health

The Best Way To Fight Pink Eye Is With Hygiene

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 | March 17th, 2023

Dear Doctors: Our 7-year-old came home from school with an itchy eye. A few days later, all three of our kids, plus my husband and I, had pink eye. Our family doctor gave us antibiotic eyedrops, and it was gone in a few days. What causes pink eye? What can you do to keep it from spreading?

Dear Reader: Pink eye is the common name for an infection known as conjunctivitis. It’s the most frequent cause of eye inflammation and occurs in an area of the eye known as the conjunctiva. That’s a thin, clear membrane that covers the white of the eye and lines the inner eyelid. The conjunctiva protects the eye from potential irritants and pathogens. It is nourished by a dense network of minute blood vessels, and it is the site of numerous lymphatic vessels, which are involved in immune response. The conjunctiva also plays a role in producing tears and mucus, which keep the exposed surfaces of the eye moist and lubricated.

Viral infection accounts for about 80% of cases of conjunctivitis. The cause is usually an adenovirus. Bacterial conjunctivitis is seen more often in children than in adults. While not as common, fungi and parasites can also cause infectious conjunctivitis.

Once the infection is present, it can spread easily and quickly. If someone touches the contaminated fluid or discharge from an infected person’s eye and then touches their own eye, they can transfer the bacterium or virus. As with a cold or the flu, the microbes can also be spread via respiratory droplets.

Conjunctivitis can also be caused by noninfectious agents, such as irritants to the eye, as well as allergies. In those instances, the condition is not contagious.

Pink eye gets its name from its most prominent symptom. When someone develops this type of infection, that network of tiny blood vessels that we mentioned becomes inflamed. This causes the whites of the eye to turn pink, or even red. The inner eyelid often becomes swollen, the membranes of the eyes begin to itch or burn, and the eyes may begin to tear. When the cause of conjunctivitis is bacterial, a discharge is often present.

Treatment for all types of conjunctivitis begins with managing the symptoms. This includes using a warm compress every few hours to keep the eyelid and lashes clean and moist and artificial tears to ease itching and dryness. People who wear contact lenses should pause their use until the infection has cleared. When the source of the infection is bacterial, as occurred in your family, antibacterial eyedrops may be prescribed. But antibiotics don’t affect viruses. In viral cases of conjunctivitis, the infection must run its course. Conjunctivitis typically clears up in seven to 14 days.

Prevention hinges on hygiene. Wash hands before and after touching your eye. Change pillowcases daily while infection is active. Don’t share personal items, such as washcloths, medications, makeup or eyeglasses. Be sure to throw away eye drops, solutions or eye makeup that were used while the family was infected. If symptoms persist -- or if they are accompanied by pain, sensitivity to light or blurred vision -- it is important to see a doctor.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Complications From Tattoos Are Rare, But They Do Happen

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 | March 15th, 2023

Dear Doctors: What is the latest understanding, from a medical standpoint, about the safety of tattoos? I read about someone with a tattoo who received burns on his chest during an MRI. I also heard about tattoo ink interfering with X-ray results. Are these possible outcomes or simply urban legends?

Dear Reader: Tattoos, in which pigments are inserted into the top layer of skin to create a permanent mark or design, date back thousands of years. Historians cite tattooed mummified remains, which radiocarbon dating revealed to be at least 5,000 years old, as the earliest known examples of the practice. Over the millennia, tattoos have variously been used as charms, talismans, status symbols, decorations, declarations of beliefs and also as punishment. Today, with their sometimes-fraught history left behind, tattoos have become a widely accepted form of self-expression. Permanent makeup, which uses the tattoo process to reproduce the effects of cosmetics on lips, eyelids and eyebrows, is also growing in popularity.

Data collected in recent surveys suggest that from one-third to up to half of all adults in the United States have at least one tattoo. This has led to a growing awareness of the potential adverse effects of the practice.

