TIME health

How Doctors of the Past Blamed Women for Breast Cancer

Motherhood
Fine Art Photographic/Getty Images 'Motherhood' by Hector Caffieri, circa 1910

Breastfeeding, corsets and aging: the mysterious dangers of womanhood

History Today

 

 

 

This post is in partnership with History Today. The article below was originally published at HistoryToday.com.

‘I congratulate … [my fair countrywomen] on their present easy and elegant mode of dress’, wrote the surgeon James Nooth, in 1804, ‘free from the unnatural and dangerous pressure of stays.’ Nooth’s concern was not aesthetic. The danger he saw in restrictive bodices was cancer: ‘I have extirpated [removed] a great number of … tumours which originated from that absurdity.’

Breast cancer in the 19th century was a consistent, if mysterious, killer. It preoccupied many doctors, unable to state with any confidence the disease’s causes, characteristics or cures. While the orthodox medical profession in Britain were broadly agreed on cancer’s ultimate incurability, they were less uniform in their understanding of its origin. The disease was thought to develop from a range of harmful tendencies and events acting together. Both the essential biology of being female, as well as typically ‘feminine’ behaviors, were understood as causes of breast cancer.

Breastfeeding was a contentious topic at the end of the 18th century. An image of idealised motherhood emerged that infiltrated concepts of femininity: women were by nature loving, maternal and self-sacrificing. This ideology was expressed through changing social and political attitudes to breastfeeding and an outcry against wet-nursing across western Europe. In 1789 only 10 per cent of babies born in Paris were nursed by their own mothers; by 1801, this number had increased to half of all Parisian infants and two thirds of English babies.

Late 18th-century medical men were explicit about the associations between breastfeeding and breast cancer. In 1772, man-midwife William Rowley wrote: ‘When the vessels of the breasts are over-filled and the natural discharge through the nipple not encouraged … it lays the foundation of the cancer.’ Frances Burney – an aristocratic novelist who underwent a mastectomy in 1811 – attributed her disease to her inability to breastfeed properly: ‘They have made me wean my Child! … What that has cost me!’

Menstruation was seen as particularly hazardous. The surgeon Thomas Denman wrote: ‘Women who menstruate irregularly or with pain … are suspected to be more liable to Cancer than those who are regular, or who do not suffer at these times.’ However, their risk only increased after menopause. Denman considered ‘women about the time of the cessation of the menses’ most liable to cancer. Elderly women were blighted by a dual threat: their gender and their age. While surgeons insisted their theories were based on clinical observation, designating these various female-specific processes as causes of cancer supported their broader thoughts about female biology.

Eighteenth-century theory dictated that all diseases were explained by an imbalance in ‘humours’: black bile, yellow bile, blood and phlegm. Into the 19th century the insufficient drainage of various substances continued to be invoked as a cause of cancer; women’s ‘coldness and humidity’ made them particularly prone to disease. Menstruation was the primary mechanism by which the female body cleansed the system of black bile and its regularity was seen as central to a woman’s wellbeing. Certain situations in which the menses were disrupted or had been terminated were, therefore, especially dangerous: pregnancy, breastfeeding and menopause. Similarly, when the female body and its breasts were not used for their ‘correct’ purpose – childbearing and rearing – the risk of breast cancer increased.

The historian Marjo Kaartinen has noted that 18th-century theorists considered just ‘being female and having breasts’ a threat to a woman’s health. This way of thinking about female biology suggested that women were more likely to suffer from all cancers, not just cancer of the breast. Denman wrote: ‘It can hardly be doubted … that women are more liable to Cancer than men.’

This association between womanhood and disease and between breastfeeding, pregnancy, menopause and cancer is still part of our 21st-century understanding of breast cancer; that certain female-specific processes make you more or less likely to succumb to it. On its website, the breast cancer charity Breakthrough lists various ways you can reduce and increase your chances of disease. According to contemporary research, having children early and breastfeeding them reduces your risk. The later a woman begins her family the higher her risk is. The contraceptive pill, growing older and the menopause also increases your risk of breast cancer.

