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August 2009 Mayo Clinic Health Letter Highlights Herbal Supplements, Groin Rashes and Hand Arthritis

Natural Herbal Supplements Aren't Always Safe

ROCHESTER, Minn., Aug. 13 /PRNewswire-USNewswire/ -- Here are highlights from the August issue of Mayo Clinic Health Letter. You may cite this publication as often as you wish. Reprinting is allowed for a fee. Mayo Clinic Health Letter attribution is required. Include the following subscription information as your editorial policies permit: Visit or call toll-free for subscription information, 800-333-9037, extension 9771.

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Natural doesn't always mean safe when it comes to herbal supplements, according to the August issue of Mayo Clinic Health Letter.

When used properly, many herbal supplements may be safe and possibly beneficial to health. However, a few supplements can cause life-threatening problems or dangerous interactions with medications.

Mayo Clinic Health Letter covers some of the known interactions between herbal supplements and medications:

St. John's wort: This supplement can greatly increase or decrease the potency of many medications and cause serious side effects. Patients who take antidepressants, anti-blood-clotting drugs, certain asthma drugs, immune-suppressing medications or steroids should probably avoid St. John's wort.

S-adenosylmethionine (SAM-e): This can cause serious side effects when taken with antidepressant medications that affect serotonin.

Garlic, ginseng, ginger and feverfew: Patients who take anti-clotting medications such as aspirin, warfarin (Coumadin) and clopidogrel (Plavix) should avoid these supplements. They may increase the risk of bleeding. Supplements chondroitin and glucosamine also may interfere with warfarin.

Ginkgo: Ginkgo may increase the risk of bleeding in patients taking anti-clotting medications. Ginkgo can counteract the blood pressure-lowering benefits of thiazide diuretic drugs. It also can interfere with anti-seizure medications.

Kava: Kava is a sedative herb and is associated with serious liver problems, even when taken for a short time. Many medications, such as cholesterol-lowering drugs, pose a risk of liver damage. Taking kava may increase the risk of liver problems even more.

It's always best to keep health care providers informed about supplement use, especially when starting a new medication or preparing for a medical procedure. Some supplements need to be discontinued two to three weeks before certain surgical procedures, because they affect blood clotting, response to sedation and blood pressure control.

Here's the Rub: Relief Available for Groin Rashes

ROCHESTER, Minn. -- Medical help can soothe irritating -- and perhaps embarrassing -- rashes in the groin area. Seeking advice or treatment from a care provider at the first sign of a groin rash or irritation can bring relief. The August issue of Mayo Clinic Health Letter covers common groin rashes and treatment approaches.

Intertrigo (in-tur-TRI go): This is one of the more common rashes and occurs when two warm, moist surfaces rub against each other. The chafing traps moisture and results in red, itchy sore skin due to tiny breaks in the skin's surface. This allows for bacterial and fungal growth, such as candida (yeast). Typically, intertrigo is reddish-brown and may ooze and crust over.

Most often intertrigo won't clear up without treatment. A nonprescription zinc oxide or antifungal powder can help, along with keeping the skin dry. If that's not effective, a doctor might recommend antifungal or antibacterial creams, oral antibiotics, or diluted vinegar soaks to help kill germs causing the infections. Mild hydrocortisone cream may reduce inflammation.

Erythrasma (er-uh-THRAZ-muh): This bacterial infection can occur along with intertrigo or independently. Affected areas have a reddish color and may be mildly itchy. The antibiotic erythromycin might be useful.

Eczema (dermatitis): Flare-ups of these red to brownish-gray patches are very uncomfortable. Tiny raised bumps may leak fluid and crust over when scratched. Home care includes avoiding harsh, irritating soaps and applying nonprescription anti-itch cream. When these measures aren't effective, a care provider may prescribe corticosteroid creams or ointments. Oral antihistamines also may help.

Inverse psoriasis: This form of psoriasis shows up as smooth, red patches of skin. It's aggravated by friction and sweating and is more common in people who are overweight. Typical treatments include topical corticosteroids or topical inflammatory medications called calcineurin inhibitors. Examples are tacrolimus (Protopic) or pimecrolimus (Elidel).

Jock itch (tinea cruris): This itchy, red and often ring-shaped rash causes a burning sensation. It typically appears in the warm, moist areas of the inner thighs, buttocks and genitals. The cause is dermatophytes (fungi) and, in many cases, the condition will respond to nonprescription antifungal ointments, lotions, powders or sprays. Severe outbreaks may require prescription antifungal topical or oral medications.

Folliculitis: This is an itchy rash made of small, white-headed pimples around hair follicles. It's caused when hair follicles are damaged due to excess sweating or friction with clothes. Sometimes, folliculitis clears up in two to three days. If it spreads or recurs, prescription antibiotic or antifungal medications may be needed.

Ways to Stop Pain, Limitations from Hand Arthritis

ROCHESTER, Minn. -- When arthritis affects the hands, a range of treatments may reduce pain and preserve joint mobility. The August issue of Mayo Clinic Health Letter provides an overview.

Osteoarthritis, also called degenerative arthritis, is related to aging. In the hands, it occurs when the stress of everyday motions or an injury wears down the smooth cartilage surfaces required for pain-free movement. The result can be swollen, tender finger joints and pain, which limit activity. Treatment options include:

Topical anti-inflammatory drugs: Of particular value for relief is the prescription gel diclofenac (Voltaren). It's rubbed on the skin around the affected joints. Because the medication is applied directly to the affected location, side-effects are of less concern than with oral medications.

Nonsteroidal anti-inflammatory drugs (NSAIDS): Nonprescription aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve, others) or prescription-strength medications may help reduce inflammation, swelling and pain. Ongoing use can cause ulcers, stomach bleeding and other side-effects.

Splints: Splints reduce pain two ways -- by supporting the joint in an optimal position for function or by providing a stable resting position, which allows for better function when the splint is removed.

Corticosteroid injections: These injections provide short-term pain relief but generally aren't given in the same spot more than once or twice a year.

When conservative measures don't control pain, surgery can be performed to fuse or replace joints.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today's health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9771, or visit

SOURCE Mayo Clinic
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