The number of times I have written a post in this blog about sun safety, skin cancer, or sunscreen could, at this point, fill a book. Well maybe not a book but at least a thick pamphlet. But since it is once again Skin Cancer Awareness Month I thought it important to revisit these topics yet again. It is always good to be reminded about proper sun safety. Skin cancer is an almost entirely preventable cancer so keeping yourself and your loved ones safe from the sun is of utmost importance. Yes, proper sun protection takes some extra time and thought, but preventing skin cancer shouldn’t be an afterthought. And I haven’t even mentioned the wrinkles and pigmentation issues that come from daily sun exposure. So if skin cancer doesn’t concern you particularly at least protect your skin from the sun in order to keep it looking young and fresh.
The Skin Cancer Foundation provides the following sun safety tips:
Since its inception in 1979, The Skin Cancer Foundation has always recommended using a sunscreen with an SPF 15 or higher as one important part of a complete sun protection regimen. Sunscreen alone is not enough, however.
- Seek the shade, especially between 10 AM and 4 PM.
- Do not burn.
- Avoid tanning and UV tanning booths.
- Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
- Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.
- Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside.
Reapply every two hours or immediately after swimming or excessive sweating.
- Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
- Examine your skin head-to-toe every month.
- See your physician every year for a professional skin exam
Allure adds even more tips:
As much as we know about skin cancer, though, only about 20 percent of us wear sunscreen daily. (Which is crazy, considering in a poll we did onAllure’s Facebook page, 68 percent of our fans said they either have had skin cancer or know someone who has.) But here’s the thing: It’s never too late to start taking care of your skin. Here, a few sun-protection tricks to keep in mind as the temperatures start to rise:
• If you’re the outdoorsy type, you may want to take a summer vacation from retinols: They thin the top layer of skin and can make you vulnerable to redness and brown spots, says dermatologist Fredric Brandt.
• One bottle of sunscreen is not going to last. “One ounce is the right goal for each application, as well as for each reapplication, so a 12-ounce bottle is 12 servings—and that’s not a lot,” says Patricia Wexler, an associate clinical professor of dermatology at Mount Sinai Medical Center in New York City. Set an alarm on your phone to ring every two hours to remind you to reapply.
• If you’re outside for 30 minutes or more, wear a chemical sunscreen (like one with Mexoryl SX or Parsol) topped by a physical one (with Z-Cote or titanium dioxide). “Neither type is 100 percent perfect, and whatever rays get through the first layer are caught by the second one,” says Miami dermatologist Leslie Baumann.
• Think twice before you use sunscreen wipes: The FDA is reviewing their effectiveness, along with powders and shampoos containing SPF. (No decisions have been made yet.)
So whatever your daily beauty routine is make sure that it includes an SPF of at 15 but SPF 30 is better. Apply 365 days a year, rain or shine. And be sure that everyone you love and care about is protected from the sun as well.
My Related Posts:
As I mentioned at the beginning of this post I’ve written so much about the topic of this post that I decided to choose some of my related posts to share here. If you type “sun” into the search line on the home page of this blog you’ll find even more related posts.
Image from askdegas.com: Sunbathing by the Sea. And yes, I do think everyone should go to the beach fully dressed 🙂
I’ve recommended several times in this blog that if you want to tan you need to fake it. I’ve discussed different ways to get a faux tan including the use of bronzers, self-tanners, and spray tans. But as many of my readers may already know the safety of spray tans has recently been called into question.
In June of this year ABC News broadcast their investigation into the dangers of DHA, the ingredient in spray tans and self tanners that gives you your tan, when inhaled. Basically, if inhaled DHA could be a possible carcinogenic. Let me be clear – you need to inhale DHA, like you would do while receiving a spray tan, in order for it to pose a health risk. Applying a self-tanning lotion to your body with DHA will not pose a cancer threat since you do not inhale the lotion through your nose, mouth, or eyes (or at least you shouldn’t if you apply it correctly).
According to the ABC News report the FDA has never approved the use of DHA in spray tans, but does allow its use in self-tanning lotions and creams, yet has not banned its use either in spray tanning. There is also little to no oversight over the tanning industry (a fact I have lamented here in my blog more than once) so that this industry can pretty get away with saying whatever they want about the safety of tanning beds (which don’t kid yourself are never safe) and spray tans. The ABC investigation included an undercover reporter who went to various tanning salons and inquired about the safety of spray tanning. Her concerns were dismissed repeatedly.
