Dear Doctor: I'm looking for new ways to deal with all the stress I feel these days, and a friend keeps talking about something called "mindfulness." What is that, exactly? Is there any proof that it actually works?

Dear Reader: We hear a hint of skepticism in your question, and we understand why it’s there. The word "mindfulness" sounds vague and a bit New Age-y, but the concepts behind the practice date back thousands of years. They have roots in Buddhism and other ancient spiritual traditions, which have been modified and Westernized over time.

As we know it today, mindfulness is an umbrella term for a range of contemplative practices that help the practitioner to become fully present in the here-and-now. Techniques to induce mindfulness can include deep breathing exercises, meditation, hatha yoga, a walk in the woods, losing oneself in a creative project or just sitting and quieting one’s thoughts. The goal is to silence the cacophony of the outside world in order to find the stillness of the inner one. Rather than letting one’s thoughts race from problem to problem, worrying about things that have not and may not happen, the practice of mindfulness seeks to bring the focus of one’s awareness to this very minute, without judgment, right now.

As anyone who has ever tried meditation probably knows, finding calm amid the turbulence of our thoughts and emotions can be a challenge. That’s why many people find it helpful when the practice is tied to some kind of movement, such as the slow and sustained flow of yoga or tai chi, or the soothing repetition of breathing exercises.

A growing body of recent research suggests that mindfulness techniques can be helpful in relieving stress, depression and anxiety, as well as lessening the physical toll that those emotional states can take on the body. There is also evidence that mindfulness is helpful for people living with chronic pain.

A study published in May 2018 found that participants who engaged in mind-body practices to induce relaxation for eight weeks had a change in gene expression that led to a measurable decrease in blood pressure. Research published in the Journal of the American Medical Association in 2016 reported that mindfulness meditation helped patients with lower back pain find drug-free relief. Scientists at Georgetown University Medical Center found that mindfulness meditation by individuals with a stress disorder lowered the biomarkers of stress response. And a review of a number of studies into the effects of mindfulness found that the practice can have beneficial psychological effects, including an increase in a sense of well-being and a decrease in anxiety.

It’s important to note that earlier studies often relied on self-reported results from participants, which caused skepticism about how effective mindfulness actually is. This has led to more scientifically rigorous studies that use control groups, which allow researchers to minimize any unintended variables. And as interest into the potential of mindfulness grows, new studies are using advanced imaging techniques, such as functional magnetic resonance imaging, to study the effects of the practice in real time.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Recently, my skin became irritated and started blistering. I was diagnosed with lichen planus, which I’m told is pretty common. What is it? How can people deal with the irritation and itchiness it causes?

Dear Reader: Lichen planus is a condition in which swelling, irritation and inflammation develop on various areas of the body. You’re correct that it’s common. And although lichen planus is most often seen on the skin, as in your case, it can also occur on the scalp, nails and mucous membranes.

The specific symptoms depend on the area of the body that is affected. On the skin, lichen planus appears as flat, itchy bumps with a reddish or purple color. These are usually firm and sometimes quite shiny. When it appears on mucous membranes, such as the inside of the cheek, the gums, the tongue or the genitals, it presents with clusters of tiny white dots that can look like lace. These may be accompanied by sores or inflammation that is often painful. On the scalp, the condition sometimes results in hair loss. Individuals with lichen planus on the nails often see thinning or splitting, develop marked ridges or grooves, and may experience nail loss that can be temporary or sometimes permanent.

Although the specific causes of the condition are not yet known, it is suspected to be a disease of the immune system.

Diagnosis of lichen planus is typically done with a physical and visual exam of the affected area, and by taking a sample of skin or a sore to examine under a microscope. Because the symptoms can be similar to several other skin conditions, including eczema and psoriasis, a blood test may be used to further narrow down the diagnosis.

There is no cure for lichen planus at this time, so the focus is on managing the symptoms. This includes using antihistamines to alleviate itchiness, and topical corticosteroid creams or ointments to help with swelling and redness. Retin A and certain types of light therapy have been found to be useful in helping to clear up the skin. For some patients, the prescription ointments prescribed for eczema are helpful. And in severe cases of lichen planus in which a patient has large areas of sores or bumps or experiences extreme itchiness or pain, corticosteroids such as prednisone, delivered as a pill or an injection, can provide relief.

When the condition develops in the mucous membranes, such as inside the mouth or on the genitals, the moist and enclosed environments make treatment more challenging. In the genitals, it can cause enough pain to interfere with sex. Sores in the mouth can make eating more difficult. Lichen planus also increases the risk of gum disease, which makes dental hygiene, including professional teeth cleaning, vital.

The good news is that the condition will often go away on its own over the course of a year or two. However, about 20% of people experience a recurrence. It’s not contagious, but there is evidence that some forms of lichen planus can run in families. Since people living with hepatitis C often also develop lichen planus, researchers are now exploring possible connections between the two.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: How bad are cleaning products for our lungs? My mom keeps talking about a news story that said chemicals in cleaning products are as dangerous as cigarettes. Is my clean kitchen killing me?

Dear Reader: Your mom is referring to the results of a study published last year that found that not only do cleaning products harm the respiratory system, they seem to adversely affect women more than men.

The study, conducted by researchers from the University of Bergen in Norway, assessed the lung health of more than 6,200 women and men over the course of two decades. Among the information the participants were asked to provide was how often they cleaned with chemical products, how much of each product they used, and whether or not they were professional house cleaners. Lung function was regularly assessed, including by measuring the volume of air each person could forcibly breathe out in a single exhale. When the data was analyzed, researchers found that cleaning with chemical products as little as once a week resulted in an increased risk of decline in lung function. More frequent use of chemicals came with a greater risk of decline. The researchers said using cleaning products for 20 years had the same adverse effects on the lungs as smoking 20 cigarettes a day for two decades.

Interestingly, although men who used cleaning products and worked as professional cleaners also experienced a decline in lung function, it was less severe than the effects seen in women.

Previous studies have identified a link between the chemicals in household cleaners and respiratory conditions like asthma, headache, migraine and allergies. This is believed to be due to the caustic agents in the products, such as bleach, ammonia and other volatile organic compounds (VOCs). These can irritate and even injure the sensitive mucosal linings of the respiratory tract. Over time, this may lead to persistent changes at the cellular level that adversely affect lung function. Also at issue are the delivery methods of cleaning products, such as aerosol sprays. With a single push of the button, these can turn harsh chemicals into a mist of billions of easily breathable particles.

The authors of the study urged health officials to consider the strict regulation of cleaning products in order to protect consumers, and asked manufacturers to move away from aerosol products. Until that day, however, there are a few steps you can take at home to protect yourself. Consider wearing a dust mask or particulate filter while cleaning. These are widely available at hardware and home improvement stores, come in several types and styles, and are rated according to the substances that they filter.

No doubt you’ve heard it before, but never use cleaning products in an enclosed space. Open a window or door, or set up a fan to keep fresh air circulating.

Consider going old-school with soap and water, baking soda for scrubbing, and a water and vinegar solution for windows and mirrors. If you just can’t give up commercial products, visit epa.gov/saferchoice to find the safest ones.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)