health

'Incredibles 2' Strobe Light Scenes Prompt Health Advisories

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | August 23rd, 2018

Dear Doctor: How often do flashing lights cause seizures? Does it happen only in people with epilepsy? I ask because I recently saw a warning about flashing lights in the new "Incredibles 2" movie.

Dear Reader: While the idea that the makers of an animated children's film would issue a health alert to potential viewers sounds like an urban legend, that is indeed what happened with "Incredibles 2," the long-awaited sequel to "The Incredibles" from Disney. Specifically, several sequences -- in which the film's villain uses a strobelike weapon -- can act as triggers for a seizure for some people. The issue emerged the same day the film opened as discussions of the specific scenes spread on social media. Several blog posts written by people susceptible to seizures due to strobing lights also helped move the issue into the mainstream. According to one blogger, whose post on the topic went viral, "After last night, I can say that the movie is unlike anything I have ever seen before, in that the villain's weapon of choice can hurt not only characters on screen, but can also hurt the people in the audience as well. The weapon? Continuous sequences of rapidly flashing/strobing lights."

The condition is known as photosensitive epilepsy. It affects about 3 percent of those living with epilepsy, which is a disorder of the brain in which abnormal electrical activity can lead to a range of different types of seizures. In photosensitive epilepsy, lights that flash at certain intensities, in certain visual patterns, or with contrasting light and dark patterns, can act as triggers for a seizure. According to the Epilepsy Foundation, photosensitive epilepsy tends to be more common among children and adolescents, particularly those with generalized epilepsy and a type known as juvenile myoclonic epilepsy.

But other populations can be adversely affected by strobing lights and patterns as well. These include anyone who is prone to migraine or other headache disorders, people with vertigo, individuals with autism or ADHD, and those living with non-epilepsy seizure disorders. For these populations, the sequences of the film with the flashing lights -- one scene reportedly lasts for more than a minute -- may not cause seizures, but can lead to headache, nausea, balance issues, light sensitivity, loss of bladder control or general physical discomfort.

There is no cure for photosensitive epilepsy, and once a seizure or other physical reaction has started, there is no way to stop it. Therefore, it's to Disney's credit that, as soon as the issue with the strobe lights emerged, the studio sent out an advisory to all theaters showing the film. The theaters then posted prominent signs, and some even had their ticket takers issue verbal warnings regarding the potentially disruptive scenes.

If this sounds a bit familiar, it may be because back in 1997, an episode of a "Pokemon" cartoon that featured similarly strobing lights adversely affected nearly 700 children in Japan. Many of them wound up in hospitals, and the issue of photosensitive epilepsy moved from medical books to the front pages of newspapers.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

health

FDA Reminds Consumers That Sunscreen Pills Do Not Work

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | August 22nd, 2018

Dear Doctor: My husband and I are terrible at remembering to wear sunscreen. I don't like how it feels, and he just plain forgets. I recently saw an ad for sunscreen pills. Could they be an option?

Dear Reader: We hate to be the bearers of bad news, but no, sunscreen pills don't work. They have been marketed as dietary supplements that will allow your skin to (magically, it would have to be) ward off sunburn, reduce sun-related aging and even shield you from skin cancer. To paraphrase the Food and Drug Administration, there's no such thing as a sunscreen pill. The risks posed by unprotected sun exposure are serious enough that the FDA put out a statement in May debunking the claims of sunscreen pill manufacturers. It also sent out warning letters demanding that the companies hawking these pills stop their false advertising, which it said violates federal law. The specific companies mentioned in the FDA's announcement are Advanced Skin Brightening Formula, Sunsafe Rx, Solaricare and Sunergetic.

You're right to be concerned that you and your husband have been lax in the sunscreen department. From the instant the sun rises to the moment it sets, amid the spectrum of light that it emits is ultraviolet radiation. The wavelengths of UV rays are shorter than those of visible light, which makes them invisible to the naked eye. But the potential damage they can cause to unprotected skin is considerable.

