parking lot, if it's below
thirty five degrees, put some jersey gloves on or something.
Any wind that's coming around your fingers is going to
again set this process into motion. So you want to
try to control that micro environment around your hands as
best you can.
Speaker 3 (29:00):
Well, Darren, I don't know if you have ever tried
to get a new patient dermatology appointment, but this is
amazing because you know, it could take a year to
get into ze A dermatologists. So I hope that this
helps you, Darren. So I really want to thank you
for calling in and joining us today.
Speaker 5 (29:18):
Yes, sir, it was very helpful. Thank you very much
for all that information.
Speaker 4 (29:22):
Yeah, you have a good night.
Speaker 3 (29:24):
So doctor Cannabel, I think you might have kind of
addressed this just by sort of talking about the age
a little bit. But do people outgrow this condition or
does it just you've got it?
Speaker 4 (29:36):
You got it?
Speaker 1 (29:38):
Nah? Probably it probably ends about a year after you've
passed away.
Speaker 6 (29:44):
I don't know more.
Speaker 5 (29:47):
You know, you're really And the other thing is that.
Speaker 1 (29:50):
Sometimes we medicate people with things that can kind of
dry them out right diuretics or as dermatologists. Sometimes if
we have people on acting medications, you know is knowing
the generic tracking team, we're drying their oil lands up
and it doesn't happen just preferentially on the face. It
just so happens that you have a lot more of
them on the face. So if you do have someone
(30:12):
who's predisposed towards ex amount, you know, and we're treating
with some of those things.
Speaker 6 (30:17):
We have to warn them about that in advance.
Speaker 1 (30:19):
And no, I think the problem becomes worse with age.
I think at some point maybe your other problems catch
up with you so that you're not as fixated on these.
Speaker 6 (30:29):
But this is an.
Speaker 1 (30:30):
Absolutely real number one, number two issue for white people.
Snowbird and go south for the winter. This and rheumati
the joint aate some things and skin itching and that's
why everybody gets the hell out of town after Christmas
and they don't come back till, you know, after Saint
Patrick's Day or Easter time.
Speaker 3 (30:52):
And I think you you also started to talk a
little bit about this, which I think would be really helpful.
So somebody's trying all these things that you're recommending at home,
what's the mental trigger for them to think, you know,
maybe maybe a doctor has something more to offer me here,
Like what should they think about coming in to be
seen instead of trying just home remedies.
Speaker 1 (31:15):
Yeah, and that's a very good question. And there's two
things that happen in this situation. That the first thing
is that people will try anything. They will listen to
me tonight, they'll try what I say. They'll listen to
their grandmother down the street, they'll listen to the mailman.
And you'll try one thing for two days, and then
another and then another, and you can really, really, through
(31:36):
no fault of your own, because you're so desperate, you'll
throw the kitchen think at it, and you sink up
a secondary activity. I would say that if you have
tried some common sense type remedies that we've.
Speaker 6 (31:48):
Talked about tonight for.
Speaker 1 (31:52):
One and a half to three weeks and you're not
getting anywhere, particularly if you're losing sleep and or quality
of sleep is being disturbed, you can't focus at work
because of it, or it's school, or if it's putting
a damper on your relationships social, sexual, whatever those relationships are,
(32:13):
then I think it would be whoovi you to go
in and get some help. You know, it's difficult under
any circumstances for single people to meet, but if you're
seeing there scratching, you know, sores into your skin, it
becomes very, very difficult. If you're the kid at school
who can't focus and listen to the teacher because you're
so preoccupied scratching holes in your elbows.
Speaker 6 (32:37):
It's a problem.
Speaker 1 (32:37):
I mean, the job of a child is to eat, sleep,
and play. So if it's interfering with any of those things,
you know, take your child into see a physician dermatologist.
You know, if you're an adult again and you can't
sleep and you can't focus, and you're dwelling on this
and you've ordered more than let's say, three different products
and you're not getting anywhere, I think it's time to
(32:59):
get in and get some help.
Speaker 3 (33:02):
You know, if the job of a child is to eat, sleep,
and play, then I should.
Speaker 4 (33:07):
Be Father of the Year. So I feel like that.
Speaker 3 (33:10):
I feel like I'm doing a really really good job there.
So we're going to take our final break here, but
we're going to come back and talk a little bit
more with doctor Cannabel about winter itches or other derminologic issues.