Drawing attention to such historical continuities questions the social and cultural environments that make certain medical assumptions possible. The causes of cancer suggested by Denman, Nooth and friends were informed by their understandings of female biology and female inferiority more generally. They were working within a school of thought that suggested any deviation from ‘appropriate’ womanhood could have hazardous consequences for a woman’s health. While the role of the historian might not be to deny the validity of 21st-century medical research, it is part of our remit to question cultural assumptions that continue to have some effect on both the conclusions of scientists and the way those conclusions are accepted by the broader public.

Agnes Arnold-Forster is a PhD candidate at King’s College London.

TIME TIME 100

Meet the Women Scientists of TIME 100

Joanne Liu TIME 100 Women Scientists
Bryan Schutmaat for TIME Joanne Liu

These five most influential women are pioneers in the field of science and medicine

It will surprise no one to learn that women are vastly underrepresented in the field of science. But in this year’s TIME 100, five outstanding women who are making huge strides in the fields of medicine, genetics, and infectious disease, made the list.

Read more about these five influential scientists.

Dr. Joanne Liu, International president of Doctors Without Borders/Médecins Sans Frontières (MSF)
Liu and her team at MSF were the first to respond to the Ebola outbreak in Guinea. Liu has become a leader in the outbreak, and has fiercely and publicly criticized the international community for its slow response to the outbreak.

Emmanuelle Charpentier & Jennifer Doudna, Creators of gene-editing technology
Charpentier and Doudna developed a groundbreaking gene-editing technique called CRISPR-Cas9, which allows scientists to add or remove genetic material as they please. The process has major implications for a variety of health problems from HIV to sickle cell anemia to cancer. In theory, CRISPR-Cas9 could be used to edit any human gene.

Dr. Pardis Sabeti, Geneticist who sequenced the Ebola genome from the most recent outbreak
Sabeti and her team are responsible for quickly sequencing the genome of the Ebola virus that has ravaged Guinea, Sierra Leone and Liberia. The task was important, since it determined that the disease was indeed spreading from person to person. Many of her collaborators and fellow researchers died during the outbreak. When she’s out of the lab, Sabeti sings in a rock band.

Elizabeth Holmes, Health technology entrepreneur
Holmes is the CEO of Theranos, a blood testing company that has challenged the traditional lab testing model. She studied chemistry before dropping out of Stanford University her sophomore year to start her company, and at age 31 she made Forbes’ Billionaires List as the youngest self-made woman billionaire.

TIME medicine

The Scary Connection Between Snoring and Dementia

Sleep disorders, including sleep apnea and snoring, can have harmful effects on the brain over the long term

If you don’t snore, you likely know someone who does. Between 19% and 40% of adults snore when they sleep, and that percentage climbs even higher, particularly for men, as we age. It’s a nuisance for bed partners, but researchers say we shouldn’t be so quick to write off snoring or other forms of disrupted breathing while asleep as mere annoyances; instead, they could be affecting the brain, according to new research.

Snoring is a form of sleep apnea, in which people stop breathing for a few seconds or several minutes dozens of times in an hour. Any disruption of breathing during sleep can affect the brain, say researchers of a new study published in the journal Neurology. They found that people with sleep apnea tended to develop memory problems and other signs of mild cognitive impairment (MCI) earlier than people without such sleep disorders.

MORE The Power of Sleep

Ricardo Osorio, MD, research assistant professor of psychiatry at NYU Center for Brain Health, and his colleagues studied 2,000 people enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI)—a population of 55 to 75 year olds, some of whom are cognitively normal, some who have mild cognitive impairment and others who have Alzheimer’s dementia. Everyone was asked about their snoring or sleep apnea, and researchers followed up every six months for two to three years to record any changes in their cognitive status.

