Does The Sun Cause Melanoma?

Yes. Isn’t the answer obvious? Doesn’t everyone know that the sun causes melanoma? Not so fast.

There are many people who think we dermatologists are needlessly frightening everyone. They argue that the sun is good for you because it boosts your vitamin D levels and that dermatologists are subsidized by the sunscreen industry. They argue that melanoma can occur in places that are not sun exposed (like the bottom of your feet), that sunscreens have never been proven to prevent melanoma, and that people who get sun every day, like farmers, are actually less likely to get melanoma. They’re right.

So, then does the sun cause melanoma? Yes. Melanoma is a potentially deadly skin cancer. Like other cancers (breast, lung, colon), there are many risk factors. Think of melanoma as a destination — the hell of skin cancer. There are many roads to that destination even though the final resting place is the same.

People who have light skin or a family history of melanoma have a much shorter route to arrive at melanoma. It takes less time and less environmental factors for them to get melanoma. People who have very dark skin have a very long road to melanoma; it is unlikely that they will arrive there in their lifetime. Older people are much more likely to develop melanoma than younger people (they have been travelling the road for much longer). Sun exposure, especially sun burns, pushes you farther down that road.

Brilliant research from people like Dr. Michael Stratton in the United Kingdom has shown that most of the mutations found in melanoma tumors are unquestionably the work of ultraviolet radiation damage to the DNA. We also know that people who use tanning beds before the age of 30 are 75% more likely to develop melanoma that those who do not.

The sun does have health benefits, but unfortunately it also is the main driver pushing us down the road to melanoma. Each person has to think about how far along the road to melanoma he or she is starting at to determine how careful to be with the sun.

Everyday in dermatology we see people who unexpectantly find themselves in a place they did not think possible — they have melanoma. Many don’t understand how they got there; it has been a long road. Stop and think about where you are along that journey. What are your risk factors of melanoma? It is never too late to stop and turn around.

Photo: Eduardo Amorim

Caffeine Plus Exercise Protects Against Skin Cancer

Do you love your morning coffee? Do you love to exercise? Well, so do I. Here’s another reason why we should keep it up: caffeine and exercise might reduce the risk of skin cancer.

A laboratory study of mice found that caffeine and exercise boosted the elimination of ultraviolet light (UV) damaged cells. Disposal of these damaged cells before they can grow reduces the risk of a skin cancer developing.

The study compared the effects of caffeine, exercise, and the combination of both in three groups of hairless mice. Hairless or nude mice are particularly vulnerable to ultraviolet light radiation and are prone to skin cancer.

One group of mice drank caffeinated water, the equivalent of one to two cups of coffee a day. Another group ran on an exercise wheel, the equivalent of a 2.5 mile jog for us.  A third group drank caffeinated water and ran the wheel. All of the mice were exposed to UV radiation. The rate of elimination of damaged cells was highest in the third group that both drank caffeine and exercised.

A different study found that topical application of caffeine can also help prevent skin cancer. Caffeine applied 30 minutes before UVB exposure inhibited cell DNA damage by 80 percent. In other studies, caffeine has been shown to decrease the risk of breast and liver cancer.

Of course, caffeine and exercise are not a substitute for wearing sunscreen; however, they might justify splurging on a latte today. But please don’t place your Starbucks Venti coffee on the gym treadmill next to me in the morning — that drives me nuts.

Photo: Adria Richards (flickr)

Caffeine Protects Against Skin Cancer

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So how does a dermatologist like me protect against skin cancer? I go to Peet’s Coffee.

There are plenty of reasons to enjoy a cappuccino in the morning (if you can still afford it), and preventing skin cancer might be one of them.

Studies of mice have shown that feeding them caffeine protects them against ultraviolet radiation, which is similar to sun exposure for humans. The protection is most effective when the mice exercise. (So the researchers basically make them drink espresso then hit the exercise wheel.)

While epidemiologic studies and animal studies are helpful, it is nice to have a scientific explanation to support the claim. New studies show how it works.

Researchers exposed skin cells that were growing in culture to caffeine (possibly when one of the graduate students spilled his Red Bull on the petri dish). They then exposed the cells to damaging UVB light. They found that the caffeine-treated, UV-damaged cells underwent programmed cell death. When cells are damaged, but don’t die, they grow into cancerous tumors. When damaged cells die, they are no longer a threat to the body and are safely eliminated.

As sunscreens become more sophisticated, ingredients like caffeine will be added to soak up the damaging oxidants or to protect the skin from developing cancer. Botanicals like ferulic acid, derived from ferns, have proven themselves as powerful additives to sunscreens and are the future of sun protection.

Although there is not enough evidence to advise patients to drink more coffee as a means of sun protection, do you really need another reason to have a nice macchiato in the afternoon?

Photo: Burnt Phrases (flickr)

UV Light for Acrylic Nails Might Cause Skin Cancer

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“It’s like a mini tanning bed for your fingers. ”

Artifical nails are a $6.3 billion dollar industry. There are nearly 60,000 nail salons in the US — 5 times as many Starbucks! Many of these nail salons use UV light, which might increase the risk of skin cancer on your fingers.

Researchers from the M.D. Anderson Cancer Center at the University of Texas noticed that some of their patients with skin cancer on their fingers (an uncommon place to get skin cancer) reported having had UV light for artificial nails. Such UV light has been shown to damage cells’ DNA (the genetic code in all cells) and to cause mutations that lead to skin cancer.

There are several types of nails. The most popular is acrylic, a two part process where a liquid monomer is combined with a powder polymer. It hardens in seconds, but takes an hour for the final hardness to set. Ultraviolet light is used to speed up the hardening.

A second type of artificial nail is the UV-gel. These are more flexible and have a high-gloss finish than acrylics. As their name suggests, ultraviolet light is used to harden the nails.

UV light is also used for a topcoat sealant. Because artificial nails yellow from UV light (especially tanning booths), a top coat can be used to protect the nail. This topcoat is cured (or set) using UV light.

The amount of radiation that your fingers get from the nail treatment is comparable to what you would get in a tanning booth. Because nails are done every 2-4 weeks (one would hope), that can add up to a significant amount of UV exposure over years.

No large scale studies have been done to examine the danger of using UV light for nails, but these patients suggest that there is likely a risk, especially if you have fair skin or have a history of skin cancer.

Photo: Monibela (flickr)

Four Self Skin Checks for Wintertime

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Summertime lends itself to showing a lot more skin. There are plenty of opportunities for checking out that mole on your back while you are walking around in spaghetti strap tops. In wintertime, your skin often doesn’t see the light of day, so you might be unaware of a suspicious mole on your back that is fully covered by a heavy sweater. Continue reading