Doctor Jeff Tublin, you're listening to Senate on Health with
Baptist Health here on news Radio eight forty whas And
(33:30):
if you missed any part of tonight or you could
keep up with all the great information and want to
hear it back, this will be a podcast.
Speaker 4 (33:37):
You can download the iHeartRadio app. It's free it's easy
to use. We'll be right back after this.
Speaker 3 (33:55):
Welcome back to Center It On Health with Baptist Health
here on News Radio eight whas I'm your host, doctor
Jeff Tublin, and tonight we're talking with doctor al Kanabel,
dermatologists and we've been talking a lot about the winter
itch and ezema and all really great practical advice as
we always get with Doctor Cannabel. Remember to download the
iHeartRadio app. It's free, it's easy to use, and you
(34:18):
can re listen to this or any of our previous
segments and have access to all the other features that
the app has to offer. So Doctor Cannabel, and the
time that we have left, I wanted to just ask
if we get to them a few different things throughout
the dermatology world. And the first one is I get
a lot of questions about these TV commercials that are
(34:39):
for these new medications, these biologics that are for all
of these different dermatologic diagnoses.
Speaker 4 (34:46):
Can you just.
Speaker 3 (34:47):
Kind of give us a very small primer on what
we're seeing on TV and what these drugs are and
who they might be right for.
Speaker 1 (34:56):
I thought I was the only one that was getting
those I thought.
Speaker 6 (35:00):
You kind of.
Speaker 4 (35:03):
Figured out the right algorithm for you.
Speaker 6 (35:05):
Yeah, they did.
Speaker 1 (35:06):
You know, if you've ever seen you know, mad Men,
which my wife and I are watching for the first
time right now and love it. You know, advertisers are
good at what they do, and they're good at name recognition,
and a lot of these products are are phenomenal. They
really are a gateway to a new quality of life
for people who've been miserable for a very very long time.
Speaker 6 (35:29):
You know, five, ten, fifteen years ago, there were really
only one or two of each of these.
Speaker 1 (35:35):
In the market for each mechanism of action, and now
what you're seeing is multiple medications with the same are
very similar mechanisms of action, all vying for patient FaceTime,
if you will, because they know that if you go
to your doctor, all else being equal, and that includes
insurance coverage and accessibility on tiered medications, if a patient
(36:01):
asks or something by name, all else being equal, a
physician is going to more often than not, you know,
be accepting of that because we like to please our
patients too, So if we know it's a good medicine
for that patient, we've got two and they asked for
chocolate instead of vanilla, and they're both going to work
equal in our eyes, We're going to give them what
they ask for so they break down thermatologically. Most of
(36:26):
those are going to be an FDA approved medication for
either a topic dermatitis which is a form of exemma
or psoriatis, or storiatic arthritis, which we're breaking into more
and more in that realm of treatment. And now with
a totally different medication which might be a great topic
for our next conversation, which is hindrat andite is superativa
(36:49):
an underdiagnosed, underappreciated cause of a lot of misery, and
there are now three FDA approved treatments available for that,
all of which are these biologic medications which is zero
in on key elements of the commune dysregulation that goes
on to produce the disease that we see. And then
(37:09):
hydrad night is super at tiva. We see large boils
and the armpits around the neck beneath the breast in
the growing area, and they are an extreme cause of misery.
But those are the four main things that the dermatologists
is going to be using these medications for. So I
would say, as an example, in the realm of atopic
(37:31):
dermatitis or egzima, since that was our main topic tonight.
Where with all the topical medications and steroids that we
might have used in the past, and then new different
types of creams that we might have used. To use
a baseball analogy, we traditionally hit a lot of singles,
a lot of doubles, We fouled off a lot, we
strike out a lot. It was pretty rare for us
(37:51):
to get triples and home runs. With the new medications
that are out there, the injectable biologics, which of which
there are or two and possibly a third that I'm
not thinking of out there now. Not to mention trade
names just because they'll confuse the conversation. And there are a
couple of types of pills that are out there that
are these Janus kind as inhibitors. We now have have
(38:14):
four or five real options where we can pretty predictably
hit a trip our home run for our most severe
patients who had this to a degree where it's really debilitating.
I mean I mentioned it to you in the past,
the people who have this, the level of itching on
a scale that some of our patients have, you know,
(38:35):
we're suicidal. In the past, you could care whatever antim
you wanted to. At the US bout anti histories earlier,
and I rarely use them anymore. You almost had to
crank them up to a level of sedation that you know,
people would kind of pass out or have brain fog
chronically to get them to that level. I mean, yeah,
(38:56):
if they work for the issuing looking to sleep, he's
been asleep for fifteen hours, Well that's not really what
we want.