Those who reported having sleep apnea or snoring tended to develop signs of mild cognitive impairment, including memory lapses and slower speed on cognitive skills, about 12 years earlier on average than those who didn’t report any sleep-disordered breathing. Mild cognitive impairment often precedes Alzheimer’s dementia, but not all people who develop MCI go on to get Alzheimer’s. The connection between disrupted sleep breathing and MCI remained strong even after Osorio accounted for the effects of Alzheimer’s-related genes, gender, education, depression and heart disease risk factors, all of which have been associated with increased risk of cognitive decline.

MORE Alzheimer’s Linked to Sleeping Pills and Anti-Anxiety Drugs

Osorio also saw a connection between sleep apnea or snoring and Alzheimer’s dementia, but it wasn’t as robust as the link to MCI. That might be because other studies have found that not only are sleep disorders a risk factor for Alzheimer’s, but they are also a symptom of the degenerative brain disease—so those who already developed Alzheimer’s dementia may not have been accurately reporting their sleep habits.

Osorio is careful not to implicate all snoring as a precursor to memory problems or Alzheimer’s. But particularly in the elderly, he says doctors should consider the potential effect that disrupted breathing during sleep can have on the brain. While it’s not clear how sleep disorders might be increasing the risk of MCI or Alzheimer’s, it’s possible that the cumulate effects of even the short periods when the person isn’t breathing could deprive brain neurons of critical oxygen, and Alzheimer’s has been linked to slower or abnormal blood flow caused by hypertension and high cholesterol levels. Other studies have also shown that the protein responsible for Alzheimer’s, amyloid, tends to build up during the day when the nerves are active and decline at night during deep sleep. If people are being roused from deep sleep by their apnea or snoring, then they aren’t enjoying prolonged periods of low amyloid production, so the substance can build up and potentially form plaques.

MORE Here’s How Much Experts Think You Should Sleep Every Night

Osorio also found that it’s possible to counteract some of the effects of sleep apnea or snoring. He also studied people who used a device to prevent apnea, known as a continuous positive airway pressure (CPAP) machine, which keeps airways open during sleep. Even though they snored or had sleep apnea, people who used the device developed MCI or Alzheimer’s at the same rate as those who didn’t have these sleep problems. CPAP machines are cumbersome and uncomfortable to use, and many people drop them after a few weeks. But, says Osorio, they may have more reason to stick with them now. “A lot of people don’t use them because they see no benefits,” he says, “but if they know it can improve their memory, they may definitely try to do better.”

Read next: 7 Signs You’re Not Getting Enough Sleep

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TIME medicine

C-Sections Should Only Be Done When Medically Necessary, Health Group Says

The surgery can also cause major complications

Caesarean sections should only be performed when they are medically necessary, the World Health Organization (WHO) said Friday.

The procedure, which is considered one of the most common surgeries performed worldwide, can put women and babies in danger when they are done without a medical need, the WHO said. The goal of caesarean sections is to safely deliver a baby when a vaginal delivery is not possible. But as the WHO said in its newly released statement, the surgery can also cause major complications including disability and even death.

The ideal amount of caesarean section births per country is between 1o to 15%. As a country’s rate moves to 10% the rate of mother and child deaths decreases, but there’s no evidence to show that rates over 10% have any effect on mother and child mortality.

“These conclusions highlight the value of caesarean section in saving the lives of mothers and newborns,” Dr. Marleen Temmerman, director of WHO’s Department of Reproductive Health and Research, said in a statement. “They also illustrate how important it is to ensure a caesarean section is provided to the women in need – and to not just focus on achieving any specific rate.”

The rate of births by caesarean section in the U.S. is 33%, according to WHO data from 2013. By comparison, the rate is 21% in France, 7% in Indonesia, 52% in Brazil and 15% in the Netherlands.

For the sake of women and infants health, the WHO said physicians should focus on providing the surgery at a case by case basis. “Every effort should be made to provide caesarean sections to women in need, rather than striving to achieve a specific rate,” the report said.

