Simple, cheap remedy for toenail fungus

I used to cringe when my yoga instructor told us to “take off your socks.” The big toenail on my right foot was an ugly flakey brownish gray, a condition I’ve had for years. It may have started when I was taking Tae Kwon Do and kept landing on my big toe while trying to do roundhouse kicking.

I don’t know which is more embarrassing, having a discolored toenail or being the only one in yoga class with socks on. I was also unhappy at the beach and the community pool in the summer. Yeah, I could paint my toenails, but I was hoping that if I let that big toe breathe, it would eventually get better.

The toe was not only discolored but sometimes uncomfortable, so I went to a podiatrist who said he thought I had a nail fungus and gave me a liquid topical with a brush (much like nail polish) to apply daily.  This I did for months and months without any noticeable change. I returned to the podiatrist and he clipped a piece of the nail to be analyzed, and it was confirmed, I had a fungus. He sent me for blood tests because the next form of treatment would be Sporanox (itraconazole), a prescription antifungal pill that carries serious health warnings and precautions. At first, it seemed as though the Sporanox was going to work and then the fungus returned. I was then given another liquid topical and another antifungal medicine.

Buzzword: Teeth bleachorexia

What does it mean? Bleachorexia is the compulsion for ever-whiter teeth.

Why the buzz? Americans have been snapping up at-home tooth whitening kits. We spent $343 million in 2008 on these products, which claim to give you a brighter smile in a week or so. And they can brighten teeth somewhat, our tooth whitener tests show. But how much tooth bleaching is too much? Can a person overdo it by wearing teeth whitening strips or trays too often?

The American Dental Association thinks so. While tooth whiteners may seem as innocuous as toothpaste, the ADA says if they’re applied improperly the chemicals in the products might damage your gums and teeth. And unsupervised use might mask an undiagnosed medical condition or an unknown allergy. 

Moreover, tooth whiteners are not regulated by the Food and Drug Administration. And some important information about the products is often missing from their labels. For example, last year the European Scientific Committee on Consumer Products recommended that home tooth-bleaching products contain no more than 6 percent hydrogen peroxide. But none of the eight tooth whiteners tested and rated (available to subscribers) by Consumer Reports included the peroxide percentage.

Finally, no one seems to know how often you can safely use tooth whiteners. The ADA simply says more studies are needed, especially for products containing a high concentration of hydrogen peroxide.

Ad for eyelash drug Latisse goes too far

The first time I saw this commercial for the eyelash-growing drug Latisse (bimatoprost) back in June, I almost wasn’t sure it was real. Sure, we’d blogged on Latisse several times since it received approval from the Food and Drug Administration in late 2008, mainly urging consumers to think hard before using it, given the cost and unsavory risks. But I still couldn’t quite believe the level of glam-infused over-the-topness the commercial imparted, making a powerful prescription drug that can cost more than $100 a month sound like just a really, really cool new makeup item (and featuring superstar Brooke Shields, no less). If I didn’t know better (and it wasn’t a Tuesday), I would have thought it was a Saturday Night Live skit, like this hilarious take on extended-cycle birth-control pills.

The Latisse commercial might portray it as the new big thing, but it’s not really new at all; it originated as Lumigan, a glaucoma medication approved in 2001 that, in a stroke of pure luck for its manufacturer, turned out to have the unusual side effect of lengthening, thickening, and darkening users’ eyelashes. Hence, a rebranding as the first FDA approved treatment for sparse or inadequate eyelashes, clinically known as hypotrichosis. A representative for Brooke Shields declined to say how long Brooke has suffered from the disease of eyelash inadequacy. But she did confirm that Brooke started using Latisse in February 2009, “after consulting with a doctor who determined she was an appropriate candidate for treatment with LATISSE,” and that she is still using it. If you’re good at math, you’ll know that adds up to around $800 worth of eyelash improvement and counting.

