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1.  Psychosocial judgements and perceptions of adolescents with acne vulgaris: A blinded, controlled comparison of adult and peer evaluations 
The purpose of the current survey was to evaluate how teenagers and adults view teens with acne as compared to those with smooth, clear skin. We also surveyed teens and adults about their experiences with acne.
We hypothesized that teens with acne would be perceived in a more negative fashion as compared to teens with smooth, clear skin. We presented digitally altered photographs to our responders and asked how they perceived the two groups. No mention was made of acne. In the first survey (n = 1,002), both adults and teens provided their impressions on photo images of teenagers with either clear skin or acne. In the second survey (n = 1,006), the adults and teens also answered questions about their own experiences with acne.
Survey 1. With respect to impressions of photo images, the first thing teens and adults noticed about a person with acne was their skin (65% and 75%, respectively). Teenagers with acne were perceived most often by other teens and adults (teen responder %, adult responder %) as being shy (39%, 43%), nerdy (31%, 21%), stressed (24%, 20%), lonely (23%, 22%), boring (15%, 6%), unkempt (13%, 7%), unhealthy (12%, 8%), introverted (9%, 23%), and rebellious (7%, 5%).
Survey 2. Most teenagers with acne (64%) felt embarrassed by it and thought that getting acne was the most difficult aspect of puberty (55%). Teenagers with acne reported lower self-confidence or shyness (71%); difficulty finding dates (43%), problems making friends (24%), challenges with school (21%), and trouble getting a job (7%).
Teens with smooth, clear skin were rated higher on every favorable characteristic and lower on every unfavorable characteristic by both teens and adults. In most cases, the first thing that respondents noticed was the skin of teens with acne. Teenagers and adults alike perceived other teens with acne as generally being shy, less socially active, more likely to be bullied, and less successful in terms of finding a job. Overall, these results show that acne has a negative effect on the way people are perceived by others.
PMCID: PMC3171294  PMID: 21838915
2.  Subjective and Objective Facial Attractiveness 
Background: Studies have not adequately compared subjective/objective ratings of female dermatology patients including patients presenting for cosmetic procedures. Objective: To examine objective versus subjective facial attractiveness ratings, demographic variables, and how men versus women judge female facial attractiveness. Methods: Sixty-five women (mean 42 years) presenting to a dermatology office. Subjects filled out a demographic and attractiveness questionnaire and were photographed. Four judges (2 male and 2 female) rated the photographs on a predefined 1 to 7 scale. Results: Mean subjective rating (subjects rating themselves) was 4.85 versus 3.61 for objective rating (judges rating subjects) (p<0.001). The mean age of subjects self-rating (subjective rating) who rated themselves in the 5 to 7 range was 39 years; the mean age of subjects self-rating (subjective rating) who rated themselves in the 3 to 4 range was 45 years (p=0.053). The mean age of subjects objectively rated by judges in the 5 to 7 range was 33 years; the mean age of subjects objectively rated by judges in the 3 to 4 range was 43 years (p<0.001); and the mean age of subjects objectively rated by judges in the 1 to 2 range was 50 years (p<0.001). The mean subjective rating (subjects rating themselves) for married women was 4.55 versus 5.27 for unmarried women (p=0.007); the mean objective rating (judges rating subjects) was 3.22 versus 4.15 (p<0.001). The mean objective rating by male judges was 3.09 versus 4.12 for female judges (p<0.001) Conclusion: Female patients presenting to a dermatology office rated themselves more attractive than did judges who viewed photographs of the subjects. Age and marital status were significant factors, and male judges rated attractiveness lower than female judges. Limitations of the study, implications, and suggestions for future research directions are discussed.
PMCID: PMC3013552  PMID: 21203353
4.  The Use of a Contact Cooling Device to Reduce Pain and Ecchymosis Associated With Dermal Filler Injections 
Objectives. Consensus guidelines developed for the use of hyaluronic acid dermal fillers describe the use of cooling the skin to reduce patient discomfort during injection. The vasoconstrictive effects of cold may provide reduced ecchymosis and swelling at the site. However, the effect of applying ice or cooled air is unpredictable because these modalities do not deliver precise temperature, which may result in cold burn or insufficient effect to targeted areas. This open-label, randomized, single-blinded, split-face trial was conducted to measure the extent to which applying a spot cooling device reduces patient discomfort and ecchymoses in the clinical setting in patients undergoing a dermal filler procedure. Subjects. Twenty male and female subjects of any race, ages 35 to 65 years, with moderate and severe nasolabial folds were included in this study. Seven (35%) subjects had received previous small gel particle hyaluronic acid injections. Methods. Prior to injection, the topical cooling system was set at 35°F and a cooled applicator was applied for 20 seconds on one nasolabial fold. A control using a noncooled applicator was applied for 20 seconds on the other nasolabial fold. Postprocedure ice packs were prohibited so as not to confound the subject's perception of procedure-related pain. Subjects (using visual analog pain scales) and blinded investigators rated pain and ecchymosis using predetermined scales and satisfaction surveys. Results. Use of the cooling system was associated with mean pain reduction of 61, 70, and 42 percent compared to control, as measured by visual analog pain scales, immediately following and one hour and three hours post small gel particle hyaluronic acid injection. Additionally, use of the cooling system was associated with mean ecchymosis reduction of 88, 89, 80, and 66 percent compared to control immediately following injection, one hour, three hours, and next-day postinjection. Conclusion. The cooling system provided adequate pain management (both subjectively and objectively through blinded evaluations) during and after small gel particle hyaluronic acid dermal filler injections for the correction of moderate nasolabial folds. Furthermore, results demonstrate that the cooling system is associated with decreased ecchymosis. Future studies are needed comparing the use of topical anesthetics to a cooling system for the reduction of pain and ecchymosis associated with the use of dermal filler injections.
PMCID: PMC2921743  PMID: 20725541
5.  Patient training in cancer pain management using integrated print and video materials: a multisite randomized controlled trial 
Pain  2008;135(1-2):175-186.
Standard guidelines for cancer pain treatment routinely recommend training patients to reduce barriers to pain relief, use medications appropriately, and communicate their pain-related needs. Methods are needed to reduce professional time required while achieving sustained intervention effectiveness. In a multisite, randomized controlled trial, this study tested a pain training method versus a nutrition control. At six oncology clinics, physicians (N=22) and nurses (N=23) enrolled patients (N=93) who were over 18, with cancer diagnoses, pain, and a life expectancy of at least six months. Pain training and control interventions were matched for materials and method. Patients watched a video followed by about 20 minutes of manual-standardized training with an oncology nurse focused on reviewing the printed material and adapted to individual concerns of patients. A follow-up phone call after 72 hours addressed individualized treatment content and pain communication. Assessments at baseline, one, three, and six months included barriers, the Brief Pain Inventory, opioid use, and physician and nurse ratings of their patients’ pain. Trained versus control patients reported reduced barriers to pain relief (P<.001), lower usual pain (P=.03), and greater opioid use (P<.001). No pain training patients reported severe pain (>6 on a 0–10 scale) at one-month outcomes (P=.03). Physician and nurse ratings were closer to patients’ ratings of pain for trained versus nutrition groups (P=.04, P<.001 respectively). Training efficacy was not modified by patient characteristics. Using video and print materials, with brief individualized training, effectively improved pain management over time for cancer patients of varying diagnostic and demographic groups.
PMCID: PMC2396560  PMID: 18093738

Results 1-5 (5)