Properties and safety of topical dihydroxyacetone in sunless tanning products: A review.

Sunless tanning products have risen in popularity as the desire for a tanned appearance continues alongside growing concerns about the deleterious effects of ultraviolet radiation exposure from the sun. Dihydroxyacetone (DHA) is a simple carbohydrate found nearly universally in sunless tanning products that serves to impart color to the skin. The Food and Drug Administration (FDA), which regulates sunless tanning products as cosmetics, allows DHA for external use while maintaining that its ingestion, inhalation, or contact with mucosal surfaces should be avoided. Given its widespread use and a paucity of reviews on its safety, we aim to review the literature on the topical properties and safety profile of DHA. Available data indicate that DHA possesses only minimal to no observable photoprotective properties. In vitro studies suggest that, while DHA concentrations much higher than those in sunless tanning products are needed to induce significant cytotoxicity, even low millimolar, nonlethal concentrations can alter the function of keratinocytes, tracheobronchial cells, and other cell types on a cellular and molecular level. Instances of irritant and allergic contact dermatitis triggered by DHA exposures have also been reported. While no other side effects in humans have been observed, additional studies on the safety and toxicity of DHA in humans are warranted, with a focus on concentrations and frequencies of DHA exposure typically encountered by consumers.

Improving Breast Surgery Outcomes Through Alternative Therapy: A Systematic Review.

Enhanced recovery after surgery (ERAS) protocols are the current standard of care when it comes to improving post-surgical outcomes in breast cancer patients. Compliance with all protocol items is required in order for patients to experience significant benefits. Given that the ERAS protocols involve numerous medications which each have unique side effect profiles and medication interactions, this is often difficult to accomplish. Additionally, breast cancer patients are often left with a large psychological burden, which ERAS protocols fail to address. This review aims to determine the role that alternative therapies can play in improving both the emotional and physical strains patients experience during the post-operative stage of recovery. A PubMed search was conducted using the following search terms ("alternative medicine" or "complementary medicine" or "integrative medicine" or "holistic medicine" or "natural medicine" or "mediation" or "aromatherapy" or "music" or "art" or "reiki" or "massage") and ("surgery") and ("pain"). Studies selected for this review include articles published or translated in English that addressed alternative medical interventions affecting pre-, peri-, or post-operative outcomes in breast biopsies, surgeries, or breast-related procedures. Eighteen articles fit the inclusion criteria, with seven addressing music, five addressing meditation, yoga, and guided imagery, five addressing massage, one addressing myofascial release, four addressing aromatherapy, two addressing acupuncture, and three addressing hypnosis. Most forms of alternative therapies offered some benefit to patients following breast-related procedures, many resulting in improvements in post-operative outcomes including pain, fatigue, energy, stress, anxiety, mood, and depression. The reviewed studies demonstrated numerous benefits to integrating alternative medicine into standardized therapy to improve postoperative outcomes. Most studies analyzed did not include placebo controls as including proper placebos was often not feasible. Future studies with larger sample sizes are needed to better quantify the benefits patients receive from these noninvasive, low-risk complementary therapies.