The fact that the Latisse commercial looks like an ad for makeup rather than a drug is only the beginning of what completely freaks me out about it. Somehow this single commercial and its print companions running in magazines like Allure manages to embody everything that’s wrong about direct-to-consumer drug advertising. Specifically:

Talking with a White House bigwig about health reform

Well, technically not big at all – Nancy-Ann DeParle, director of the White House Office of Health Reform is so petite that when she arrived for our interview Friday morning, we had to switch to smaller chairs because the ones we had chosen, she said, “make me feel like I’m in kindergarten.” But we covered a lot of ground on a subject that is anything but small. I’ll have full details (and a video) early next week, but here are some preview highlights from her answers to the questions we assembled from the experiences and suggestions of our readers:

• The elimination of medical underwriting – a feature of every one of the bills before Congress – is an underappreciated boon for consumers. Once insurers are barred from using pre-existing conditions to deny or limit coverage, or charge people higher premiums, they’ll no longer have any reason to look into anyone’s medical history. Insurers right now spend untold billions investigating and evaluating applicants’ medical histories, DeParle pointed out – especially those who get their insurance as individuals or as part of small employer groups. After reform, that money can be spent on providing health care, instead of denying it.

• I asked her what relief might be available right now for people who can’t get or afford coverage because of pre-existing conditions while they wait for full reform to begin in 2013. She said the Administration is working with Congress to set up a temporary national high-risk pool that could be up and running within a year of the passage of a reform bill, complete with subsidies to make coverage more affordable. Folks shut out of the market because of their health history could buy health insurance there for the time being.

-- Nancy Metcalf, senior program editor 
 

For women, foot pain often comes on the heels of poor shoe choices

Listen up, ladies: think carefully about your shoe choices today if you want happy feet in the future. That's the message of a new study, which found that women who wear sensible shoes are much less likely to have pain in their hindfoot when they're older.

The study included 1,900 women and 1,472 men who were age 50 or above. They were asked whether they currently had pain, aching, or stiffness in one or both feet, and if so, whether it affected a specific part of their foot. They were also asked about their current and past footwear across five age groups: 20 to 29 years, 30 to 44 years, 45 to 64 years, 65 to 74 years, and over 75 years. The researchers sorted the footwear into three categories: good (low-risk shoes offering lots of support and stability, such as athletic shoes and sneakers), average (mid-risk shoes, such as hard- or rubber-soled shoes and work boots), and poor (high-risk shoes lacking good support and structure, such as high heels, sandals, and slippers).

Overall, 29 in 100 women and 19 in 100 men reported having foot pain on most days. But while men's current and past footwear didn't seem to affect their chance of having pain, women's did. Women who had a history of wearing good shoes were 67 percent less likely to have pain in their hindfoot than those who wore average shoes. (The hindfoot is the rear of the foot, above the heel.) Why the difference? The researchers point out that good footwear is designed to cushion the foot, often with softer soles infused with foam, gel, or other shock-absorbing material. Since the hindfoot receives the largest shockwave with each step, these shoes could help prevent pain in this area.

7 ways to fewer wrinkles

Some people are born lucky—but for the rest of us wrinkles are a natural part of aging. And defying nature can mean trying out a number of eye creams, overnight serums, collagen-based injectables, and even some pretty interesting "facial toning" devices. While any one or combination of these products may work for you, our sister publication, ShopSmart, has some simple, do-it-yourself ways to prevent those fine lines from getting deeper:

1. Use a facial moisturizer with an SPF of at least 30 to limit the sun’s damage every day, not just when you’re at the beach.
2. Shield your face with a hat and sunglasses when you’re outdoors, particularly on sunny days.
3. Avoid tanning beds. Those ultraviolet rays can be even more intense than the sun’s and can increase your risk of skin cancer.
4. Don’t smoke. Tobacco ranks second only to sunlight in its dire effects on skin.
5. Try not to rub your eyes. Treat hay fever so you’re less itchy and not tempted to rub.
6. Sleep on your back. Mashing your face into a pillow can cause lines to form over time.
7. Get an annual eye exam. If you can’t see clearly, you’re likely to squint, which can create wrinkles.

—Ginger Skinner

FDA warns maker of Latisse about misleading claims

We’ve blogged about the new eyelash enhancement drug Latisse several times before. And we’ve talked about how the drug has some side effects that are rather serious for a cosmetic product, and that Allergan’s promotional materials tend to downplay such risks. Now the Food and Drug Administration has sent a warning letter to Allergan, saying that many claims on its website are misleading and, in fact, unlawful.

