Maskne – From Wearing Masks

Maskne. What is it?

A breakout on face from mask-wearing. Actually quite common. Acne is due to many things including clogged pores, hormones, and C. acnes bacteria, also from mechanical insult to the skin.

Termed ‘acne mechanica  Repeated friction leads to skin irritation in the short term. Over time, continued friction leads to inflammation that can block pores, and here comes ‘break-out’! As we try to avoid serious illness by wearing a mask, untold negatives can occur. Moisture and sweat become trapped, the area corresponding to the mask can erupt with lesions.

Prevention

Avoid makeup, humidity, and in cold weather, our skin drys and can contribute negatively. Use lightweight sunscreen or facial moisturizer, so as not to plug pores.

Our skin has microscopic layers of protection in form of oils and fats. This can be broken down by mask-wearing. So use petroleum-based moisturizer.

The lips require your attention, use lip balm under the mask, protective petroleum jelly. I use the Desert Essence Tea Tree stick. 

Reusable masks must be washed and if possible use UV-C light to clean, once any mask is damp it must be discarded if non-reusable or washed is reusable.

Wash reusable masks, by soaking in soapy water for 20 min. then let air dry. 

Reusing disposable masks isn’t ideal from an efficacy standpoint nor to prevent skin concerns. 

Research out of University Illinois showed one layer face mask of regular cotton blend t-shirt material can decrease respiratory droplets by 40% and a double layer of these breathable materials offers 98% droplet reduction. * 

simplify skincare, you don’t want products under your skin to contribute to clogged pores, sweating. Avoid harsh products, use petroleum-based products.

Pay special attention to your facial appearance now that mask use is so pervasive.

Should you have had skin problems prior to mask-wearing you must be extra vigilant and as necessary see a dermatologist.

*University of Illinois conducted by mechanical science professor Taher Saif and two graduate students, Onur Aydin and Bashar Emon

 

Virus On The Skin

Just when you think scientists have learned all there is to know about the new coronavirus spread that is by aerosol and droplets, another concerning bit of info hits the medical journals. This time it is how stubborn and long-lasting this virus can be on human skin! 

Preformed on cadaver skin researchers noted that Influenza A survived less than 2 hours while the virus causing COVID-19 is infectious for more than 9 hours!

Recall the CDC recommends 60-90% alcohol-based hand rubs with air dry OR a thorough wash with hand soap for at least 20 seconds.PLEASE Count!

Take away – you must be vigilant, carry a small bottle of hand sanitizer, and use it.

Near Death Experiences & After Life

I feel I would not be a responsible physician nor a good medical blogger if I did not discuss aspects of death. I prefer to discuss near-death experiences that can occur during the Lazarus Syndrome or autoresuscitation chronicled in the medical literature. End-of-life experiences abound but as with any information it must be reviewed and reading authoritative accounts are helpful. Sooner or later we all look for information on this topic. I turn to those who have near-death experiences. There are psychics and physicians, many published. My research has led me to a podcast and a few books I want to share in this blog.
A podcast (NearDeathExperiencePodcast.org) co-hosted by the anesthesiologist, John Meser, DO is the official podcast and audio source for the Near-Death Experience Research Foundation (NDERF.org) is a great starting place. The NDERF was founded in 1999 by a radiation- oncologist, Jeffery Long, MD. Also in your search be sure to listen to Debra Diamond, Ph.D. She has authored Life After Near Death. I particularly value her print (audio available) publication, Diary of A Doula, 25 Lessons the Dying Teach Us About Afterlife.

Long – Haulers – COVID-19 Can Hang Around

It bad enough to contract COVID-19 but some individuals do not  ‘get rid’ of it! While we do not know much about this worldwide illness, the medical community is trying to keep up with learning on the job.

There are some individuals, no profile yet determined for, in which symptoms persist for longer than the typical 2-3 weeks. 

These individuals are varying persistent and even new problems post-acute illness from the SARS CoV-2 virus. This post-viral illness has affected all age groups and in no specific way. New symptoms can develop, for example, actress Alyssa Milano after contracting COVID-19 in March suffering from common symptoms now have hair falling out. Medical professionals need to heed their patients’ bodily complaints as they try life post-acute COVID-19 infection.

