Sunscreen Ingredients are Absorbed says FDA

For years public health officials, dermatologists and primary care physicians have been encouraging people to apply sunscreen before going out into the outdoors to reduce the risk of sunburn and skin cancers.  We are taught to apply it in advance of exposure by about 30 minutes and to reapply it every few hours especially if we are sweating and swimming.   Living in South Florida, sun exposure is a constant problem so we tend to wear long sleeve clothing with tight woven fabrics to reduce sun exposure.  My 15-month old grandson, visiting last weekend was smeared with sunscreen by his well-meaning parents before we went out to the children’s playground nearby.

These precautions seemed reasonable and sensible until an article appeared in JAMA Dermatology recently.  An article authored by M. Mata, PhD. evaluated the absorption of the chemical constituents of sunscreen after applying it as directed four times per day.  The article was accompanied by a supporting editorial from Robert M. Cliff M.D., a former commissioner in the FDA and now with Duke University School of Medicine and K. Shanika, M.D., PhD.

The study applied sunscreen four times a day to 24 subjects. Blood levels were drawn to assess absorption of the sunscreen products avobenzene, oxybenzone and octocrylene.  The results of the blood testing showed that the levels of these chemicals far exceeded the recommended dosages by multiples. The problem is that no one has evaluated these chemicals to see if at those doses it is safe or toxic causing illness?

The editorial accompanying the findings encourages the public to keep using sunscreen but cautions that the FDA and researchers must quickly find out if exposure to these levels is safe for us?  We do know that the chemical oxybenzone causes permanent bleaching and damage to coral reefs in the ocean from small amounts deposited by swimmers coated with sunscreen. The state of Hawaii has actually banned sunscreens containing oxybenzone to protect their coral reefs.

The fact that these chemicals have been approved and are strongly absorbed with no idea of the consequences is solely the result of elected officials wanting “small government” and reducing funding to the oversight organizations responsible for making sure what we use is not toxic.  It is a classic example of greed and profit over public safety.  The research on the safety of these chemicals must be funded and addressed soon. The American Academy of Pediatrics and Dermatology need to advise parents of youngsters whose minds and bodies are in the development and growth stages what is best to do for their children – sooner rather than later.

Sunscreen Works!

Sunscreen - FDA v2For decades, dermatologists and health care professionals have been urging patients to use sunscreen to protect against sun damage and skin cancer. What has been lacking is excellent research to prove the point.

The June 4th edition of the Annals of Internal Medicine Volume 158 #11 contains the results of just such a study. The study originated in Australia in a collaborative study of the University of Queensland and the Manchester Academic Health Sciences Centre in the United Kingdom under the authorship of Maria Hughes, Gail Williams, Peter Baker and Dele Green – all PhD’s. Nine hundred and three adults, younger than 55 years old, were randomized into one of four groups. One group used a broad spectrum sunscreen daily and 30 mg of Beta Carotene. The second group used sunscreen and a placebo, the third group had a choice of using sunscreen and beta carotene when they felt they needed to and; the fourth group had a choice of using sunscreen and a placebo.  All four groups were then followed between 1992 and 1997 for changes in their skin.

The findings:

·         ~ At 4 ½ years, the daily sunscreen group showed no detectable increase in skin aging.

·         ~ Skin aging was 24% less in the daily sunscreen group compared to the discretionary sunscreen group.

·         ~ Beta Carotene had absolutely no effect on retarding skin aging.

Despite some questions about the methodology, the study clearly showed that, in middle aged men and women, daily use of sun screen prevented skin aging.

As we head into summer it’s important to take this research to heart and use sunscreen of SPF applied to sun exposed areas before you go out.  Depending on how long you are exposed to the sun, you will need to reapply the sunscreen to continue receiving the protection you require.

Squamous Cell Skin Cancers Can Kill

Skin CancerAs part of my office visits, I routinely question patients about health checkups and benchmarking. We talk about eye exams and glaucoma. We talk about women’s health issues and gynecologic exams plus mammograms and bone densitometry.  We talk about colon cancer screening and colonoscopies and immunochemical fecal occult blood slides.  We always ask about skin and whole body checkups with a dermatologist or a primary care physician.

Patients often ask me why I am constantly harping on looking at these issues. “I am old and have survived quite well without these checkups until now.”  

Florida is my home state and it is in the extreme Sun Belt and one of the skin cancer capitals of the world. MedPage Today, the University of Pennsylvania online journal justified my questions about skin cancer and skin exams by publishing a synopsis of Chrysalyne D. Schmults, MD and associates at Harvard University publication in the May issue of JAMA Dermatology.  They reviewed the pathology reports of skin cancer from Brigham and Women’s Hospital in Boston from 2000 through 2009 identifying 1,832 tumors in 985 patients. More than half of the patients were men, most were Caucasian and a suppressed immune system was present in almost 15%. Tumor diameter was less than 2cm (2.54 cm equal an inch) in 85%, was well differentiated in 66% and the tumor was limited to the upper skin level or dermis in 89.5%. The most common locations were the head and neck (28.7%), the legs or feet ( 23.7%), and the hands or arms in 21.6%. Treatment included standard excision in 69.5% and Moths Surgery in 20.2%

Analysis for spread to the lymph nodes, local recurrence, or death due to the disease directly or indirectly seemed to be related to certain factors.  Age over 70, male sex, poor tumor differentiation and perineural invasion all were considered poor risk factors. The death rate from the squamous cell skin cancer approached 3%

The data reviewed in this study will allow researchers to design evaluation and surveillance protocols for high risk skin cancer patients. Until now, no study actually defined what characteristics comprised a high risk skin cancer patient.  

As we head into the summer season it is a reminder of the need for us to use SPF 30 or greater sunscreen on all exposed areas and reapply liberally. Wear wide brimmed hats and clothing with a tight weave to protect your skin. Above all, see your board certified dermatologist for a whole body skin checkup regularly to prevent the growth and spread of a preventable killer disease.