Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Sunscreen Myths – Beware of Things You Read and Hear July 2, 2012

Filed under: sun protection — askanesthetician @ 5:00 am
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A few weeks ago as a patient was leaving our office she turned to tell me and the doctor I work for that Dr. Oz had recommended on his TV show that you go outside without sunscreen on for 15 minutes in order to get enough Vitamin D.  Both the doctor I work for and myself told her that we did not agree with Dr. Oz’s recommendation.  We explained that by going outside, even for 15 minutes, without sunscreen you still get too much sun exposure and expose yourself to the risk of skin cancer.  The stakes were simply too high to follow that recommendation.  If you aren’t getting enough Vitamin D take a supplement instead of going out into the sun unprotected.

Of course being the sunscreen fanatic that I am along with the fact that I see it as a personal responsibility to warn people about the dangers of skin cancer, I was very upset after hearing that Dr. Oz had made that comment on TV to millions of viewers.  I can tell you that many women take Dr. Oz’s medical advice extremely seriously and want to follow it to a T.  So I did a little online research and found the reference our patient had mentioned:

If these foods don’t sound very appealing to you, there is good news: you don’t have to eat vitamin D to make sure you’re getting your daily dose! Vitamin D is actually produced in your body when ultraviolet rays from sunlight strike your skin. The UV rays trigger synthesis of vitamin D, which then gets converted in your liver into its active form.

This means one of the best ways to get vitamin D is to spend about 10-15 minutes a day outside in the sun. Keep in mind that wearing sunscreen will prevent you from getting adequate vitamin D outdoors. In the summertime, an easy solution is skipping sunscreen on your legs for the first 15 minutes in the sun. Just make sure you apply in time to prevent any burns or damage.

If this sounds complicated (or it’s cloudy!), there’s an even easier way to get your vitamin D: many foods in the American diet are fortified with this essential nutrient. In fact, fortified foods provide the majority of vitamin D in our diets.

(From Daily Dose: Vitamin DThe Dr. Oz Show website)

I am not here to quibble about the fact that you can get all the Vitamin D that your body needs from the sun, what I am going to argue against is Dr. Oz’s advice.  Let’s be very realistic here – you’ve thought about it and today you notice it is sunny outside so you think “I’ll be out and about running errands, I won’t put sunscreen on for the first 15 minutes I am out”.  Now how many people do you know who will stop during their busy day and put on sunscreen??  I don’t know any.  People drastically underestimate the amount of damage intermittent sun exposure does to their skin.  Put your sunscreen on everyday before you leave the house.  If you are inside during the day and then leave to go out while it is still sunny put more sunscreen on all your exposed skin.  A tan may look sexy now but wrinkles and dark spots are not sexy later on.  And remember – a tan is a sign of damage to your skin no matter how fabulous you think you look right now.  One of the most common complaints any esthetician hears is about sun damage.  It is very hard to treat hyperpigmentation (one way you can gauge how hard it is to treat a specific skin issue is by the number of products on the market sold to treat it.  There is no perfect solution for hyperpigmentation hence the vast proliferation of products to erase it).  I found this comment about Vitamin D and sun exposure to be just another example of how well-meaning advice will be improperly followed and interpreted out in the real world.

Another case in point – terror over the safety of sunscreens.  The EWG has made numerous headlines over their claims that sunscreens are more harmful than helpful.  As with many controversies the cold hard truth gets lost adminsts the hype.  Renee Rouleau does a good job at explaining one controversial sunscreen ingredient in her blog post Does Sunscreen Cause Cancer?:

While the internet is an amazing resource for information, when a rumor gets out there, it spreads like crazy on the web and when people read it they may consider it to be factual.

