The Washington Post - 06.08.2019

TUESDAY, AUGUST 6 , 2019. THE WASHINGTON POST EZ EE E3

BY LINDA A. JOHNSON

Does your tattoo sport your old
flame’s name? Or the one you got on
a whim no longer fits your image?
You’re not alone. Many people
have “tattoo regret” — or “regert”
if there are misspellings in the
design — and are opting to get the
ink removed.
Nearly 3 in 10 American adults
have one or more tattoos and
25 percent want them removed,
said Paul M. Friedman, director of
the Dermatology & Laser Surgery
Center in Houston and New York.
Friedman, a spokesman for the

American Society for Dermatolog-
ic Surgery, says people of all ages
are seeking removals, but he has
seen an increase among millenni-
als. The medical group estimates
its members performed 85,000
tattoo removals in 2017, the latest
data available, but that doesn’t
include ones removed by other
medical workers.
Dermatologists say the newest
laser equipment can eliminate
most tattoos without scarring, but
be prepared for a long, expensive
process. Insurance won’t cover it.
Tattoos can be removed three
ways:

Laser removal, generally the
preferred method. The laser sends
lights pulses of different wave-
lengths for each color for fractions
of a second. The pulses break
apart skin cells and rupture the
ink inside them into tiny particles,
which the lymph system picks up
and the body gradually excretes.
Local anesthetic is given to pre-
vent pain.
This usually produces the best
result, but takes four to 10 ses-
sions, depending on the tattoo’s
size and colors, the patient’s skin
tone and other factors. Each ses-
sion can run about $450 for a small

tattoo to $1,000 for a large one.


Dermabrasion, or scraping

away the skin’s top layers. It can

leave big scars and not remove all

the ink, said Eric F. Bernstein,

director of the Main Line Center

for Laser Surgery in Ardmore, Pa.


Surgical removal, or cutting

out top layers of skin. This can also

leave scars, but can be a good

option for small tattoos or if the

tattoo inks have caused an allergic

reaction and need to be removed

quickly, Bernstein said.

“Wait till you can do it the right

way,” said Bernstein, past presi-

dent of the American Society for

Laser Medicine & Surgery. “If you

try to do something on the cheap,

you take a fixable problem and

turn it into an unfixable problem

with a big scar.”

Ryan Tucker, a firefighter who

lives in a Houston suburb, spent

about $6,000 over 10 laser treat-

ments to have Friedman remove

a tattoo across the back of his

neck that said “Natalie,” his ex-

wife’s name.

“I was young and stupid and

thought it was a good way to show

affection, which it’s not,” the 39-

year-old Tucker said.

Tucker said he occasionally felt

a poking sensation but otherwise

the brief treatments didn’t hurt —

unlike the “super painful” process

of getting the tattoo. Tucker said

the area felt like it was lightly

sunburned for a few days after

each treatment.

Some tips from the medical

groups:


Find a dermatologist, prefera-

bly board certified, with tattoo

removal expertise and advanced

laser surgery training.


Make sure the doctor has la-

sers that cover multiple light wave-

lengths, matching the colors of

your tattoo. Ask whether they have

the newest lasers — Q-switched or

picosecond lasers, Bernstein said.


Ask to see before-and-after

photos of patients with a similar

skin tone.


Follow after-care instructions.

The area will probably be red and

irritated, as skin is right after get-

ting a tattoo.


Don’t rush the job. It’s best to

wait a couple of months between

sessions.

“That’ll cut down on the num-

ber of sessions,” produce the best

result and reduce the cost, Fried-

man said.

— Associated Press

If the word “hospital” elicits a

mental image of sterile rooms and

hallways and dreary decor, think

again.

Modern hospitals have hit on a

simple but effective way to foster

even more healing: art.

It’s a creative approach to an

age-old need — and one that’s

transforming not just the walls of

modern hospitals but the atmos-

phere in which patients heal. In

an engaging feature for Artnet,

journalist Menachem Wecker

dives into the world of hospital

art.

It’s a much deeper well than

you might think.

Clinicians have long wondered

how to make hospitals more, well,

hospitable. Art and architecture

have always been parts of those

conversations. Wecker takes a

long view of his topic, incorporat-

ing the latest scientific research

into art’s beneficial effects for pa-

tients.

He doesn’t stop there: The arti-

cle takes readers to modern-day

clinics where art and science com-

mingle. Many leading hospitals

have public art programs and per-

sonnel whose jobs revolve around

aesthetics. Wecker interviews art

experts from the Cleveland Clinic

and the health facilities at the

University of Texas at Austin.

The art goes way beyond ho-

hum landscapes in hospital

rooms. So do its effects, which can

linger with patients and their

families long after they’ve been

discharged.

“One engages with works of art

with a different mind-set when

one’s sick than when one’s

healthy,” Wecker writes.

