Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Challenging the EWG on Their Sunscreen Findings April 4, 2011

For the past few years The Environmental Working Group, a health and environmental watch group, has come out with an annual sunscreen report that casts an extremely damning eye on the vast majority of the sunscreens on the market today.  Last year the EWG recommended only 39 out of the 500 sunscreens that they reviewed.  The group called into question the use of retinyl palmitate (or vitamin A) and oxybenzone in sunscreens saying that retinyl palmitate could actually cause cancerous tumors if exposed to sunlight and that oxybenzone (which is so widely used in sunscreens it is hard to find a readily available commercial sunscreen without it) is an endocrine disruptor.  The report also went on to make harsh statements against The Skin Cancer Foundation for putting their seal of approval on sunscreens and the FDA for still not updating its sunscreen regulations, something they said they were going to do back in 1978 (yes, 1978 that isn’t a typo).   One more thing the EWG emphasized in their report was the fact that sunscreens’ were promising false security with exaggerated spf ratings.  I happen to agree with that last point wholeheartedly.  (For more on that issue please see my previous post – Spf 100 is a Joke.)

Last year’s EWG sunscreen report created quite a ruckus and got a lot of media attention.  In my opinion it also created a lot of unnecessary stress, worry, and aggravation particularly for parents who wanted to make sure that their children were properly protected from the sun.  Perhaps what bothered me the most wasn’t the debate about which sunscreens were best because I actually don’t think all sunscreens are created equal, but the lack of insight and the blind following that many people engaged in after reading (or just hearing) about the EWG report.  Instead of investigating the issue for themselves many people, and I knew quite a few personally, didn’t give the EWG’s statements a second thought and instead of doing some of their own investigating they simply became hysterical about buying the “right” sunscreen.  (I tried to cover different sides of this debate in my blog last summer is my posts: Sunscreen Woes – The EWG Releases Its Annual Sunscreen Report and The Debate Continues: More on the Sunscreen Controversy)  So I was pleased to see the recent article Shedding Light on Sunscreens in MedEsthetics Magazine which addressed many of the issues raised in the EWG report last year.

The article in MedEsthetics addressed the issues brought up by the EWG about retinyl palmitate and oxybenzone.  The article explains that the EWG reached their conclusions about retinyl palmitate causing cancerous tumors when exposed to sunlight:

based on initial, unpublished findings from a National Toxicology Program study released in late 2009 by the FDA.  The NTP is the federal government’s principal evaluator of substances that raise public health concerns.  In the study, lab mice were coated in 0.1% to 0.5% vitamin A cream and then exposed to the equivalent of up to nine minutes of midday Florida sunlight each day for one year.  The EWG says that tumors and lesions developed in up to 21% sooner in lab animals coated in the vitamin A cream compared to control animals covered in a vitamin-free cream.

The EWG’s interpretation caught physicians and the industry by surprise.  It wasn’t until November 2010 that dermatologists responded in a paper published in the Journal of the American Academy of Dermatology.  Lead author Steven Q. Wang, MD, from Memorial Sloan-Kettering Cancer Center in New York City, and colleagues disagreed with the EWG conclusions, saying that the number of malignant neoplasms in the two groups of mice were not significantly different in mice exposed to the higher doses of radiation.  They concluded that the evidence did not support calling the combination of retinyl palmitate and UV photocarcinogenic.

The EWG countered with its own online critique of the journal article, saying that it stood by its analysis of the data.  As we await a final report from the NTP, industry leaders weighing in on the evidence seem to agree with this statement from Tatiana Kononov, principle scientist at Revision Skin Care:  Although I applaud the stated mission of the EWG, the release of its report on sunscreens highlighted some harsh generalizations that I think were made solely for publicity purposes.  This specific act by the EWG was unfortunate and irresponsible.  I am sure that many future studies will show that retinyl palmitate is perfectly safe and even beneficial in sunscreen products.”

 As for oxybenzone, which the EWG labeled an endocrine disruptor, once again most experts disagreed with their findings:

The EWG bases its conclusion on studies in which mice were fed large amounts of oxybenzone.  “Oxybenzone has been around for 30 to 40 years, and there is no data showing that topical use is estrogenic in any way,” Dr. Lim says [Dr. Lim is the chairman of the department of dermatology at Henry Ford Hospital in Detroit].  “Since the original mouse studies, several groups have done human studies looking for hormonal effects but found none.”

Oxybenzone is a helpful ingredient because it has some UVA absorption characteristics,” says Kononov.  “It is approved for use in sunscreens by many other countries including Japan, Australia and South Korea.

I have to say that I was pleased to read these counter interpretations of the EWG’s conclusions.  Though I was initially inclined to think the EWG was on to something when I read their report last year I have since decided that their claims were way overblown.  Of course all this makes me wonder – what is the EWG going to say in their 2011 sunscreen report?  Only time will tell.