The New York Magazine piece about this controversy quotes one of the doctors seen in the ABC News report:
“I have concerns,” said Dr. Rey Panettieri, a toxicologist and lung specialist at the University of Pennsylvania’s Perelman School of Medicine. “The reason I’m concerned is the deposition of the tanning agents into the lungs could really facilitate or aid systemic absorption — that is, getting into the bloodstream. These compounds in some cells could actually promote the development of cancers or malignancies,” he said, “and if that’s the case then we need to be wary of them.”
Back in the seventies, when DHA (short for dihydroxyacetone, the chemical ingredient that darkens skin) was first approved by the FDA, it was only meant to be an ingredient in tanning creams. No one foresaw the popularity of spray tanning today, which obviously disperses DHA into the air (and, by proxy, into your lungs if you’re nearby).
“DHA should not be inhaled or ingested” today. It tells consumers on its website, “The use of DHA in ‘tanning’ booths as an all-over spray has not been approved by the FDA, since safety data to support this use has not been submitted to the agency for review and evaluation.” The agency advises consumers who spray tan they are “not protected from the unapproved use of this color additive” if they are inhaling the mist or allowing it to get inside their body. The agency recommends, “Consumers should request measures to protect their eyes and mucous membranes and prevent inhalation.”
While further studies will be conducted for more conclusive results (the original data was formulated after testing DHA on nonhuman cells), the bottom line is, be pale. You’ll look and feel much better in the long run.
(Now Spray Tanning Might Cause Cancer, Too – New York Magazine)
I always like to present two sides to every controversial topic I bring up here in my blog so I was interested to read a rebuttal to the ABC News report on the esthetician centered publication website Skin Inc. in the article Is Spray Tanning Safe?:
Many questions have recently been posed regarding a story featured by Good Morning America/ABC News regarding the safety of spray tanning. Kelly Richardson of B.Bronz offers her response to the report, and provides some tips and advice when discussing this with clients, employees and others.
The report, information and interpretations
The study that was used in the report presented by the media was done by the European Commission Scientific Study on Consumer Safety. This study was published in 2010.
The news media did not differentiate between data that was obtained for automated spray booths and for hand-held turbine devices. The hand-held turbine devices are considered to be safe and do not need/require many of the safety precautions that the automated spray booths require.
Spray tanning technique
The techniques that should be used are designed to minimize dihydroxyacetone (DHA) exposure to the clients. The suggested treatment time consists of less than two minutes of spraying with approximately 50 mL of product. The spray pattern should be designed to push the overspray to the ground, minimizing it and, lastly, it is always recommended that you do not run fans during or after the treatment, as it promotes inhalation. Also recommended is using an extraction fan if you do not have proper room ventilation.
The report by the European Commission shows that high levels of DHA should not be inhaled by either the technician or the client. Most “rapid-developing” products that are on the market have active ingredient levels of 14-22%, which are considered too high for inhalation.
The U.S. Food & Drug Administration (FDA)
DHA (the same active ingredient in every self-tanner, spray tan or sunless tanning treatment) has been approved for decades by the FDA for cosmetic use. As there have been no studies on inhalation and exposure done directly by the FDA (even though the European Commission has done studies), they advise that the products should not be used in the mucous membranes. It is a good idea to have this verbiage in your client release form or available for your clients to review.
Additionally, the FDA has not studied DHA, and pregnancy or nursing. It is recommended you have clients who are pregnant or nursing to ask or get permission from their doctors before starting any tanning regimen.
It is important to use a face mask or other protection when spraying. If you are spraying, especially multiple clients in a poorly ventilated area, it is crucial. Keep items stocked at your skin care facility, including lip balm, nose plugs and silicone covers for the nipple areas.
After having discussions yesterday with many spray tanners, and professionals in the industry from insurance companies and other manufacturers, most had serious questions as to whether or not eye coverings used in tanning salons for UV protection would protect for spray tanning. It was our general consensus that these products do not, and better protection would be having the customer keep their eyes closed during the treatment. I would discuss with your insurance agent and find out what they require and recommend you to have on hand for your customers.
Of course, the ABC News report gave me a lot to think about. Anytime I have a client who tells me how much they love tanning (either on the beach, by the pool, or in a tanning booth) I recommend that they get a spray tan instead. I guess I should stop giving out that recommendation or recommend that they wear a mask, nose plugs, and goggles while receiving the spray tan.
Please share your thoughts below on this controversy.