One such skin care rumor that has swirled around on the internet for a while now is that octinoxate–the most common sunscreen ingredient in the world– causes cancer. Then the other day I was reading one of the handled bags from a recent Lululemon purchase and was shocked when I read the following printed on their bag: “Sunscreen absorbed into the skin might be worse than sunshine. Get the right amount of sunshine.” What? Did I really read this correctly on a Lululemon bag? Why is a fitness clothing company implying this claim on their cute bags that are given out in the stores? While I’m certainly okay with getting the right amount of sunshine as I do many of my own workouts outdoors, I am not okay with the comment implying that sunscreens may be worse than sunshine. This is wrong and misleading. Can we say melanoma–one of the deadliest forms of cancer??? There is so much scientific evidence that excessive sun exposure can increase your chances of skin cancer.  (Read more about melanoma here.)…

So does sunscreen cause cancer? No. This is simply not true because there is no study at all that proves octinoxate causes cancer, and without a proven scientific study, this claim simply can be not accurate and true.

Some cosmetic brands that do not use this ingredient in their sunscreens will use scare tactics to get consumers to believe that their product is safe and others are harmful. This has been the case with parabens and I have spoken publicly about this here. Instead, they use the phrase “linked to cancer” to scare the public to buy their product, instead of “proven to cause cancer”– and there is a huge difference between the two.

In some studies where octinoxate is “linked” to cancer, the ingredient has been placed in high concentrations directly onto various types of cells taken from skin or other areas of the body (liver, uterus) or was fed to rats or mice in their food. One such study, conducted by researchers at the University of Zurich in Switzerland in 2004, found evidence of endocrine disruption activity in rats fed octinoxate but did not find a link to cancer.*1 Shortly after the 2004 study was published, another research group in Australia found detectable amounts of octinoxate in the stratum corneum and epidermis layers of the skin 24 hours after applying the ingredient to intact skin, but the amount found was 5 times less than studies where octinoxate was applied directly to human keratinocytes in a Petrie dish.

Bottom line: There is no evidence or information about octinoxate causing cancer. Trust me, if there were valid, published studies about octinoxate as a cause of cancer, we would all know about it.

The Skin Cancer Foundation has long refuted the EWG’s claims that sunscreen ingredients are dangerous and are doing more harm than good.

Recent attacks on sunscreens in the media point to imperfections and potential risks, but miss the point that sunscreen continues to be one of the safest and most effective sun protection methods available.

We are concerned that the criticisms will raise unnecessary fears and cause people to stop using sunscreen, doing their skin serious harm.

In general, the criticisms have not been based on hard science. In fact, The Chair of the Skin Cancer Foundation’s Photobiology Committee, an independent panel of top experts on sun damage and sun protection, reviewed the same studies cited in the media, and found that their determination of what made a sunscreen bad or good was based on “junk science.”

(If Recent Attacks on Sunscreen Concern YouThe Skin Cancer Foundation)

In the same article The Skin Cancer Foundation goes on to refute different claims made against sunscreens such as:

• Retinyl Palmitate, a Form of Vitamin A and an Ingredient in 41 Percent of Sunscreens, Speeds up Growth of Tumors and Other Lesions When Exposed to the Sun.

An FDA study is often cited for this data, with some faulting the FDA for not releasing the study. However, the FDA is yet to release the study precisely because it has not gone through proper peer review. Thus, the criticisms are based on an unapproved 10-year-old study of mice that has never been published in any journal. To date, there is no scientific evidence that vitamin A is a carcinogen in humans. What’s more, only trace amounts of retinyl palmitate appear in sunscreens, and some evidence suggests that it is actually protective against cancer.

I think the lesson here is don’t believe everything you read or see on TV.  You’re a smart person, right?  Do some of your own research before just accepting what someone else has to say.

Further watching and reading (from my related posts):

Mary Cassatt painting Children Playing on the Beach image from wikipaintings.org

 

Vitamin D and Your Skin: Part II March 1, 2012

Filed under: Skin and Skincare — askanesthetician @ 6:00 am
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We all know that Vitamin D is essential to good health, but how does one reconcile the need for Vitamin D, which humans can synthesize through sun exposure, with the need to protect your skin from skin cancer and, if we can be vain for a moment, unnecessary aging?  I’ve written about this subject in the past (see my previous post), but armed with some new information on the subject I thought it was time to revisit this controversy.

Why Our Bodies Need Vitamin D and How to Get Enough

Our bodies need Vitamin D in order to maintain normal calcium metabolism and to support our bone health.  Further, Vitamin D helps form strong, healthy nails, plays a role in cellular metabolism and the growth of new skin cells, and helps stop the effects of skin diseases like psoriasis.

