Q. I am beginning to have those little age wrinkles that run along the borders of my lips. I hate them, for otherwise I have a pretty wrinkle-free face.
I can no longer cover them adequately with makeup and have been thinking of surgery. My neighbor, however, swears by a cream called Retin-A, and I wonder if you thought using this would be a good idea. Do you know how this cream works?
A. I am not sure anyone is exactly sure how Retin-A (or tretinoin) really works in erasing wrinkles. According to the package insert approved by the Food and Drug Administration, this product is indicated for topical application in the treatment of acne.
Tretinoin, which comes in cream, lotion and gel forms, is a chemical derivative of Vitamin A. It’s a prescription medicine and has a list of adverse reactions that should be carefully explained to any user. Lately it has also gained a reputation for smoothing out wrinkles that are a result of the damage that sunlight can do to the skin.
Skin is composed of two layers, the epidermis or outer skin, and the dermis–the layer that lies immediately below. According to some researchers, microscopic fibers of collagen, called anchoring fibrils, hold the two layers together. The theory is that the effect of ultraviolet light is linked to the production of an enzyme that destroys these fibrils.
The action of tretinoin may be to neutralize this enzyme, preventing the destruction of the fibrils, which then pull the epidermis smooth over the dermis, causing those unwanted wrinkles to disappear.
Q. After an examination of my colon, I sat up (finally) and could see the pan with all the instruments on it. It was not the most pleasing sight I have had in my days, but it was clear to me that there was a big mess to clean up. That led to the thoughts about the dangers I may have faced, with the chances I could have caught an infection from the last guy they used this on, maybe even AIDS.
Can the simple solution of hot, soapy water the instruments were placed in be enough to protect the next person? Please tell me about how these things are kept clean.
A. While anything is possible, it is not at all likely that this could happen. Although we have no means of destroying the AIDS virus once it has established itself in the body, the materials used to disinfect the flexible instruments used to examine our colons and intestines are so powerful that we can be assured that all viruses and bacteria are destroyed.
Soap and water are powerful disinfectants, as is alcohol (especially in high concentration), but better still are other germicides that can be used to render the examining instruments sterile.
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Write to Dr. Bruckheim in care of the Chicago Tribune, Room 400, 435 N. Michigan Ave., Chicago, Ill. 60611.
