Sunscreens Cause Acne! (and Other Summer Acne Facts!)

With blonde hair and big blue eyes, she looked like a young Betty Draper from Mad Men. My patient, Julie, had been faithfully treating her acne for months. Just when she was starting to clear (in time for her senior photos), wham! Red dots cropped up over her forehead and cheeks. What went wrong? Summertime.

July can be the cruelest month for acne. Acne on the chest and back (bacne) and big, red pimples on your face can make going to the beach an embarrassing experience. Here are a few acne facts for summer:

1. Although there is some suggestion that sun can help acne, its effect varies and sun often makes acne worse. (Bacne + sunburn = bacne burn. Not good).

2. Retinoinds such as topical Retin-A, tretinoin, Differin, Tazorac, Ziana, Atralin, and Accutane all remove the outer layer of skin, leaving you more susceptible to a bad sunburn. Benzoyl peroxide and salicylic acid also peel the outer layer of skin, making you more sensitive.

3. Oral antibiotics such as doxycycline, minocycline, tetracycline, and sulfa antibiotics predispose you to a  painful pink burn on your nose, hands, and arms called a phototoxic rash; I see patients with this all summer long. The pink splotches can take weeks to fade and sting every time you’re in the sun.

4. Sunscreens can cause acne. It’s a cruel fact. Often the best sunscreens such as zinc and titanium, or water resistant sunscreens are the most likely to worsen acne. In order to be effective, sunscreens have to coat your skin which also clogs your pores.

Here are 5 tips to help keep you acne-clear this summer:

1. Remember that sun exposure is not a good way to clear up acne; most people get far more sun that what is helpful and just the right amount of sun to make it worse.

2. If you have fair or sensitive skin and are taking oral antibiotics for acne, then discuss with your physician if you are taking the best antibiotic during summer. Some patients take a break from antibiotics during summer months or switch to antibiotics that are less sun sensitizing.

3. Find ways to protect against the sun other than sunscreen: avoid the sun between 10 AM and 2 PM, wear a big hat (demonstrated here) and cover up.

4. When you need sunscreen, consider products designed for your face which are less oily or less likely to worsen acne such as: Neutrogena Ultra-sheer Dry Touch, Eucerin Facial Moisturizer with SPF 30, La Roche-Posay Antihelios Tinted Cream, or Proactiv’s Daily Protection Plus Sunscreen.

5. Avoid overusing scrubs, toners and slamming face-first into the beach; the added exfoliation will only make risk of sunburn worse.

Just hang-on, winter will be here again before you know it. Does your acne get worse in summer? What sunscreen do you use.

Photo: Foreversouls (flickr). Patient identity changed.

Where Are You More Likely To Sunburn: Beach Or Mountains?

While vacationing in Idaho and Montana last week (blissfully off the grid), I experienced something beautiful: altitude. At 6,260 feet Stanley, Idaho is a mile higher than my home in San Diego. The skies there were a brilliant blue. There was daylight well after 10 PM. The mornings were a chilly 35 degrees. And I got sunburned.

How can this be? Montana is over 1,000 miles north of San Diego. Shouldn’t the sun be stronger down here?

Several things determine the sun’s intensity. The closer to the equator you are, the more intense the sun’s rays. But also, the higher up you are, the more intense the sun’s rays. Your UV exposure increases by 10% for every 3,280 feet in altitude; at 6,000 to 8,000 feet in elevation, you’re exposed to 25% more ultraviolet radiation than at sea level.

Also, snow (which fell during our mid-June trip) is an efficient reflector of sunlight. When skiing or hiking in snow, 80-90% of UV light is reflected at you, dramatically increasing your sun exposure. Grass in comparison reflects only about 3% of sunlight.

Water, especially when still, also reflects sunlight. Still lakes, including the beautiful Yellowstone Lake pictured above, can reflect up to 100% of UV light (hence the term mirrored lake), doubling your UV exposure.

So although you might feel hot lying on the beach in June in Southern California, you might be more vulnerable to sunburn on a chilly hike in Yellowstone after a June snowstorm, which is exactly what happened to me. (Hence the Stetson later in the trip…)

Photos: Madsit, Stanley, ID (top) Purticortico Yellowstone Lake, WY (middle) Dermdoc White Bird, ID (bottom).

Dermdoc Drills Down Vitamin D in High Def!

You know the sun makes vitamin D. Did you know that it does so in just minutes?

After a few minutes of sun, your skin stops making vitamin D.

After a few minutes of sun, your skin starts making skin cancer.

Lying out at the beach or the pool for hours this summer will do far more damage than good.

What do you think, should Dr. Oz be worried? (Or should I stick to podcasts?)

What do you think about the sun and your vitamin D?

If you have trouble with the HD, then click here for the YouTube video.

Sunscreens Cause Skin Cancer? What?!

Just what you needed: another mixed message about your health. The top health story this Memorial Weekend was sunscreens might cause skin cancer.

The story originated from the Environmental Working Group (EWG), a nonprofit organization that “protect(s) the most vulnerable… from health problems attributed to a wide array of toxic contaminants.”

EWG announced their list of best and worst sunscreens last week. They also published a statement that claims creams which contain a vitamin A derivative, retinyl palmitate, increase the risk of skin cancer in laboratory mice. The creams studied were not sunscreens, but rather simple cream with retinyl palmitate. Because many sunscreens contain retinyl palmitate, the EWG is urging the FDA to study this further and is also urging people to avoid sunscreens with vitamin A derivatives in the meantime. Some sunscreens contain retinyl or retinols as a “wrinkle-fighting” ingredient in the sunscreen.

So what should you do? Here are my tips:

  • Ultraviolet light from the sun is radiation and is unquestionably the most important cause of skin cancer.
  • Sunscreens in general do not cause skin cancer.
  • No study has yet looked at retinyl palmitate when used in a sunscreen.
  • It is reasonable to avoid sunscreens that contain retinyl or other vitamin A derivatives until more studies are done, if you’re concerned.
  • Choose a sunscreen with an SPF of 30. Look for zinc oxide, titanium dioxide, avobenzone, ecamsule (Mexoryl) or octocrylene.
  • Reapply sunscreen every 2 hours.

Photo: James Justin (flickr)

What is your take on sunscreen safety?

What about sunscreens and vitamin D?