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Nicotinamide

Nicotinamide, a form of vitamin B3, is an over-the-counter tablet that has the potential for preventing and resolving actinic keratosis (AK) and sun-induced aging that are caused by sun exposure.

Guidelines for Using Nicotinamide:The recommended dosage for preventing and treating AK is 500 mg twice daily. It is intended for long-term use given its preventive effects.

Sun Protection: Nicotinamide should be part of a comprehensive sun protection strategy that includes the use of a sunscreen, protective clothing, and avoiding excessive sun exposure.

Monitoring: Regular follow-ups with your healthcare provider are essential to monitor the effectiveness and any potential side effects of the supplementation.

Standard Dosage: 500 mg of oral nicotinamide twice daily  Be careful to avoid Niacin.  Niacin and niacinamide are not the same.  Niacin can cause unpleasant flushing and has not been studied for actinic keratoses.

Side Effects: Nicotinamide is generally well-tolerated, but some individuals may experience mild gastrointestinal discomfort or flushing.

 

Reference: Effect of Nicotinamide in Skin Cancer and Actinic Keratoses Chemoprophylaxis, and Adverse Effects Related to Nicotinamide: A Systematic Review and Meta-Analysis FULL TEXT

 

About Frailty

Deciding When Older Patients Should have an Operation, by Paula Span, NY Times, October 31, 2017.

Full NY Times Article

In geriatrics, frail is not merely an adjective. A syndrome marked by slowness, weakness, fatigue and often weight loss, frailty tells doctors a lot about their patients’ likely futures. It can, for example, predict how well older patients rebound from physical stresses — like surgery.

The “timed up-and-go,” test measures how long it takes someone to rise from a chair, walk 10 feet, turn around, walk back and sit down again. This is a simple and important test.

A study that Dr. Seib and her colleagues published in JAMA Surgery (October 2017) shows that frailty is associated with increased perioperative morbidity in common ambulatory general surgery operations, independent of age, type of anesthesia, and other comorbidities. Surgeons should consider frailty rather than chronological age when counseling and selecting patients for elective ambulatory surgery.

Even for out-patient surgery, it is important to take frailty into account for any operation, big or small. One should screen for frailty before any procedure.

Here is a free online article from the Journal of Gerontology (11/2015) Frailty in Older Adults: A Nationally Representative Profile in the United States.

The Relativity of Time in Dermatology

By Leonard J. Hoenig, MD

Abstract: Rarely, human aging can dramatically speed up or slow down, resulting in devastating clinical consequences for patients. Two case histories are presented to illustrate this “relativity” of the human aging process. One patient suffered from progeria and aged rapidly, dying prematurely at 17 years-old. The second patient suffered from syndrome X and seemed not to age at all, remaining a toddler till her death at age 20. Despite their many handicaps, both patients lived inspiring lives that brought much love to their families and friends.

Full Article: Download The Relativity of Time in Dermatology

Younger Skin Through Exercise

By Gretchen Reynolds 
NY Times,  April 16, 2014

Exercise not only appears to keep skin younger, it may also even reverse skin aging in people who start exercising late in life, according to surprising new research.  Read Full Article.

This is an interesting article.  Exercise does not appear to reverse the effects of photo aging, however.  The key researcher in this work is Dr. Mark Tarnopolsky of Mcmaster Medical School, in Ontario, Canada.  His group has done a lot of research on the effects of exercise on muscle, bone, skin and other organ systems.