Image from tareendermatology.com
My newest skin obsession is finding out how the foods we eat impact our skin both positively and negatively. Recently I came across the following information about foods that may help prevent skin cancer.
According to Prevention magazine (August, 2012, page 26):
Supplements – including vitamins, minerals, and antioxidants from berries, green tea, red wine, and dark chocolate – may help protect against skin cancer, a recent spate of studies show. “Regularly drinking green tea or adding antioxidants in the form of vitamin E or beta-carotene may be helpful, although topical use shows greater promise,” says Andrew Weil, MD, director of the Arizona Center for Integrative Medicine. “Compounds found in grapes (resveratrol); berries (ellagic acid); cruciferous vegetables such as broccoli, cauliflower, cabbage, kale, bok choy, and brussel sprouts; garlic; onions; and the spice turmeric also show promise for general cancer prevention.” But the effects are modest, Dr. Weil says. Preliminary studies also suggest that Heliocare, an oral supplement made from South American fern plants, may boost the body’s defense against sun damage slightly, but it’s very expensive. So don’t forget the sunblock!
And drinking caffeinated coffee may help prevent certain types of skin cancer as well:
Drinking more cups of caffeinated coffee could lower a person’s risk of developing the most common form of skin cancer, basal cell carcinoma, according to a recent study published in Cancer Research, a journal of the American Association for Cancer Research.
“Our data indicate that the more caffeinated coffee you consume, the lower your risk of developing basal cell carcinoma,” said Jiali Han, associate professor at Brigham and Women’s Hospital, Harvard Medical School in Boston and Harvard School of Public Health.
Han and his colleagues conducted a prospective analysis of data from the Nurses’ Health Study, a large and long-running study to aid in the investigation of factors influencing women’s health, and the Health Professionals Follow-up Study, an analogous study for men.
Of the 112,897 participants included in the analyses, 22,786 developed basal cell carcinoma during the more than 20 years of follow up in the two studies. The results revealed a decrease in the risk for basal cell carcinoma as coffee consumption increased. Similar results were seen with other caffeinated products such as tea, cola and chocolate. Caffeinated coffee also reduced risk for other serious conditions such as type 2 diabetes and Parkinson’s disease.
However, consumption of decaffeinated coffee was not associated with a decreased risk of basal cell carcinoma, the study found. Also, neither coffee consumption nor caffeine intake were associated with the two other forms of skin cancer, squamous cell carcinoma and melanoma, the most deadly form of skin cancer.
Still, Han said more studies in different populations are needed before the group can make a “definite” determination on the impact of caffeine on these serious health conditions.
At least now I know my morning coffee is protecting my skin instead of hurting it, and I’ll continue to drink my green tea in order to help my skin.
Chemical peels are a great way to rejuvenate the skin and an excellent way to treat many skin conditions like acne and hyperpigmentation. But it turns out that chemical peels can do even more than that – some peels might help prevent further development of superficial skin cancers.
According to Morag Currin in her book Oncology Esthetics *(page 134):
Superficial chemical exfoliations and peels are recommended for treatment of skin conditions that primarily affect the epidermis such as actinic keratosis and superficial skin cancers. There is a usually a decrease in the incidence of superficial skin cancers after resurfacing procedures.
Chemical exfoliation and peels are not the only treatment for skin cancers, however, any resurfacing procedures (the deeper the better) may actually decrease the chance of developing superficial skin cancers and precancerous lesions.
Strong chemical peels may kill very early skin cancer cells since the treatment removes the top layer of sun damaged skin, which can include precancerous cells as well as sun-damaged cells, and give the skin a rough, blemished and discolored appearance.
Renee Rouleau concurs on the same subject in a recent blog post of hers:
Exfoliation by using facial scrubs, acid serums and professional chemical peels are all popular treatments for shedding dead skin cells to improve the look and feel of your skin. But the latest research now shows another benefit of exfoliation: the reduction of the number of actinic keratosis–skin lesions that can develop into squamous cell cancer. For home use, physicians recommend glycolic acid serums in formulas up to 20%.
So remember – the next time you are considering a chemical peel as a way to treat your skin remember that there are added medical benefits to getting that peel.
My Related Posts:
* I recently completed Currin’s 3 day intensive course on oncology esthetics and highly recommend it to all my fellow estheticians who are interested in working with cancer patients. I learned so much!
Image from myadvancedderm.com
I was delighted to hear the other day that California has become the first state to ban the use of tanning beds by anyone under the age of 18. The law goes into effect on January 1st, 2012.
