The FDA has issued a safety alert for some vials of methotrexate, which may contain small flakes of glass. Sandoz is recalling the following products:

Product : Methotrexate Injection, USP, 50mg/2mL
NDC Number : 66758-040-02 (10 vial pack) and 66758-040-01 (Individual vial)

Product : Methotrexate Injection, USP, 250mg/10mL
NDC Number : 66758-040-08 (10 vial pack) and 66758-040-07 (Individual vial)

If you have one of the affected vials, call the dedicated Methotrexate Recall Hotline at 1-888-896-4565 (staffed around the clock) or email  Sandoz.methotrexaterecall@gencopharma.com. If you have already used some of the methotrexate and have experienced any side effects that you think might be related to the recall, contact your doctor right away.

I think this discovery is very exciting.  In the early online edition of the journal Nature, scientists report that they were able to observe the "healing" of a DNA strand that had been damaged UV radiation.  They observed an enzyme inject a single electron and proton into a damaged strand of DNA.  This enzyme known as photolyase was able to heal the DNA in a billionth of a second.

UV radiation causes damage to cells by creating chemical bonds in the wrong areas on DNA.  Photolyase actually breaks those incorrect bonds and puts them back together correctly.  Then the electron and proton get expelled back to photolyase which moves on to the next bond.

Of course knowing what's going on at the molecular level is just the beginning, but the possibilities of sunburn, skin cancer, and even wrinkle treatment are enormous.

Many teenagers have acne and one of the most difficult issues with treatment is consistency.  Teens have busy lives and often don't think about their skin care regimen every morning and night.

In the past tretinoin (Retin-A, Avita, Retin-A Micro, Renova) could not be used at the same time with benzoyl peroxide because they inactivate eachother.  Both topical medicines help fight acne by different means and using them together is more effective than using one medication alone.

In the past this meant using tretinoin at night and benzoyl peroxide in the morning, but often teens would get frustrated with what one of my patients called "always putting gunk on my face".

A new study just out shows that a new tretinoin formulation, Retin-A Micro Pump, used with benzoyl peroxide in the morning is as effective as splitting the application of tretinoin and benzoyl peroxide.

While this may be great news to teens who want to simplify their skin care routine, insurance companies aren't going to care that this is a more effective treatment.  It's likely that most insurance companies will not cover this new formulation.  Why pay for a more expensive treatment when the teen just needs to be more consistent with a cheaper option.

Scientists have recently discovered an important mechanism the skin uses to form scars after an injury. Normally when the skin is injured special cells come in and produce proteins like collagen that act as a scaffolding for the full repair of the skin.

In a study published in Nature Cell Biology, researchers found that one type of these specialized repair cells called fibroblasts which normally produce collagen, stop their production completely.  In addition, these fibroblasts actually release proteins that break down collagen. As these dormant cells accumulate in the wound they reduce the formation of excess scar tissue.

The scientists also discovered a protein that is responsible for making the fibroblasts go dormant.  They were able to apply this protein topically to the skin reducing the amount of scar tissue that was formed.

This experiment was done on rats so it still needs to be tested on humans.