According to Dr. Jessica Wu, in her book Feed Your Face (pages 149-150), Vitamin D plays a vital role in our health for many reasons:

Vitamin D is essential for good health.  It helps the body absorb calcium for strong bones and muscles, and recent research suggests that vitamin D also plays a role in preventing colon, prostate, and breast cancer as well as diabetes (types 1 and 2), hypertension, and multiple sclerosis.  Since a number of cells (including the skin cells) contain vitamin D receptors, it’s possible that there are additional uses and benefits of vitamin D that we don’t yet know about.  And here’s another thing: Many of my patients tell me they feel healthier when they’ve had a little sun – and so do I.  Perhaps that’s our body’s way of telling us that it needs vitamin D, just as you might crave red meat during your period since your body loses a lot of iron when it’s that time of the month.

There is a lot of debate in medical community about what the optimal levels of Vitamin D are.  Different doctors recommend a very wide range of doses for certain age groups so it hard to know what the correct dosage is.  Certain groups are a risk for Vitamin D deficiencies:  the obese, people with darker skin tones, the elderly, and skin cancer patients/survivors.

You can obtain the necessary amount of Vitamin D through diets and supplements like a multivitamin or a calcium supplement with Vitamin D in it.  In terms of diet, foods that are rich in Vitamin D include some fish (like salmon, mackerel, and tuna), some varieties of mushrooms, fortified breakfast cereals, and dairy products that are also fortified with Vitamin D.  Vitamin D is also found in small amounts in egg yolks, beef liver, and cheese.

Despite the fact that your diet alone or combined with supplements can provide you with enough Vitamin D many people persist in claiming that the only true way to get enough Vitamin D is to get it through sun exposure.  Some people even say that they won’t wear sunscreen for this reason.  Personally, I completely disagree with this idea since going without sunscreen can expose you to a whole host of other problems like skin cancer.

But if you insist on getting your needed Vitamin D from the sun – just how much sun exposure is necessary to do that?  Not much.

Let me quote from Dr. Wu again (pages 150- 151):

How much vitamin D your body makes depends largely on where you live.  For example, if you live above 40 degrees north latitude (that’s like drawing a line from the northern border of California across to Boston), then the sunlight isn’t strong enough to make vitamin D in the winter, from November through February.  On the other hand, if you live below 34 degrees north latitude (a line from Los Angeles to Columbia, South Carolina), then spending just a few minutes a day outdoors will give you all the vitamin D you need, regardless of the season.

Another indicator of vitamin D production is the UV Index, which measures the strength of ultraviolet radiation on any given day.  (You can look up the UV Index in any basic weather report.)  One recent study showed that when the UV Index is 3, a fair-skinned individual will produce an adequate amount of vitamin D by exposing hands and face (without sunscreen) for just 10 minutes a day (it would take an hour to burn).  In the summer, when the UV Index might be 7 to 8, you might need only three to four minutes outside.

A little sunlight can be good for you, but that’s not an excuse to get a rotisserie tan or to visit the tanning salon every other week.  You can get enough UVB to make vitamin D well before developing a sunburn.  If you do burn, you’ve overdone it.  The body will break down the excess vitamin D (so it won’t even be stored for use later), and you’ll have increased your risk of skin cancer and premature aging.  After no more than a few minutes in strong sunlight, you’ll want to apply a sunscreen with UVA and UVB protection.  (I recommend a minimum SPF of 30)  And if you have a lot of sun damage, a previous skin cancer, or a family history of melanoma, get your vitamin D from food or a supplement, not the sun.

Keep something else in mind – most people don’t apply enough sunscreen anyhow so they are still getting their Vitamin D from sun exposure even though they are using sunscreen.  People routinely forget to apply sunscreen to every area of their exposed skin like their hands, necks, chests, and tips of their ears.  Your body can produce Vitamin D when any part of your skin is exposed.

One last thing to keep in mind – your body cannot recognize if the Vitamin D in your body came from the sun or from your diet.  No matter what the source, once it’s in your body the Vitamin C is all the same.