According to The Skin Cancer Foundation:
Close to 2.5 million teens tan indoors in the US every year, increasing their risk of developing melanoma by 75 percent. Indoor tanners are also 2.5 times more likely to develop squamous cell carcinoma, and 1.5 times more likely to develop basal cell carcinoma.
The law aims to protect minors from the dangers of tanning beds:
“Tanning is like smoking, we know what the cause is. We protect our minors from cigarettes. This is the same thing. As many as 40% of 17-year-old girls are exposed to tanning beds, and we need to protect them,” says Darrell Rigel, MD, skin cancer expert and member of the American Society for Dermatologic Surgery Association (ASDSA). “We hope this will help girls form healthy habits and decrease the rates of melanoma in women especially.”
Melanoma is the No. 1 form of cancer in people ages 25-29, according to the Skin Cancer Foundation. Rates for melanoma in this age group are seven times higher for women, the primary factor being the use of tanning beds, says Rigel.
The American Academy of Dermatology expressed support for the law in a statement, noting that use of tanning beds sharply increases the risk of melanoma, the most deadly form of skin cancer. A recent study from the University of Minnesota’s Masonic Cancer Center and School of Public Health shows that people who use any type of tanning bed for any length of time are 74% more likely to develop melanoma, and frequent users of indoor tanning beds are 2.5-3 times more likely to develop melanoma, than those who never use tanning devices.
I applaud the California legislators and Governor Brown for enacting this law. I hope it helps to educate minors and ultimately saves lives as well.
I have my husband to thank for this post since he emailed me the link to this blog. Though this is a design blog it contains a pretty great post on sunscreen. But this isn’t your typical written post; the post is an illustration/graph covering sunscreen basics so the images and the words work together seamlessly to convey a lot of good information. See below:
Me being me there are two points I have to quibble with. The first one is the repetition of the EWG’s “information” on dangerous sunscreen ingredients. Keep in mind there is a lot of debate on this topic and few experts agree with the EWG. (See my post Nothing New: The EWG’s 2011 Sunscreen Report for more details on that subject)
Yes, the sun feels great and does our body’s good, but there is never an excuse for going outside without sunscreen on. (See my post Let’s Debunk Some Sunscreen Myths for more information on sun exposure and Vitamin D)
Prevention Magazine published a great article, SPF Excuses Even Smart Women Make, debunking lots of common excuses on why some people refuse to use sunscreen. After presenting each excuse the magazine very clearly and precisely refutes it. For example –
The Excuse: “The chemicals in sunscreen are probably more dangerous than sun exposure”
Reality Check: Sunscreens have gotten some bad press lately, including claims that they contain cancer-causing ingredients. But a recently published review of the studies on which these claims are based should ease fears. “Many of the safety concerns are not well founded—they’re based on petri dish or animal data that doesn’t relate to humans,” says Steven Wang, MD, director of dermatologic surgery at Memorial Sloan-Kettering Cancer Center in Basking Ridge, NJ, and coauthor of the review. For example, in one study, mice fed a whopping dose of oxybenzone, a UV-light absorber commonly found in sunscreens, exhibited estrogenic effects, which the researchers believe could cause cancer cells to grow more rapidly. But by Dr. Wang’s calculations, it would take more than 250 years for someone who uses sunscreen daily to be exposed to the amount of oxybenzone used in the study.
Still worried? Use a sunscreen like Beyond Coastal Natural SPF 30 Sunscreen ($16; beyondcoastal.com), which has zinc oxide and titanium dioxide in lieu of chemical sunscreens.
OR for instance –
The Excuse: “I don’t get a lot of sun”
Reality Check: You don’t have to be on the beach to soak up rays. Most people rack up 14 hours of casual UV exposure per week. And in one study, short spurts of UVA light twice a week resulted in significant damage to the fibers that keep skin smooth and firm in just 12 weeks. Skin care products like makeup and a daily lotion with SPF are great steps, but “the protection is short-lived on hot, sunny days,” says NYC dermatologist Arielle Kauvar, MD. Use a sweat-resistant sunscreen with at least SPF 30 on all sun-exposed areas to be safe. Supergoop! Save Face Sunscreen Serum SPF 30 ($32; supergoop.com) is decidedly ungoopy, meets our experts’ guidelines, and works great under makeup. Another option: Neutrogena Pure & Free Liquid SPF 50 ($13; drugstores).