To date, just anecdotal reports but no good large study but many are starting worldwide. But research needs time, one sampling found that one in five, 18-34-year-olds were not ‘bouncing’ back to their previous health. (phone surgery by CDC July 31).

When we practice risky behavior putting ourselves and others at risk – think the virus may move in and not leave!  

Viral Load vs. Viral Dose

Viral load exposure versus viral dose exposure – frequent small amounts versus one large exposure – determines how ill you become from exposure to the SARS-CoV-2 virus. It has been repeatedly been shown that this will affect the severity of your illness and outcome. Makes perfect sense when you know that the body can start to develop an immune response (mount a defense) if it is exposed in frequent small amounts of a foreign substance (in this case virus) as opposed to receiving a large dose all at once. Time to mount a response can be critical. 

Simply put a large exposure to SARS-CoV-2 is more likely to trigger severe COVID-19 and poor outcomes.

An illustration in humans is the cruise ship that left Argentina in March. All passengers wore masks almost all who were positive by end of the cruise were asymptomatic. True evidence that universal masking may result in a higher proportion of asymptomatic COVID-19 cases. 

Prospective studies in humans can’t ethically be undergone, but multiple animal studies support this very principle.

Writing in the New England Journal of Medicine, Monica Gandhi, MD, and George Rutherford, MD, of the University of California in San Francisco, postulate that ‘masking’ may act as a “variolation,” exposing individuals to a smaller amount of viral particles and producing an immune response. Further, they write “the initial dose of virus that a patient takes in, is one likely determinant of ultimate illness severity.”

Is the size of the viral load found in a person that determines the outcome?  A South Korea-based study published in JAMA Internal Medicine found that viral load was no different in asymptomatic patients versus those with symptoms. Our bodies are so very complicated, one simple explanation/process does not apply to all of us. 

It must be how you got to that load slowly or all at once. I believe viral load makes a difference, no matter the bottom line –

Wear a Mask!

Caffeine Is A Drug

Caffeine has its benefits!  A caffeine research overview shows us that the ‘drug’ boosts alertness and wakefulness, increases fat breakdown (lipolysis), and may lower the risk of Parkinson’s disease, among many other benefits. But like anything even water excess consumption  can  be a bad thing. The reality is caffeine is everywhere not just in a ‘cuppa’. Caffeine is in Teas, pills, power drinks even with CBD (touted to give a focused burst energy).

‘Caffeine Use Disorder’ is actually a recognized mental disorder!  Your doctor can find it listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)  2013 update to the Diagnostic and Statistical Manual of Mental Disorders, a diagnostic tool published by the American Psychiatric Association (APA).’* I must share that there is a  Journal Of Caffeine Research that has been around for over 40 years. 

Point of this blog is to share how the diagnosis of this condition is made. Presence of at least 3 of the listed findings within a 12 months period. They are:

1. a strong desire for, an inability to cut down on caffeine consumption

2. continued use despite knowledge caffeine has adverse effect on your body. For me it brings on atrial fibrillation an abnormal heart rhythm that can can cause stroke. 

3. presence of withdrawal symptoms when stop use. These include: headache, fatigue or drowsiness, dysphoria, trouble concentrating, and even flu-like symptoms.

4. dependence like with any substance, more is needed with time. You will develop physiological and behavioral tolerance. The body get used to it so caffeine no longer keeps you awake, nor causes diuresis (urinates allot) and the blood pressure doesn’t increase from consumption. Isn’t the body amazing – it adjusts.

5. failure to meet commitments – work, school at home. 

6. continued use despite evidence of caffeine abuse causing interpersonal problems include arguments with a spouse about the consequences of caffeine consumption, resulting medical problems, or cost.

Our society freely accepts open use of this drug – Starbucks on every corner is the best example. It is a legal drug.  You may not know but it has many medical uses, examples include it’s use, IV to delay a baby’s delivery also to wean premature infants off ventilators.

About Wearing A Mask

DO NOT TOUCH MASK -SIDE GAPPING

I want you to know no matter what your community or government says it would be very smart to wear a mask. Communities that don’t mandate mask use, have a higher incidence of spread. By now you’re smart enough to know that masks make a difference.