The Newest Ways to Get Your Vitamin D

It turns out that there are a number of new products on the market that protect your skin from sun damage while helping your body produce Vitamin D.  There are a few things to keep in mind before running out to purchase the first product that says it will help your body get enough Vitamin D.

In order for a product that claims to provide Vitamin D to the body to work properly and topically the Vitamin D has to be active.  The ingredient ergocalciferol is the active form of Vitamin D, but the application of Vitamin D topically will only deliver the vitamin to the area where you applied the product, unlike a supplement which enters the blood stream.

There is a new sunscreen ingredient being developed, Uniprotect PT-3, which is said to protect against oxidative and UV damage at the same level as spf 20, but it still allows the body to product Vitamin D at the same time.  Currently this ingredient is found in Supergoop!  Save Face Serum SPF 30+, but keep your eyes open for it in more products in the future.

In the meantime you can look for the following products that claim to help the skin produce or at least boost the amount of Vitamin D in the skin:

Source and Further Reading:

Image from hopkins-arthritis.org

 

Great Sunscreen Article – Hooray! August 27, 2010

(Though I know that summer is coming to an end I thought it would be useful to highlight this article about sunscreen as a reminder that you need to use your sunscreen year round.)

Recently I read More magazine, a fashion/lifestyle magazine geared toward women who are 40+, for the second time.   The tagline of More is: “For women of style & substance”, and I have to say that the magazine lives up its motto.  While I have yet to reach the age demographic the magazine is geared toward (though I am fast approaching it), I enjoy reading the articles in the magazine and really like the fashion advice.  While reading the June issue of the magazine I came across an excellent article about sun protection and sunscreen entitled Customize Your Sun Protection Strategy.

The article does a great job of debunking sunscreen myths and truly covers all the important issue when it comes to sun protection.  The published version of the article, though not the online version unfortunately, has short but thorough “asides” about SPF ratings, getting enough Vitamin D, and what level of SPF you need.  I especially liked the fact that the article correctly explains that even moderate to little sun exposure can be harmful and that everyone needs a sunscreen on a daily basis even if they are not spending the day outdoors. 

I only have one quibble with the article.  The author of the piece Genevieve Monsma writes:

If the formula you choose contains only chemical sunscreen, you must re­apply it every two hours to ensure protection. And when you’re in and out of water or sweating a lot, you should reapply any sun protection every two to three hours, whether it’s a chemical or physical formula.

No matter what sunscreen formula you use – chemical or physical – you need to reapply it every two hours if you are outdoors.

Bottom Line:  This is a great article to both read and save for future reference.  A job well done More!

 

Vitamin D and Sun Protection April 1, 2010

It’s funny how once one person mentions something to you the same topic seems to pop up everywhere.  For instance, Vitamin D deficiencies.  A few weeks ago a client mentioned to me that many people nowadays suffer from Vitamin D deficiencies and that perhaps I was going overboard when recommending that people be sure to use sunscreen on every exposed part of their bodies every time they went outside.  She pointed out to me that the sun helps our bodies produce Vitamin D.  So after that conversation I read an interview with “Dr. Sunshine” in The New York Times about the same topic, and then a few days ago a friend mentioned the same issue on her Facebook status update.  So as you may well imagine the topic of Vitamin D and sun protection has been on my mind.

For me the issue of getting enough Vitamin D is very simple: take a supplement and use your sunscreen.  I take a multivitamin everyday and it has 200% of the recommended daily amount of Vitamin D.  It turns out that even regular sun exposure does not always result in the body creating enough Vitamin D.  Going without sunscreen on a regular basis puts you in too much of risk for skin cancer (and if you want to be more frivolous – wrinkles) even if you justify it by saying that you need the Vitamin D.  There are also many foods that are good sources of Vitamin D.  These foods include mushrooms, fortified dairy products like milk, and fish such as salmon and cod. 

So please think twice when you forego using your sunscreen because of a need for Vitamin D.  Take a supplement instead or cook a dish with salmon, mushrooms, and milk in it.  I just hope it tastes better than it sounds.

 

 

Sources and Further Reading

 

 

 
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