Because the act of tattooing pierces the skin, bacterial or viral infection is a risk. This can occur if the inks are contaminated, if the tattoo artist’s tools or hands are not clean, or if the person fails to take proper care of their fresh tattoo while it is healing. Some people find they are allergic to pigments or other ingredients in the ink and develop an itchy rash with bumpy, scaly or flaky skin. And because the ink is permanent, the body’s response to it can persist, as well.

The tattoo process itself, during which the tattoo needle punctures the skin thousands of times per minute, can lead to the development of scar tissue, raised bumps known as granulomas or a thickening of the skin known as keloids. Medical data shows that about 5% of people who get a tattoo develop an infection, and up to 10% experience short-term complications.

You’re correct that tattoos have been known to interfere with certain types of medical scans, such as an MRI. When pigments in tattoo inks include metal ores, it is possible for them to interact with the magnetic field of the scanner. Surgeons doing biopsies have noted that nearby lymph nodes are sometimes stained with tattoo ink that has been absorbed and then carried off by immune cells. It’s possible that, if ferrous particles are present, the migrated ink can affect the appearance of a lymph node in an X-ray. However, these types of complications are quite rare. A hospital in Germany, where scans were performed on thousands of patients with tattoos, found that it occurs in less than 1% of cases.

But you bring up a good point: Tattoo inks are not regulated in the U.S., and manufacturers are not required to disclose their contents. In addition to researching the skill and safety of a specific tattoo artist, learning as much as possible about the inks that are used is a good idea.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Transitioning From Keto Diet Should Be Done Slowly

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 | March 13th, 2023

Dear Doctors: I’ve been doing keto for a few months to lose weight. I’ve almost reached my goal, and I’m ready to go back to eating more carbs. Is there a good way to switch from keto back to a regular diet? I’m worried that when I eat carbs again, I’ll gain back the weight I lost.

Dear Reader: When someone follows a keto diet, it means that they are severely limiting their intake of carbohydrates. These are the building blocks from which the body manufactures glucose, which is its preferred source of fuel. With carbohydrates mostly removed from the diet, the body is forced to switch to Plan B, which is burning fat for energy. This is a metabolic process known as ketosis, which gives the keto diet its name.

In a ketogenic diet, carbohydrate intake drops to about 10% of total food intake. The remaining 90% of the diet is made up primarily of either fat or protein. The proportions depend on which type of keto plan you are following. There’s a high-fat and moderate-protein approach, which currently is the most popular form of keto. Another way to put the body into ketosis is with a high-protein and low-fat diet, which many people know as the Atkins, paleo or Zone diets. Whichever version of keto you choose, it’s the limits on carbohydrates that lead to the fat-burning state of ketosis.

Keto can be a good way to jump-start weight loss, but it has its drawbacks. With such strict limits on carbohydrates, eating a nutritionally balanced diet takes careful planning and sustained effort. And whenever you follow a restrictive diet for a period of time, returning to “normal” eating can be daunting. For the best results, it’s a good idea to make the switch gradually. Plan on taking several weeks to slowly add more carbohydrates -- and also more calories -- back into your daily diet.

It’s also important to pay attention to the two different categories of carbs -- simple and complex. Complex carbohydrates have more nutrients than simple carbs. They are also higher in fiber. Because they are made up of long chains of sugar molecules, they take longer to digest. Complex carbs are found in whole, unprocessed foods, including vegetables, whole grains, legumes, nuts, seeds, leafy greens and fruits.

Simple carbs, by contrast, are short chains of sugar molecules that absorb quickly. They include table sugar and sugar syrups. Simple carbs deliver calories but lack nutrients. They can cause a spike in blood sugar and leave you feeling hungry. Fruits, vegetables and other whole foods do contain simple carbs. However, the effect is mitigated by their higher fiber content.

As you move away from keto restrictions, steer clear of simple carbs. This includes sugar, soda, candy and other sweets, and highly processed foods. Instead, concentrate on a diet that is rich in lean proteins, healthy fats and complex carbs. A good model to follow is the Mediterranean diet. Call on the same discipline that allowed you to stick to keto, and choose high-quality carbs, lean proteins and healthy fat.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

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