Our experts field your questions

This month we're excited to introduce the new Consumer Reports Medical Advisory Board. This group of accomplished physicians will lend their expertise to our health coverage—reviewing articles, weighing in on recommendations, and collaborating with our in-house medical advisers. They'll help us give you the best, most up-to-date health advice, as well as answer questions like these.

You don't, in most cases. Unlike drugmakers, who have to get approval for their products from the Food and Drug Administration, cosmetics companies don't have to submit evidence that their products actually do anything before they reach the market. The only anti-wrinkle cream that's FDA approved is tretinoin (Renova, Retin-A, and generic), which requires a prescription. Most other anti-aging products are regulated as cosmetics, meaning that companies can claim pretty much anything as long as it falls under the umbrella of enhancing your appearance rather than altering the structure or function of your skin. Companies have good reason to keep their products on the cosmetics side of the fence: It costs upward of $80 million to get a new drug approved. The market for anti-aging products is so big that it's more lucrative for companies to focus their efforts on attracting consumers with packaging and claims. Now here's the rub: Just because something lacks FDA approval doesn't mean it won't work. But unless you can see the company's research, you might just have to try it to see whether it does anything.

—Jessica Krant, M.D., M.P.H.

Stopping early might put you at risk for a relapse or prolong your infection. That's especially true for serious infections, such as tuberculosis or bone or joint infections. For milder infections, such as sinusitis or acute bronchitis, it's not always clear what the ideal length of antibiotic treatment is or how beneficial the drugs are. But because longer courses of antibiotics have been associated with an increased risk of antibiotic resistance, you should always ask for the shortest course necessary to do the job. And make sure that you're prescribed antibiotics solely for bacterial infections. Bronchitis that stems from a virus, for example, will not respond to antibiotics, and by taking them you risk experiencing side effects as well as encouraging the growth of antibiotic-resistant bacteria.

—B. Joseph Guglielmo, Pharm.D.

It's a difficult decision. Studies have shown that artificial nutrition, either by tube or intravenously, neither prolongs life nor improves the quality of life for people with advanced dementia. Feeding tubes also create risks, including infections, bowel problems, and the need to tie down the patient's hands in some cases to prevent him or her from dislodging the tubes. Because of those risks and the lack of a clear benefit, medical ethicists usually advise against artificial nourishment for patients like your mother. But doctors and families often have a hard time following that advice, perhaps because it's hard to accept that an intervention won't help or because they think that it's inhumane to withhold nourishment. If your mother doesn't have an advance directive that specifies her wishes and you don't feel sure as to what she would have wanted, ask for a consultation with the nursing home's ethics committee or palliative-care specialist. They should be able to provide some guidance. —David S. Seres, M.D.

They belong to different drug classes and protect the bones in different ways. Raloxifene is a selective estrogen receptor modulator, or SERM, a class of drugs that affects the way different parts of the body respond to the hormone estrogen. In the bones, raloxifene essentially acts as supplemental estrogen, increasing bone density and preventing bone loss. But it can also increase the risk of blood clots and strokes, so women who have a history of blood clots or who smoke, drink heavily, or have diabetes or heart disease should generally avoid it. Alendronate and similar drugs, such as ibandronate (Boniva), are bisphosphonates, which work by inhibiting enzymes involved in the breakdown of bone. For most postmenopausal women, lifestyle steps, such as taking calcium and vitamin D, exercising, and avoiding smoking and excessive alcohol consumption, should be the first line of defense against osteoporosis. Medication should generally be added only for those who have a history of fractures or are otherwise at high risk. —James Woods, M.D.

Yes, especially if your depression is mild or moderate, or is related to a recent event. Evidence-based treatments for depression include both antidepressant medication and psychotherapy, specifically two forms called cognitive behavioral therapy and interpersonal therapy. For mild depression, there's good evidence that psychological treatment alone for 10 to 12 weeks can be beneficial. When depression is more severe and persistent—a real change from one's usual self, lasting more than two weeks—it might be necessary to consider a trial of medication for 10 to 12 weeks. That amount of time should give you and your doctor a good idea of how helpful drug treatment would be for you. If it's beneficial, expect to continue taking medication for at least 6 to 12 months, in most cases. Don't stop without talking with your doctor first, because antidepressants should be discontinued gradually. In cases where depression is long-standing and has affected a person's functioning, adding psychological treatment to medication can offer additional improvement. —John T. Walkup, M.D.

The evidence suggests that there is a small group of people at very high risk for lung cancer who may benefit from annual CT screening for three years. It's a very specific group: those 55 to 74 years old who have smoked 30 pack years, which is calculated by multiplying the number of years they have smoked by the number of packs per day. (Former smokers who quit within the last 15 years are candidates, too.) If you fall into this group, it's worth discussing screening with your doctor. But there are risks, too, including that the CT might uncover something that won't harm you but might lead to more testing. If you don't meet the above criteria, then screening probably isn't for you. Even for people at very high risk, we must always balance the potential benefits of screening with the risks of radiation exposure or over-treatment that could result. If you do get screened, choose a hospital or clinic that has radiologists who specialize in reading CT scans of the chest and experienced lung physicians to interpret the findings. —Peter B. Bach, M.D.