Protect yourself while protecting others – that is what wearing a mask is all about!

Many of us have several cloth masks hopefully you have a three-layer cloth mask or one with 2 laters plus a changeable filter. How to wear and clean properly is critical otherwise why wear? Remember:

  • Be sure there is a seal on the sides and nose. If it clouds your glasses it is not making a seal. Be sure it is snug sealing the sides on your face and nose.

  • Be sure the mask is clean, and that by washing and drying the fit does not change. I place my mask in a UV-C lightbox then wash it in hot water and air dry.

  • Be careful not to touch your nose when wearing and taking off the mask.

  • Before and after use – wash your hands with soap for at least 20 seconds.  All recent research points to the fact that it is through the nose that the virus comes in and quickly does the most damage.

Follow these guidelines:

  • replace the mask should become damp, and keep it in a secure place so you can wash it with hot water,

  • as you remove your mask always do so from behind to avoid spreading germs,

  • if it’s a single-use mask throw it in the trash that has a li.

 I know I’ve been touting wearing masks, but you should know there are certain situations where mask should not be used:

  •  a child under two,

  •  a person who has trouble breathing,

  •  or a person who cannot put the mask on or take it off by themselves.

We Need Lots Protein

No matter age lifestyle or activity, protein is critical to our health. I believe protein is the most important of the three macronutrients (fats, carbohydrates)that the body requires  to function properly.  We must have it in our diet as our bodies do not make all proteins required.  Vitamins are nutrients also needed but not made in our bodies. 

Proteins are large molecules made up of amino acids – 9 of which are body cannot manufacture. They are lysine, histidine, threonine, methionine, valine, isoleucine, leucine, phenylalanine, and tryptophan.When you hear high protein diet you think meat, eggs and diary, but plant based protein sources are superb and include beans, nuts, soy, peas lentils and more. Excellent studies have shown those using plant based protein do live longer!  You can now find meatless meats, meatless fish etc are plant based and rather tasty, even national fast food chains offer  Impossible Burgers’ or “Beyond Meat’ options. A plant based chicken meal is being tasted national chains presently.

So how much do you need?  Yes age dictates we need more since it is not all absorbed as our gut ages. The Institute of Medicine’s recommended daily allowance (RDA) of protein is 0.8 g for every kg of body weight, regardless of age.Please always regard the RDA as a minimum, not the ideal intake amount.

If you are a healthy 65 or older increase to 1.0-1.2 mg/kg. of protein daily.

Interesting to note that seniors on high protein diet lost more weight than those on any other diets.This study has not been disproved despite being 20 years old.

Athletic types to increase muscle mass should have minimum intake of 1.2-1.7mg/kg of protein daily. The suggestion by the American College of Sports Medicine (ACSM) is that it be met by diet not supplements.

Remember whole foods are always better than supplements that are of isolated nutrients as it is the balance of the ingredient within a food that enriches the value of the nutrient you are attempting to increase in your diet.

Worried About Lurking Virus?

Remember a virus needs to survive till it can get into a living being and replicate. Consider what to date is known about  possible lurking virus in our surroundings.Data can show for example in wood as late as 5 days some protein from virus can be measured, however a viable virus lasts much less, it must come off totally intact to infect a human.This blog address the duration for a ‘viable’ virus on surfaces. Much is common sense for instance NEVER shake used or unused clothing, sheets or clothing. The virus becomes ‘glued’ on a porous surface, it is very inert and disintegrates in 3 hours and also on fabric, it takes 4 hours on wood, because it removes all moisture and does not let it detach and so it disintegrates. Virus does not survive cooper as it is antiseptic! On cardboard it hangs in for 24 hours, 42 hours on metal and 72 hours on plastic surfaces. But if you shake it or use a duster, the virus molecules float in the air for up to 3 hours and can settle in your nose, eyes or mouth – you will not sense it.

Viral molecules remain very stable in external or artificial cold like air conditioners in homes and cars. They also need moisture to remain stable and especially darkness. Therefore, dehumidified, dry, warm and bright environments will degrade it more quickly.

* UV LIGHT especially UV-C breaks the virus protein – inactivates.