TIME medicine

How Traumatic Life Events During Childhood Affect Diabetes

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JFCreative—Getty Images

Researchers say that traumatic life events can play a role in raising risk of type 1 diabetes

Type 2 diabetes tends to get more attention than type 1, mainly because the risk factors for type 2—obesity, for instance—are thought to be more in our control. Type 1 is believed to be primarily a genetic disease, triggered by an unfortunate DNA configuration that signals the body’s immune system to destroy insulin-producing beta cells.

Now, in a report published in the journal Diabetologia, Dr. Johnny Ludvigsson, a pediatrician from Linkoping University in Sweden, and his colleagues say that life events, including traumatic experiences such as the death of a family member or a serious accident, can triple the risk that young children have of developing the disease.

The researchers studied 10,495 families with children born between 1997 and 1999 and asked them to participate in at least one of four follow-up sessions when the children were between two and 14 years old. The parents filled out questionnaires about whether the children had experienced anything that might be considered a serious life event, including things like the death of a family member, a new sibling, divorce or a move. Parents were also asked about their own stress and whether they felt they had social support.

Once the scientists adjusted for factors that also contribute to type 1 diabetes, such as BMI, mother’s age and a history of diabetes in the family, children who experienced deaths and accidents in their early years showed a three-fold higher risk of developing diabetes than those who didn’t live through these events.

“People may be worried and have feelings of guilt that not only did their child get diabetes, but that in a way they contribute to it,” says Ludvigsson of the results. But parents should take some solace in the fact that after he adjusted for other factors that can contribute to type 1 diabetes, including BMI, mother’s age at child’s birth, and family history of diabetes, events such as divorce, new siblings and other changes in the family structure weren’t as strongly associated with an increased risk for the disease.

What may be happening is that some children may have a genetic predisposition to developing type 1 diabetes, but these genetic triggers aren’t “activated” unless they experience some extreme stress or trauma, such as the death of a loved one. Biologically, scientists believe that high stress situations may lead to a boost in the hormone cortisol, and that pushes the beta cells that produce insulin to work harder and release other potentially toxic factors as well. The added influx of insulin may be viewed by the immune system as abnormal and undesirable, which may prompt them to start attacking the beta cells and destroying them.

“This study does not say that you should never divorce,” says Ludvigsson. “But stress from life events can be one factor that influences the immune balance, just like many other factors do, like sleep, physical activity and so on.” Which highlights the need to address traumatic experiences and children’s reactions to them. Supporting families that go through difficult times, whether caused by marital conflicts or financial worries, could also be an important way to keep young children even healthier and to avoid certain chronic diseases. “If society could be a bit supportive, we could perhaps save some families and relationships, and that would be good for the children,” says Ludvigsson.

TIME medicine

Can Plastic Surgery Make You More Likeable? A Close Look at a New Study

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Robert Daly—Getty Images/OJO Images RF

Sure, getting facial plastic surgery can make you look younger, but can it change your personality? Or at least what other people think of your personality?

Putting aside reconstructive surgery, facial plastic surgery is all about vanity. Which, let’s face it, means looking younger and more symmetrical. But erasing those signs of experience and maturity also changes the way other people see you. Like it or not, and socially acceptable or not, we make snap judgments about people based on purely superficial traits all the time. Furrowed brow? You might be interpreted as mean or anti-social. Heavy, hooded eyes? Clearly untrustworthy. While it seems ridiculous now, at one time in our evolutionary history, being able to make such determinations might have been life-saving: Who’s out to do us harm? Who is there to help?

MORE: From Kim’s Butt to Angelina’s Lips: The Plastic Surgery Procedures Women Want

In modern times, the sad truth is we still make snap judgments about certain facial features and the way we read some faces—as aggressive or unlikeable, say—tends to be connected with saggy skin, heavy chins and more crepe-like skin. That’s what plastic surgeon Dr. Michael Reilly from Georgetown University and his colleagues found in a report published in JAMA Facial Plastic Surgery.