His piece will leave you with a

sense of art’s role in modern

health care — and a healthier

appreciation of its healing power.

— Erin Blakemore

HEALTH NEWS

Got real ‘regerts’ over your old tattoos? There

are surgery facilities that can erase that ink.

HEALTH SCAN

LANDSCAPE OF MEDICINE

Modern hospitals discover the therapeutic touch of sculptures, murals and other artworks

‘Fine Art Is Good Medicine’

http://www.artnet.com

T

o find the healthiest

brown bread, start by

looking for whole

grains. Adults should

eat about 48 grams of

whole grains a day, and studies

show that they may help lower the

risks of heart disease and Type 2

diabetes. Examine these labels to

choose your loaf wisely.


100% Whole Grains. This

language indicates that a bread’s

flour is made from the entire

grain kernel — the bran, en-

dosperm and germ. Refined

grains, such as white flour, con-

tain only the endosperm. The

bran and germ are where most of

the healthy stuff — antioxidants,

B vitamins, fiber and other nutri-

ents — is found.


100% Whole Grain stamp. A

100% Whole Grain stamp means

all of the bread’s grain ingredients

are whole grain, and it has at least

16 grams of whole grains per serv-

ing. A 50%+ stamp means at least

half are whole grains, and a stamp

without a percentage means less

than half are whole grains, but the

product contains at least 8 grams.


Whole Grain and Whole

Wheat. Whole-wheat bread is

made with whole-wheat flour.

Whole-grain bread can also in-

clude other types of grains, such

as oats, brown rice and barley. As

long as the bread is 100 percent

whole grain, the two types are

equally nutritious.


Made with Whole Grain.

This phrase can be confusing —

especially when “made with” ap-

pears in small print — because the

bread may still contain mostly

refined grains, which are not as

nutritious as whole grains.


Multi-Grain. This indicates a

bread with more than one type of

grain, but you won’t know how

many — or whether they’re re-

fined or whole — based on those

words alone.


21 Whole Grains and Seeds.

How many types of whole grains a

bread has matters less than where

they appear in the ingredients

list: Look for whole grains toward

the top, which means they are a

main ingredient. If they’re buried

far down on the label, they may

just be sprinkled in or added as a

topping.


USDA Organic. Breads with

this seal are made with at least 95

percent organic ingredients, and

the grains used were not grown

with harmful synthetic pesti-

cides.


Good Source of Fiber. By

Food and Drug Administration

standards, a product with this

claim contains between 2.8 and

5.3 grams of fiber per serving. But

if you want to know the exact

amount, check the fiber grams on

the nutrition panel.


Double Fiber. This typically

means a loaf ’s fiber is double the

amount found in that same

brand’s other whole-grain op-

tions. To get there, some brands

use added fibers such as “cellulose

fiber,” but our experts say fiber

from whole grains is better.

© Copyright 2019, Consumer Reports Inc.

FROM CONSUMER REPORTS

Check bread labels to pick the right loaf

ISTOCK

35

inches

A woman’s body shape, and not just her weight,
may have an impact on her health. Women
with a waist circumference of 35 inches
(88 centimeters) or more face an increased risk
for obesity-related health issues, including
premature death, according to new research
culled from the long-term Women’s Health
Initiative study. And that was so even if a
woman’s weight or body mass index (BMI) was
within a normal range. Postmenopausal women with excess fat in
their midsection — known as central obesity and sometimes referred
to as an apple shape — were 31 percent more likely to die prematurely,
including from cardiovascular disease and obesity-related cancer,
than were normal-weight women who did not have extra belly fat.
That risk was considered comparable to the risk faced by someone
deemed obese by BMI standards. The results, published in the journal
JAMA Network Open, were based on data that tracked the health of
156,624 postmenopausal women for more than two decades. Whether
the findings apply to younger women or to men was not tested. A
commentary published along with the study says the findings serve as
“a reminder that the scale is not everything” and that people with a
low BMI are not automatically fit and at low risk. Rather, where fat
accumulates on your body can have an effect on your health.
— Linda Searing

THE BIG NUMBER

Perhaps the skin

in between your

toes is itchy. Or

the skin on the

sides of your feet

is flaking and

irritated.

These are classic signs of

athlete’s foot. Doctors call it

tinea pedis and it’s a common

fungal infection, affecting 15 to

25 percent of people at any one

time.

“It’s flaky dead skin overlying

redness,” says Adam Friedman,

a dermatologist at George

Washington University School

of Medicine and Health

Sciences. Skin between the toes

may look white and soggy, the

soles of the foot are more likely

to be dry and flaky, and

reddening and blistering can

appear anywhere.

Still it might be something

else — psoriasis and eczema can

look a lot like athlete’s foot.