You can read the whole letter for yourself, but here some highlights.
 
Latisse’s Website says:
In the “Is Latisse safe?” section of the drug’s website: “The FDA reviewed clinical study results to verify the identity, potency, purity and stability of the ingredients, and demonstrated that the product is safe and effective for its intended use if used as prescribed.”

The FDA says:
This description is misleading and it fails to mention that Latisse may have side effects, or mention any of those side effects. It also implies, according to the FDA, that Latisse is “especially safe because the FDA has verified the identity, potency, purity, and stability of the ingredients.”

Latisse’s Website says:
The website also answers the question, “Why do the directions say to only apply Latisse solution to the base of the upper eyelashes?” by saying: "A clinical trial of Latisse was conducted on patients who applied the product to the base of their upper lashes only. Applied nightly, the transfer of Latisse solution from the upper to lower eyelid may occur naturally because the eyelids are closed and the eyelashes touch each other."

Latisse: Long lashes, longer list of risks

Recently, we reported on some safety concerns surrounding the use of the eyelash-enhancing drug Latisse, including some common side effects, such as red and itchy eyes, and what the ad for this controversial drug calls a potential for "eyelid skin darkening," and "increased brown iris pigmentation."

Our new video takes a closer look at the health drawbacks and the advertisement behind this drug, featuring celebrity spokesperson Brooke Shields. Take a look as ShopSmart magazine editor, Lisa Freeman, and our medical consultant, Dr. Amy Newberger, tell you why the risks of using Latisse may outweigh the drug's cosmetic benefits.

—Ginger Skinner

Clearing up acne myths, and tips on preventing breakouts

Good news for chocolate lovers—that chocolaty treat you devoured after dinner last night is not the cause of your unwelcome breakouts. In fact, there’s no evidence that eating chocolate or fatty foods triggers acne. The perceived connection between the foods you eat, such as chocolate, pizza, and french fries, and the pimples that oh-so-inconveniently appear on your face, neck, back, chest, and shoulders is just one popular myth. Here are some others:

You get acne when you don’t wash enough. Blackheads are not black because of dirt, and actually, hard scrubbing can lead to dryness and irritation, and make acne worse.

Popping pimples can make them disappear. While popping pimples can make them temporarily less noticeable, popping a pimple pushes bacteria further into the skin, making the area around the acne even more reddened and inflamed, and possibly leaving a scar that could last for months or longer.

Heavy Metal: When it’s bad for your ears

No, despite the title, this is not another noise blog. Last month I wrote about the health risks of skinny jeans after I saw a magazine ad for a "Skinny jeans challenge" while waiting to see a surgeon for a torn earlobe. Ironically, I, too, had sacrificed my better judgment for the sake of fashion. After years of wearing heavy gold and silver earrings, gravity had caused a split in the piercing that needed to be surgically repaired.

So as I wait for my incision to heal and sit out the three-month period before I can get my ear lobe re-pierced, I did some investigating. Ear piercing has been around for centuries and practiced in many cultures. Over time the custom has grown in the Western world with around 90% of women currently adorning at least one ear with jewelry. Along with this increase in popularity has come a rise in the number of complications, 35% according to one survey of 452 hospital nurses, most of those infections.

It’s not unusual to develop an infection as a result of piercing. Although infections are most often localized to the skin, if left untreated, they can lead to more serious illness including abscess, septicemia (an infection of your blood) and endocarditis (an infection of the heart lining and valves). Earrings may also become embedded in the lobes of children and require surgery. The risk appears to have an association with the practice of using ear piercing guns.

Q&A: Poor diet to blame for brittle nails?

I have brittle fingernails and toenails that are prone to splitting. Is my diet deficient? —Philip Schaefer Louisville, KY

Not likely. Although nails can reflect dietary deficiencies, the deficits must be extreme, a rarity in this country. Nails can also be affected by chronic diseases such as anemia and hypothyroidism. But the most common cause of nail brittleness is exposure to water. Use moisturizing hand soap, limit your shower or bath time, wear cotton-lined rubber gloves to wash dishes, and regularly use hand cream. If brittleness persists, consider seeing a dermatologist.