In his study, he asked people to rate either before or after photos of women who had had cosmetic procedures. Not only did he ask them to evaluate how attractive and how feminine she was, he also had people make guesses about her personality based on the photos. Why the personality traits? Previous studies have shown that physical features have a strong correlation to certain personality types, and Reilly says he wanted to understand exactly how the changes he made as a plastic surgeon were affecting his patients. “If I’m embarking on this career, and if I’m doing this type of surgery, I want to know what I’m doing to patients,” he says. Laudable, certainly, but what are the raters’ responses really telling us? The raters never saw the before and after pictures of the same person, which Reilly says he did in order to reduce any potential bias.

Reilly found that people consistently rated the post-op photos as higher on things like social skills, likeability, femininity and overall attractiveness. Not a surprise, given that cosmetic procedures are supposed to improve attractiveness. But likeability? Social skills? Not to mention trustworthiness and risk-seeking?

MORE: Here Are the Most Popular Plastic Surgery Procedures In Three Charts

For one, asking people to rate faces on these characteristics is a bit artificial to begin with. The personality traits people were asked to assess have biased terms—like “aggressiveness,” says Dr. Sam Lam, a facial plastic surgeon practicing in Dallas, who wrote an editorial accompanying the study. Raters might be saying that faces have certain traits only because they’re forced to make a choice when they might not if they weren’t in a study setting.

The results also reinforce the fact that — surprise!— our society has a bias against aging. Since the post-op, and presumably younger-looking, images of the same women seemed to score higher on things like social skills and likeability than their pre-op pictures, that strongly suggests that aging-related features are associated with less-than-desirable personality traits like anti-social behavior. “Aging reverses positive dynamic expressions like smiling,” says Reilly, noting that when we smile, we bring our cheeks up and tighten certain facial muscles. “When we age, our faces look like the opposite of a smile.”

MORE: Plastic Surgery Doesn’t Work — but Neither Does Our Standard of Beauty

Yet couldn’t aging also be seen in exactly the opposite light, as a factor that makes someone more adept and experienced at social interactions and therefore more likeable than a younger person who is more awkward and uncomfortable navigating among strangers?

A previous study from 2013 of before and after plastic surgery ratings didn’t find the same improvement in attractiveness that the current one did. In that study, people looking at photos of patients pre- and post-op didn’t think the procedures made patients any more attractive, and only seemed to make them look about three years younger.

Which only goes to show that we still have a long way to go before we can figure out exactly what we’re doing to ourselves when we go under the knife for cosmetic procedures. We’re changing our outward appearance, yes, but how that affects our inner selves and how others perceive us isn’t — and likely won’t ever — be entirely clear.

TIME medicine

10 Ways to Soothe a Sore Throat

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Your newest excuse to eat marshmallows

A sore throat can be the first sign of a cold, a side effect of strained vocal cords, or an indication of something more serious (like strep throat).

Regardless of the cause, your immediate concern when soreness strikes is how to get relief, fast. You may be tempted to run to your doctor, but some of the best treatments are home remedies and over-the-counter meds, says Jeffrey Linder, M.D., an internist at Brigham and Women’s Hospital, in Boston.

Here are 10 to try the next time you’re feeling scratchy, hoarse, or just plain sick.

Anti-inflammatories

One of the most effective treatments for sore throat is probably already in your medicine cabinet: an over-the-counter, non-steroidal anti-inflammatory drug (NSAID) such as Advil or Aleve.

“These medicines are combination pain relievers and anti-inflammatories, so they’ll make you feel better and they’ll also reduce some of the swelling associated with a sore throat,” Dr. Linder says. “If you have a fever that’s also contributing to your symptoms, they can help reduce that as well.”