So how can you be sure you

have athlete’s foot? Do you need

to see a doctor for diagnosis and

treatment?

“Most people want to treat

athlete’s foot,” says Shari Lipner,

a dermatologist at Weill Cornell

Medicine in New York. Even

when the itching and burning

symptoms are very mild, the

condition is unsightly. Also, the

fungus can invade the nail —

and nail fungus is much harder

to treat, Lipner says.

But you don’t necessarily

need to see a doctor. It’s okay to

try an over-the-counter product

on your own. Look for those

that contain an antifungal

medication such as terbinafine

(Lamisil), clotrimazole

(Lotrimin), tolnaftate

(Tinactin), miconazole

(Micatin), or undecylenic acid

(Cruex). Other products, such as

those containing tea tree oil or

“natural” salts, have little

evidence to back their use,

Lipner says.

“Generally, we recommend

treating for about a month,”

Lipner says.

But if your symptoms don’t

improve after a couple of weeks,

you should probably see a

doctor.

Friedman says even doctors

cannot always identify athlete’s

foot correctly. He says he found

that dermatologists looking at

still images may make errors in

identifying various skin

conditions. And errors can have

consequences. Steroid creams,

for example, might be

appropriate for eczema but can

make athlete’s foot worse.

Dermatologists can diagnose

athlete’s foot by taking fungal

cultures or doing a two-minute

in-office procedure, called a

potassium hydroxide (KOH)

test.

The fungi involved are

usually one of two species of

Trichophyton, either rubrum or

mentagrophytes.

“Our skin cells are foie gras to

them,” Friedman says. “These

organisms just like the top layer

of skin.” But when fungus take

up residence on the surface, he

says, “They can open the door to

bacteria and other infections to

cross the barrier.”

For instance, athlete’s foot

might start out scaly red, but if

it becomes red, swollen and

painful, it’s a warning sign of

something else. Inflammation

might indicate a bacterial

infection, even a serious one

such as cellulitis.

Untreated athlete’s foot

means you’re harboring fungal

growth. That fungus can spread

to the toenails to cause a

condition called onychomycosis

— or more simply, toenail

fungus.

“With nail fungus, it’s even

more important to see a board-

certified dermatologist,” Lipner

says. “Lots of things make the

nails look abnormal. About

50 percent of the time, it’s nail

fungus.”

Over-the-counter ointments,

powders and sprays don’t work

against nail fungus. Typically,

this condition is treated with

oral antifungal medications, or

one of the newer topical

preparations, which are pricey

and by prescription only.

It’s important to treat nail

fungus because it serves as a

reservoir of organisms,

Friedman says. The first-line

treatment is oral terbinafine —

“A pill a day for three months,”

he says. Toenails grow slowly, so

you’ll have to wait for the

unsightliness to grow out. “It

can take a year to look normal,”

Friedman says.

Once you’ve rid yourself of

athlete’s foot, you might want to

focus on preventive measures.

Lipner advises wearing flip flops

on pool decks and in locker

room showers, wearing

moisture wicking socks and

keeping your nails short.

“Probably the biggest risk

factor is a family member with

athlete’s foot,” Lipner says.

You’re sharing floors and

showers in your home.

“Genetics may play a role, but

exposure is the key thing.”

Keeping your feet clean and

dry is important, especially if

you wear closed shoes and if you

exercise. “Running shoes are

petri dishes — dark, warm and

salty,” Friedman says, ideal for

fungal growth.

Still, Friedman says dry skin

on your feet also can be a

problem. Fungus in our

environment is looking for a

way to latch on. Dry cracked

skin offers that opportunity. So

moisturizing your feet regularly

can help.

If you’re prone to athlete’s

foot or have a history of nail

fungus, Lipner recommends

daily treatment with a drugstore

antifungal product — it reduces

your chance of recurrence

threefold, she says.

“Athlete’s foot tends to be a

chronic condition,” Lipner says.

“Expect it to come back. Expect

to treat it again.”

[email protected]

Treating athlete’s foot and avoiding bigger problems

AnyBODY

JILL U.

ADAMS

Consumer Reports is an independent, nonprofit organization that works side

by side with consumers to create a fairer, safer, and healthier world. CR does

not endorse products or services, and does not accept advertising. CR has no

financial relationship with advertisers in this publication. Read more at

ConsumerReports.org.

Dermatologists say the

newest laser equipment

can eliminate most

tattoos without

scarring, but be

prepared for a long,

expensive process.

PAUL FRIEDMAN/ASSOCIATED PRESS

These images show Ryan Tucker’s back before and after laser tattoo
removal procedures in Houston. Tucker spent about $6,000 for
10 treatments to get rid of “Natalie,” the name of his ex-wife.

Untreated athlete’s foot

means you’re harboring

fungal growth. That

fungus can spread to

the toenails.

ISTOCK