The other excuses include:
If any of the excuses above sound like something you have thought then click on the excuse in order to see why it just isn’t true.
And lastly I want to offer some proof why the anti-sunscreen excuse – I don’t wear sunscreen so I can get my needed Vitamin D – is silly. The July issue of Allure offers some illuminating (pun intended) statistics on that point:
200: Number of international units of vitamin D the United States government recommends getting per day.
10,000: Number of IUs of vitamin D the average fair-skinned person absorbs after ten minutes in the midday summer sun wearing shorts and a tank top.
I hope that people realize that they can get all the Vitamin D they need from supplements or from a very, very short time in the sun without sunscreen. For more information about Vitamin D and the sun please see my previous post – Vitamin D and Sun Protection – which contains links to lots of articles about Vitamin D and sunscreen.
Lastly, I would like to point out that there are so many sunscreens on the market today that there really is a sunscreen out their for everyone no matter if you breakout or not or if your skin is sensitive or not. (I was slightly horrified to read recently that Liv Tyler doesn’t use sunscreen on a daily basis because she feels that it clogs her pores. At least, at the moment, she has superior genetics on her side so she still is very beautiful. I wonder how she will look when all that sun damage catches up with her.) If you want a really light but effectively sunscreen be sure to check out La Roche-Posay’s Anthelios 45 Ultra-Light Fluid for Face or one of their other sunscreens. I can’t imagine someone complaining about how this sunscreen feels on their face.
- Broad Spectrum designation. Sunscreens that pass FDA’s broad spectrum test procedure, which measures a product’s UVA protection relative to its UVB protection, may be labeled as “Broad Spectrum SPF [value]” on the front label. For Broad Spectrum sunscreens, SPF values also indicate the amount or magnitude of overall protection. Broad Spectrum SPF products with SPF values higher than 15 provide greater protection and may claim additional uses, as described in the next bullet.
- Use claims. Only Broad Spectrum sunscreens with an SPF value of 15 or higher can claim to reduce the risk of skin cancer and early skin aging if used as directed with other sun protection measures. Non-Broad Spectrum sunscreens and Broad Spectrum sunscreens with an SPF value between 2 and 14 can only claim to help prevent sunburn.
- “Waterproof, “sweatproof” or “sunblock” claims. Manufacturers cannot label sunscreens as “waterproof” or “sweatproof,” or identify their products as “sunblocks,” because these claims overstate their effectiveness. Sunscreens also cannot claim to provide sun protection for more than 2 hours without reapplication or to provide protection immediately after application (for example– “instant protection”) without submitting data to support these claims and obtaining FDA approval.
- Water resistance claims. Water resistance claims on the front label must indicate whether the sunscreen remains effective for 40 minutes or 80 minutes while swimming or sweating, based on standard testing. Sunscreens that are not water resistant must include a direction instructing consumers to use a water resistant sunscreen if swimming or sweating.
- Drug Facts. All sunscreens must include standard “Drug Facts” information on the back and/or side of the container.
The above changes will become law in a year. Interestingly one important change has, for the moment, been left out of the new rules:
The proposed rule, if finalized, would limit the maximum SPF value on sunscreen labels to “50 +” because there is not sufficient data to show that products with SPF values higher than 50 provide greater protection for users than products with SPF values of 50.
Additionally, the FDA is going to study spray sunscreens to determine what level of protection they provide and if they could be toxic if inhaled. The FDA is also going to reexamine 17 sunscreen ingredients.
Though this has been a long time coming I applaud the FDA’s new rules though I would love for there to be a ban on SPF 50 or higher when the new rules go into effect in a year.
Sources and Further Reading:
As May, Skin Cancer Awareness Month, comes to an end I wanted to highlight a few ways all of us can help support skin cancer research.
Or if you prefer to donate in a more roundabout way – consider buying from one of these companies. When you do a donation will be made to The Skin Cancer Foundation.
And remember to always set a good example when it comes to sun protection. Never use a tanning bed and educate others on the risks of tanning beds (see my post Teens and Tanning Beds for more information). Always apply sunscreen daily. Wear a hat and sunglasses when you are outdoors. Get a skin cancer screening.
Also help out by signing a “ letter to the Surgeon General asking her to urge the FDA to enact stricter regulations and more oversight of tanning beds”. The letter is sponsored by The Skin Cancer Foundation.
The Skin Cancer Foundation offers even more sun safe tips.
Have a great and sun safe Memorial Day Weekend!