Saltwater gargle

Several studies have found that gargling several times a day with warm salt water can reduce swelling in the throat and loosen mucus, helping to flush out irritants or bacteria.

Doctors generally recommend dissolving half a teaspoon of salt in one cup of water. If the salty taste is too unpleasant for you, try adding a small amount of honey to sweeten the mixture slightly. (Just remember to spit the water out after gargling, rather than swallowing!)

Lozenges and sprays

Sucking on cough drops stimulates saliva production, which can help keep your throat moist. But many varieties are no more effective than hard candies, Dr. Linder says. For an added benefit, choose brands with a cooling or numbing ingredient, like menthol or eucalyptus.

Over-the-counter sprays like Chloraseptic produce an effect similar to cooling lozenges. They won’t cure your sore throat or help you fight off the underlying cold, but they may help dull the pain temporarily. Chloraseptic’s active ingredient, phenol, is a local antiseptic that also has antibacterial properties, Dr. Linder says.

Cough syrup

Even if you don’t have a cough (yet), over-the-counter cough syrups can help ease soreness. Like drops and sprays, they coat the throat and provide temporary pain relief.

If you’re headed to work, be sure to choose a non-drowsy formula. But if you’re having trouble sleeping due to a sore throat, a nighttime formula like NyQuil (which contains a pain reliever and an antihistamine) or Robitussin AC (guaifenesin and codeine) can relieve pain and help you get some shuteye.

Fluids

“Staying hydrated is very important, especially when you’re sick and your throat is irritated or inflamed,” Dr. Linder says. “You should be drinking enough fluid so that your urine is light yellow or clear. This keeps your mucous membranes moist and better able to combat bacteria and irritants like allergens, and makes your body better able to fight back against other cold symptoms.”

What you drink is up to you, Linder adds. Water always works (ice cubes, too!), but you can also change it up with something slightly sugary, like a watered-down fruit juice, or something salty, like chicken broth.

Tea

Tired of drinking water? A warm cup of herbal tea can offer immediate, soothing relief for a sore throat. What’s more, non-herbal teas—whether they’re made with black, green, or white leaves—contain antioxidants that are thought to strengthen immunity and ward off infection.

For an extra boost, add a teaspoon of honey. It’ll help the “medicine” go down, and it has antibacterial properties that may help you heal faster.

Chicken soup

An age-old home remedy for colds, chicken soup can help soothe a sore throat, as well. “The sodium in the broth may actually have anti-inflammatory properties, and it can feel good going down,” Dr. Linder says.

Soup has an added benefit when you’re sick: Eating can be painful and difficult with a swollen or very sore throat, so sipping some liquid nourishment will ensure that you’re getting the nutrients you need to fight off your infection.

Marshmallows

Although there’s no hard evidence that it works, sap from the marshmallow plant has been used for hundreds of years—usually in tea form—to treat coughs, colds, and sore throats. And while real marshmallow bears little relation to the puffy campfire treats that took its name, both may have sore throat-fighting properties.

According to anecdotal reports, modern-day marshmallows can help ease sore throat pain, possibly because the gelatin coats and soothes. “It’s not the wackiest thing in the world,” Dr. Linder says. “If your throat is really swollen and it really hurts to swallow anything, I can see how something slippery and sweet like marshmallows might provide some relief.”

Rest

It may not be the quickest solution, but getting some rest is probably the best thing you can do to battle the infection that caused your sore throat in the first place, Dr. Linder says.

“The vast majority of sore throats are caused by cold viruses, and we know that there’s very little we can do to cure a cold once we’ve got it,” he says. “Making sure your body is well rested will at least help it fight off the virus so you can get better sooner.”

Antibiotics

Every once and a while—about 10% of the time in adults—a sore throat will be caused by a bacterial infection such as Streptococcus pyogenes. If, and only if, you test positive for strep throat or another bacterial infection, your doctor should prescribe an antibiotic. (Taking antibiotics for a sore throat caused by a virus will not be effective.)

