Massage & Bodywork

September/October 2012

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liver toxicity, stomach and intestinal complaints, and related side effects. It may also allow medications to work faster. When a topical medication is applied via a patch, it is easy to identify. This is a delivery system that is frequently used for nicotine, nitroglycerin, and birth control, and products are in development for many other types of medications. Patches show obvious boundaries for where the medication is active, but when the medicine is applied without any identifying marker, it's impossible to know it is there. This unintentional absorption may be an issue for massage therapists. UNINTENTIONAL HORMONE ABSORPTION Both men and women commonly use topical hormone preparations. For women, this hormone combination typically includes estrogen and progesterone, which can serve as a form of birth control or can ease menopausal symptoms. Androgen preparations (testosterone and related derivatives) serve to enhance masculine features for men. But what is the risk of skin-to-skin transference of a hormone preparation? We know that some proportion of medicine is absorbed into the skin while some remains on the surface. Several studies suggest skin-to-skin transference does, in fact, occur. For example, when women have short-term contact (one week) with male partners' testosterone-treated skin, the women exhibit elevated blood testosterone levels.2 With prolonged contact (months to years), women may have significant physical changes, such What If? Are MTs in danger of absorbing toxins while working on a client who uses drugs (legal or otherwise)? No, the MT is not at risk when touching a client who's used pharmaceuticals if the substances were ingested, inhaled, or injected by the client. There is no evidence that these drugs can move from the bloodstream to the skin. as acne, a deepened voice, facial hair growth, hair loss, genital changes, and muscle hypertrophy.3 In some men, contact with topical estrogen caused elevated blood estradiol levels.4 However, no significant physical changes were reported in these studies. Other studies report that children show early sexual development and bone growth changes after prolonged exposure to topical testosterone.5 of contact with topical estrogen show changes in breast and genital development.6 Children who have months to years In children and adults, most adverse effects reverted back to normal within months after cessation of physical contact with hormone-treated skin. It is important to note that hundreds of thousands of people use topical hormone preparations, and relatively few negative consequences are reported. Of those cases of adverse physical changes, most resulted because patients failed to follow medical directions intended to protect against skin-to-skin transference. These directions include covering the treated area, avoiding skin-to-skin contact with others, and washing the treated area if contact is made. WHAT CAN A MASSAGE THERAPIST DO? Obviously, it is preferable not to be exposed to topical medication, especially when pregnant. The good news is that if contact is made with a client's topical hormones during a massage session, it is likely the 50 massage & bodywork september/october 2012

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