UV radiation is broken down into UVA, UVB and UVC rays. (We don't hear much about UVC, the shortest of the three, because it gets absorbed by the Earth's ozone layer.) But UVA rays, which are the longest of the three and account for 95 percent of the UV radiation that reaches us on Earth, and UVB rays, which are slightly shorter, do a real number on our skin. UVA, in addition to causing the physiological changes that we call a suntan, penetrates the deepest. It plays a big role in premature aging, and more recent research shows that it plays a part in skin cancers as well. The shorter UVB rays give us sunburns and play a significant role in a range of skin cancers. Both types of UV rays can damage the skin's cellular DNA and thus give rise to genetic mutations that can lead to cancer.

All of this bad news about UV rays would be far more alarming if it weren't for the existence of sunscreens. Legitimate sunscreens are all applied topically. Each contains a mix of certain types of organic and/or inorganic chemicals, which either deflect, reflect, scatter or absorb the UV rays. All types of sunscreens need to be reapplied throughout the day because they either wear off through contact or perspiration, or, if they're absorbing the UV rays, their chemical bonds break down. The array of legitimate sunscreen products is vast.

We think that if you're willing to experiment, you'll find one you don't hate. Just be sure to choose a full-spectrum product that absorbs both UVA and UVB rays and choose an SPF of at least 30. Use sunscreen liberally and reapply often.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

health

Heat Stroke Deaths on the Rise During Dangerously Hot Summer

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | August 21st, 2018

Dear Doctor: My siblings and I are very frustrated that we can't get our grandparents to pay attention to those "excessive heat" warnings that get issued during a heat wave. Can you help? They don't take information coming from us grandkids seriously, but I bet they'd listen to actual doctors.

Dear Reader: You've raised an important -- and timely -- issue and we're happy to help you out. You are right to be concerned because the dangers inherent in hot weather are very real, and the potential consequences can be severe. Between 2015 and 2016, the number of people who died as the result of extreme heat more than doubled from 45 to 94. Just this year, 54 people died during a heat wave in Quebec, many of them over 65.

Here in the United States, excessive heat is generally defined as two or more days in which temperatures exceed 90 degrees, often with correspondingly high humidity. While excessive heat poses a grave health threat to all of us, it is particularly dangerous for the elderly. It's also a threat to the very young, those living in urban centers who are isolated and don't have ready access to air conditioning, and individuals doing physical labor or exercising outdoors. People living with certain diseases, such as cardiovascular and respiratory illnesses, are also at elevated risk.

When we can't stay sufficiently cool, our core temperature will rise. The result is a range of heat-related illnesses. Heat exhaustion is characterized by muscle cramping, headache, fatigue, nausea or vomiting, rapid heart rate, and dizziness or fainting. More serious is heat stroke, in which the core body temperature rises to 103 degrees or more. At this point, the body no longer sweats. Instead, the skin will be hot, red and dry. In addition to the symptoms of heat exhaustion, people with heat stroke will experience confusion and even unconsciousness. These extremes in body temperatures can lead to brain and organ damage. In severe cases, multiple organ failure leads to death.

During an extreme heat warning, you should:

-- Seek out air conditioning. If you have it at home, turn it on. If not, find an air-conditioned public space like a shopping mall, public library, community center or a city-run cooling center.

-- Avoid any strenuous activity.

-- Dress in light and loose clothing.

-- Stay hydrated, preferably with water.

-- If you have any vulnerable family members, friends or neighbors, check in on them.

-- Never ever (EVER) leave people or pets in a parked car for any period of time during an extreme heat event, even in the shade or with the windows open.

With heat waves becoming more frequent and severe, it's wise to plan ahead. Know the locations of public spaces with air conditioning. Use drapes or shades to cover windows. Store plenty of bottled water and drink it. A cool bath or shower can help maintain body temperature. And if someone you know exhibits the symptoms of heat stroke, it's a medical emergency. Call 911, then use whatever means available to cool them down until help arrives.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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