Always take the full course of medicine, even if you feel better after a few days.

This article originally appeared on Health.com.

TIME medicine

Could An Allergy Drug Treat Hepatitis C?

A drug that's been around for decades may help find a new solution for an expensive chronic disease

An over-the-counter drug commonly used to treat allergies may one day also contribute to the treatment of hepatitis C, according to new research in mice published in the journal Science Translational Medicine.

For the last 10 years, researchers at the National Institutes of Health (NIH) and Hiroshima University have been searching for new, better drugs to treat hepatitis C, an infectious disease that attacks the liver. By screening thousands of drug compounds in a U.S. Food and Drug Administration library—many of which are already approved and on the market—the researchers have determined that a class of antihistamines may be repurposed to treat hepatitis C. The drug chlorcyclizine HCI (CCZ)—a drug that’s been approved since the 1940s—was shown to be the most promising inhibitor of the virus, the new research found.

“Current drugs against hepatitis C, although they are effective, are expensive, have side effects, and are associated with drug resistance,” says study author Dr. T. Jake Liang, a senior investigator of liver disease at NIH. “There’s definitely unmet needs in the current regime of treatment.”

Promising drugs to treat hepatitis C have made it to market in the last few years, but at a hefty price. The biotech company Gilead Sciences has two hepatitis C drugs with high price tags: one drug, Harvoni, costs $95,500 for 12 weeks, and the other, Sovaldi, costs $84,000. That comes out to $1,000 per pill. Still, many patients with hepatitis C prefer oral drugs over the daily injections that were previously required.

MORE: Why Hepatitis C Drugs May Soon Get Far Less Expensive

The researchers of the new study report that CCZ can specifically target hepatitis C, and prevented infection in mice by blocking hepatitis C from entering liver cells. That’s a different mechanism from the current drugs, which block replication of the virus once it gets into the cells. “This is certainly new compared to the existing drugs,” says Liang. “I think that’s the exciting part of our research: We are finding a new class of drugs that are active against hepatitis C.”

The drug showed promising results when tested on a population of mice who were infected with the virus. The researchers discovered that when the mice were given the drug on a daily basis, there was a significant decline in their viral levels. “That’s typically what we look for when we test any drugs,” says Liang.

The findings are still preliminary, and there are several steps that need to be taken before there’s any clinical use available for people. The scientists still do not know if the drug has the same effect in humans, how exactly it works and what form the treatment should take. “We want to caution people that these drugs have not been tested in people yet,” says Liang. “They should not run out and take this medicine to treat hepatitis C.”

Liang says his team is working on understanding how CCZ and antihistamines in general could contribute to the treatment of hepatitis C. They will be initiating a small proof of concept trial in humans which will look at the effect of short term CCZ dosing on the infection. Liang says that since the drug is already approved, his team doesn’t have to go through a slog of regulatory approval for trials, and that the FDA is interested in drug repurposing, which appears to be a growing area of drug discovery. The same process was recently used to identify drugs during the Ebola outbreak. Liang says his team is also looking at ways to modify and optimize CCZ to make it more effective and suitable for humans.

With CCZ costing about $0.50 a tablet for allergy-related uses, the big question is whether a new hepatitis treatment that could come from existing drugs would be more affordable. Liang says he doesn’t have a “clear answer” to that question, but he says he envisions a few scenarios where the treatment could bring down costs. “If this particular class of drugs turns out to be effective against hepatitis C, it could be used in combination with existing drugs to perhaps shorten the duration of use,” he says. “Instead of [taking the drugs] for three or six months it could be [taken] for four weeks. That will certainly reduce the cost of the drugs because you are not taking them for as long.”

More research is needed in the search for better treatments for the 3.2 million Americans living with chronic hepatitis C.

TIME medicine

You Asked: Why Is My Hair Falling Out?

You Asked: Why Is My Hair Falling Out?
Illustration by Peter Oumanski for TIME

Drugs can help. But a lasting solution might require lifestyle changes.

