Ask Dr. Etingin, M.D. – Cervical cancer screening recommendations … “Hypoallergenic” products

Q: What are the current recommendations for cervical cancer screening?

A: There is some debate about the age at which cervical cancer screening should begin.

For women ages 30 to 65, the U.S. Preventive Services Task Force recommends a Pap test every three years or human papillomavirus (HPV) testing every five years. However, the American Cancer Society and the American College of Obstetricians and Gynecologists advise that women have a Pap test every three years beginning at age 21 and both a Pap and an HPV test every five years starting at age 30. Once a woman reaches age 65, if she has had three negative Pap tests in a row or two negative co-test (Pap and HPV tests) results within the past 10 years, she can stop screening.

If a Pap test is abnormal or an HPV test is positive, women are advised to follow up with their gynecologist for additional testing, which may include cervical biopsies and/or a colposcopy (an examination of the cervix, vagina, and vulva with a colposcope, an instrument that magnifies tissue so abnormalities are more easily detected). A woman with an abnormal Pap test or a positive HPV test will likely need screening more frequently than every five years and may not be able to safely stop screening at age 65.

It’s especially important that all women be screened regularly, since cervical cancers are often asymptomatic in the early stages. However, as the disease progresses, symptoms can include heavy and/or irregular vaginal bleeding or bleeding after vaginal intercourse. Women who are postmenopausal may experience bleeding even though their periods have stopped. Other symptoms include an unusual discharge form the vagina that may contain blood, pain during sex, and pain in the pelvic region.

More advanced cervical cancers can produce pain in the pelvis or back, changes in bowel or urinary habits, or blood in the urine or stool. If you experience any of these symptoms, especially if they are persistent, schedule an appointment with your gynecologist or primary care physician as soon as possible.

Q: I recently purchased an expensive face cream that was labeled “hypoallergenic,” but my skin broke out in a rash when I used it. Why did this happen if the product is supposed to be free of allergens?

A: The term “hypoallergenic” is used on many health and beauty products, but while it suggests that the products are less likely to cause allergic reactions, the U.S. Food and Drug Administration (FDA) says no scientific evidence backs up those claims. In fact, the FDA has no standards or definitions for the term “hypoallergenic.” Moreover, research suggests that many products labeled as hypoallergenic contain at least one known skin allergen.

The best precaution you can take is to check product labels for allergens, but even that can be a challenge, since many of the chemicals included in face creams and similar products are marketed under five or six different names.

Another word frequently used to describe beauty and cosmetics products is “noncomedogenic.” According to the product manufacturers, this means that the product is not likely to block pores. But the FDA also has no regulations or rules governing the use of this term.

When buying a face cream, choosing one with the fewest ingredients gives you the best chance of avoiding allergens and other irritants. Also select products that are fragrance-free; fragrances are one of the biggest triggers for allergic reactions and breakouts. Finally, always test a new product on a small area of skin and wait 24 hours to see if there is a reaction before using it elsewhere.

One final tip: Cost is not necessarily a reflection of the product’s quality. Many women find they get similar results whether they use lower-cost products or products with high price tags. Most women find their favorite products by word of mouth and/or trial and error.

-Orli R. Etingin, M.D.

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