Get information on fungal nail infections, which affect about 1 in 7 U.S. adults, and see which treatments work best (subscribers only).

Image courtesy of goodcatmum

Q&A: Are sunless tanning products safe?

Are self-tanning lotions safe to use? —T.V., Winona Lake, Ind.

They appear to be. All self-tanners approved by the Food and Drug Administration use the same color-producing chemical, a substance called dihydroxyacetone (DHA) that reacts with proteins in the outermost layer of your skin to create a brownish pigment called melanoidin. The sunless tan usually lasts two to five days, wearing off as you naturally shed the darkened outer skin cells.

While a few test-tube studies have suggested that DHA might cause cell damage, we could find no human studies examining that risk. But it’s been used in the U.S. for more than 40 years with no major ill effects reported. And the FDA allows DHA in cosmetics only if, as in lotions, they’re not likely to enter the body. (The spray “mists” available in tanning salons technically aren’t FDA-approved since they can come in contact with your eyes, lips, and nose.)

Read more on how to get a tan without the sun, and see our sunless tanning product Ratings  (subscribers only). And before you go out in the sun this weekend, take a look at our new sunscreen survey and Ratings (subscribers only).

Q&A: Should you apply sunscreen to your eyelids?

After spending a day out in the sun, my eyelids get red and sore as if they were sunburned. Should I put sunscreen on them? —A.G., Port Chester, N.Y.

That depends. It’s safe to apply sunscreen to eyelids, but swimming or sweating may cause it to run into your eyes and irritate them. You may have better luck using a moisturizer or eye cream with a sun protection factor (SPF) of 15 or higher, which is absorbed more easily into the lid and less prone to run into your eyes. The best strategy might be to wear wraparound sunglasses that block ultraviolet (UV) light and a wide-brimmed hat to protect both the delicate skin around your eyes and the clear membrane covering the front of the eyeball. (In severe cases that membrane can get burned, a condition called snow blindness because it often happens in winter when the snow reflects sunlight.)

Check out our sunscreen poll for more on who's more likely to use sunscreen—men or women. And take a look at our latest Ratings (subscribers only) to find out which 3 sunscreens performed better than the rest.

Q&A: Cosmetic concerns

Is it dangerous to inhale the dust from facial powder? —P.C., via e-mail

That's unclear. People exposed to very large amounts of those powders, such as workers in manufacturing plants, may be at higher risk of lung disease and certain cancers. But there's little research on the amount people breathe in while applying makeup. If you're concerned, look up potential hazardous cosmetic ingredients at the Environmental Working Group's Cosmetic Safety Database or at www.GreenerChoices.org.

Read more on the risky chemicals that could be lurking in your cosmetics.

Brooke Shields touts benefits of Latisse in ad that downplays risks

We’re accustomed to seeing celebrities pushing prescription drugs in TV ads, so I was not surprised when I saw that Brooke Shields had signed on as spokeswoman for the new $120-a-month eyelash-lengthening drug Latisse (bimatoprost). But it did strike me as surprising that Shields would have the condition hypotrichosis, for which the FDA approved the drug. Allergan, the maker of Latisse defines the condition as "inadequate or not enough lashes."

I suppose adequacy is in the eye of the beholder to some degree. These promotional before and after pictures suggest that Shields’ lashes did get longer. But were they really “inadequate” to begin with? That’s an important question because the drug has some serious risks that should be considered. Latisse’s benefits are strictly cosmetic, the side effects might not be.

Our consultants are concerned not just about the common side effects of red and itchy eyes, or the potential for adverse cosmetic outcomes. Note that the ad, which has been posted online by Sona Medspa, downplays the risk of "eyelid skin darkening" by saying that this effect “may be reversible.” I guess that means it may also be irreversible, no? Further the ad describes a potential for “increased brown iris pigmentation.” But that suggests that the irises were brown to begin with, doesn’t it? The fact is that, while rare, bimatoprost has been known to darken even blue and green eyes to a permanent dark brown.