First, let’s debunk a few myths: Shampooing, brushing and towel drying your hair aren’t making it fall out. “People associate these things with hair loss because they see the hair come away. But these aren’t the cause,” says Dr. Melissa Piliang, a dermatologist with the Cleveland Clinic. In fact, Piliang says shampooing less frequently may make things worse. “It can lead to dandruff and scalp inflammation, which can exacerbate hair loss,” she says.

Hats and ponytails also get a bum rap. “If a ponytail is worn so tightly it pulls on your eyes, that could damage your hair and lead to breakage,” Piliang acknowledges, adding that tight braiding, extensions and weaves—which yank on small groups of hair follicles—can also cause problems. “But generally wearing a ponytail or a hat won’t cause hair loss,” she says.

Men and women lose their hair for different and interrelated reasons, ranging from genetic factors to a poor diet, says Dr. Adam Friedman, director of dermatologic research at the Montefiore-Albert Einstein College of Medicine in New York. “It’s rare for hair loss to be caused by just one thing,” he says.

To understand these causes, it’s helpful to know how your hair works. Similar to the way your skin’s cells turn over, your hair is constantly sprouting, growing and falling out. Guys with healthy hair shed between 60 to 80 follicles a day, while women lose roughly 100, Friedman says.

When it comes to male- and female-pattern baldness—the most common types of hair loss—certain hairs grow in shorter and shorter over time, and eventually stop growing back at all. This is usually the result of a genetic sensitivity to hormones in the skin, Friedman says. “In men, you see this most in the front and sides of the scalp,” he explains. “In women, it’s more centrally located and diffuse.” Friedman says this is a slow process, one that can take years to become apparent.

For these people, drugs that block the production of skin hormones or keep hairs from falling out—such as minoxidil and finasteride—tend to work well, Friedman says. But both are better at stopping hair loss than they are at regrowing hair. “If you’re bald and want treatment, there’s often not much you can do,” he says. For this reason, it’s imperative that you see a doctor as soon as you notice a problem.

Poor nutrition is another potential contributing factor. Friedman says low levels of iron, vitamin D, some B vitamins and zinc have all been linked to hair loss. While typically not the main cause of your thinning mane, nutrient or vitamin deficiencies can make the problem worse, he says. Fixing your diet or taking supplements can help, but it’s often just one part of a multifaceted solution.

If clumps come out when you shower or you notice thinning in just a few weeks or months, you’re more likely dealing with another common condition called acute telogen effluvium, Piliang says. This rapid hair loss is basically a short-term ramping up of your hair’s normal shedding process.

Any event that puts a lot of stress on your body—like childbirth, surgery or rapid weight loss—can result in this alarming, clumpy hair loss, which tends to start a couple months after the event, Piliang says. The shedding can last for six months and may result in your losing up to 70% of your hair. But typically the hair grows back, she explains.

There are many more explanations for hair loss, including scalp infections, inflammatory diseases like alopecia areata, or systemic diseases like lupus. Treatments vary widely and may include a combination of oral or topical drugs, light therapy, dietary changes, and stress-reducing interventions. You really need an expert’s help to assemble all the puzzle pieces, says Dr. Laurel Schwartz, a dermatologist in private practice at the Philadelphia Institute of Dermatology.

If you’re experiencing skin irritation, redness, scaling or pain, Schwartz recommends seeing someone ASAP to head off risks like permanent hair loss and scarring.

More good advice: Stay away from “miracle” cures marketed online or in late-night TV infomercials. They’re not the answer. “Hair loss is such an emotionally charged experience,” Schwartz says. “And when you’re really upset, you’re willing to try anything.” Time spent experimenting with different over-the-counter or infomercial products is often time (and money) wasted.

Your hair can offer a glimpse of what’s going on in the rest of the body, Schwartz says. “If you notice a problem, discuss it with a doctor to determine the ultimate cause.”

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