Speaker 5 (39:03):
Oh yeah.
Speaker 1 (39:05):
So the biologics are just it's an incredibly brave new
world with regards to that. That the overwhelming downside to
those that I see because most of the potential downsids
are kind of manageable. You tell people this is the risk, right,
one out of one hundred people is going to get
a B or C, and people will either take those
or they won't. You know, you can talk about air travel,
(39:28):
people will either get on the plane or they won't.
The big downside to these that I see is that
with the new players to market, one would hope through
capitalism that the cost on these medicines will come down,
and I've seen that yet they seem to be at
an elevated plateau. And even though some of them are
getting biosimilars, which is similar to a generic. The cost
(39:51):
savings has not been what one would hope in a
free market. So I don't know if these things become
more and more and more routine and a greater percentage
of a population are using them. You know, that's why
employees see their insurance rates going up every year because
some of the costs of some of these medications. The
same things is for procedures too, right, I mean, you
(40:13):
and I both went to medical school at about the same
time when people going into oncology might as well have
been you know, more titians that they just didn't have
a lot of wins. And right now the oncologists are
are hitting lots of triples and home runs and extending
life and curing illness to a degree that I thought
imaginable as a medical student. But who pays for all this,
(40:36):
you know, and the answers we collectively at this point
in time. But as the even as our population kind
of steadies, longevity goes up. I mean, except for this
mild aberration with COVID, but you know, demographically people are
living longer. They're living longer through better medicine. A lot
of these cases, but there are also more expensive medications,
(40:58):
so I don't know where that line is, but yeah,
the commercials are great because I think they do create
an awareness and they do get people into the discussion.
And I don't mean that's selfish like like oh, Craig,
you're coming into my office and I'm going to make
money off in office?
Speaker 5 (41:12):
Is it?
Speaker 1 (41:12):
I mean, right right, commercial has told you that there
is a better way of life and you don't necessarily
have to sit there in your own misery watching television
shows from twenty years ago like how Canabel is well?
Speaker 4 (41:30):
And you know we use we use these.
Speaker 3 (41:34):
NGI a lot as well, so you know, obviously we've
seen just how amazing you know, these drugs improve people's
quality of life.
Speaker 4 (41:42):
One of the side effects they do.
Speaker 3 (41:44):
Talk about with some of these biologics just you know, interestingly,
given having you tonight, is you know the kind of
the risk of skin cancer and I know we have
to have you back to have a whole hour on
skin cancer alone, but in general in general, like what
do you what do you how do you tell your
patients to protect themselves against skin cancer with these biologics?
Speaker 1 (42:05):
Which about thirty Yeah, I'll be very quick a lot
of the increased risk of skin cancer on those of
squamo cell skin cancers. So it's a non milium of
skin cancer and a certain per percentage of squaymo self
skin cancers are promoted by human papilloma virus HPV virus
that can lay dormant in the skin. So when you're
putting people on some of these medications that decrease iim
(42:28):
you know policing right, you're getting some APV breakthrough. It's
producing more DNA, and it's producing a little bit more
square my cell and that whole thing can be promoted
by ultraviolet light as well. So that's kind of gid
in a nutshell.
Speaker 4 (42:43):
Perfect.
Speaker 3 (42:44):
Well, we definitely need an hour on hydrat and itis.
Speaker 4 (42:47):
We need an hour on pirias's acting and skin cancer.
So you'll be back. So that's going to do.
Speaker 3 (42:52):
It for tonight's segment centered on health with Baptist Health,
I'm your host, doctor Jeff Talblin. I really want to
thank our guest doctor alf Dinabel. You always give us
such practical advice which we are all looking for. Join
us every Thursday night for another segment. I want to
thank our caller Darren, and I want to think mister
Jim Finn, our producer, and you the listener. I hope
(43:12):
everybody has a great warm rest of the weekend.
Speaker 1 (43:26):
This program is for informational purposes only and should not
be relied upon as medical advice. The content of this
program is not intended to be a substitute for professional
medical advice, diagnosis, or treatment. This show is not designed
to replace a physician's medical assessment and medical judgment. Always
seek the advice of your physician with any questions or
concerns you may have related to your personal health or
(43:49):
regarding specific medical conditions. To find a Baptist health provider,
please visit Baptistealth dot com.
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