 

Rosacea: Causes, Triggers, and Treatment Options October 7, 2010

Rosacea poses a vexing problem for estheticians and physicians.  It is a fairly common skin condition since it affects around 16 million people a year yet a poll found that 78% of Americans have no knowledge of this condition and do not know how to recognize or treat it.  Perhaps what is most frustrating about rosacea is that there is both no known cause* or cure (though there is ongoing research to determine the cause of this disorder).  Correct diagnosis can be difficult since there is no test for rosacea and symptoms can sometimes mimic those of acne or other skin problems and diseases.  Be sure that you trust the source of your rosacea diagnosis.  I should point out here that we estheticians cannot legally diagnosis health problems and rosacea is classified as a skin disorder.  So while an esthetician may be sure you have rosacea because of her experience be sure to get a physician’s opinion as well.  Plus as you will read below there are treatment options for rosacea that can only be dispensed by physician.

 

What is Rosacea?

 

Rosacea is a genetic inflammatory skin disorder that usually affects the face but can also affect other parts of the body as well such as areas as the chest and ears.  It is particularly common in people with fair skin and light-colored eyes.  Normally the symptoms of rosacea appear after the age of 30, and rosacea is more commonly found in women than men.  But interestingly rosacea is usually worse in men than in women.  Rosacea shows a range of symptoms from mild to severe (see the illustration below).

According to The National Rosacea Society:

 

Rosacea (pronounced “roh-ZAY-sha”) is a chronic and potentially life-disruptive disorder primarily of the facial skin, often characterized by flare-ups and remissions. Many have observed that it typically begins any time after age 30 as a redness on the cheeks, nose, chin or forehead that may come and go. In some cases, rosacea may also occur on the neck, chest, scalp or ears. Over time, the redness tends to become ruddier and more persistent, and visible blood vessels may appear. Left untreated, bumps and pimples often develop, and in severe cases the nose may grow swollen and bumpy from excess tissue. This is the condition, called rhinophyma (pronounced “rhi-no-FY-muh”), that gave the late comedian W.C. Fields his trademark bulbous nose. In many rosacea patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.

 

 

Sun exposure and other rosacea triggers, more on triggers in a moment, cause blood vessels near the surface of the skin to dilate.  As this occurs the complexion appears red.  This causes the body to send inflammatory cells to the area of the dilated blood vessels and even triggers the growth of more blood vessels in the area.  The body tries to stop this process by creating more veins so that the inflammatory cells can fix the problem but all this does is create more of a problem. 

 

Rosacea Triggers

 

If you have been diagnosed with rosacea you need to take the time to figure out your triggers.  Managing your triggers will help keep your symptoms under control as much as possible.  UV (aka sun) exposure is one of the biggest rosacea triggers.  Using sunscreen and staying out of the sun (wearing a hat as well) are key to controlling rosacea.  Heat, stress, hormones, hot tubs, fragrance, allergies, spicy food, alcohol, exercise, and topical products can all trigger rosacea flare-up or make symptoms worse.

 

Rosacea Treatment Options

 

 First and foremost use your sunscreen everyday if you have rosacea.  Do not forget to reapply throughout the day even if the only time you are “outdoors” is when you are only driving to and from work.  Figure out your personal rosacea triggers and avoid them.  Use gentle skincare products (recommendations below) that contain anti-inflammatory ingredients.

A doctor can prescribe Metrogel (metronidazole) which is a powerful anti-inflammatory.  Some doctors prefer to prescribe Finacea which is azaleic acid, another strong anti-inflammatory ingredient.  Lotions and creams with sulfur, yet another anti-inflammatory ingredient, may also be prescribed.  If those steps are not enough than oral antibiotics such as Oracea may be prescribed.  Hydrocortisone is only sporadically prescribed today to patients, but a low dose of a beta-blocker like propranolol may be prescribed to prevent vasodilation and redness.

In terms of in-office treatments for rosacea IPL (intense pulse light) and laser treatments are available.  IPL is a very effective way to get rid of extra blood vessels and to calm redness.  In the case of severe rosacea a doctor may opt to treat with a laser such as the Vbeam instead of using IPL.

Rosacea patients need to be patient since it usually takes 12 to 16 weeks to see improvement when treating rosacea.  Additionally, as with acne you must be diligent and persistent in treating rosacea since, as of yet, there is no cure for this disorder.

 

Products:

  • Obagi Medical, which is a great physician dispensed skincare line, as set of products for rosacea:  Rosaclear
  • I have also seen that Avene has a rosacea line though I don’t know anything about it specifically.

 

Sources and Further Reading 

 

*  There is a theory that rosacea is caused by microscopic skin mites but as with all theories about the causes of rosacea this has not been conclusively proved.

 

 
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