Dr. Oz Is Wrong On This One

Millions of patients turn to Dr. Oz for advice about their health. He makes complicated health issues easily understandable. Like any doctor, we don’t expect him to be correct all the time. Recently he made a mistake. He recommended using tanning beds for their health benefits.

The only known health benefit of ultraviolet B light (which is in some, not all tanning beds) is to increase vitamin D levels. We know that using tanning beds increases the risk of getting melanoma and the risk of getting other skin cancers. Fortunately, we also know there’s a safe and inexpensive way to increase your vitamin D3 level — simply take vitamin D supplements.

I’m sure if he  consulted a dermatologist (and it needn’t be me), then Dr. Oz would be better informed and would modify his advice. Melanoma skin cancer rates are increasing (while most other cancers are falling) and death from nodular melanoma skin cancer is unchanged despite decades of advances in medicine. We need to give our patients the best evidence we have so they can keep themselves and their families safe.

If this issue is important to you, then please help me by sharing  your thoughts with Dr. Oz and his audience.

Baby Skin Needs Extra Sun Protection

Baby skin is especially vulnerable to sun damage. Here are five tips to keep your baby safe this summer.

Baby skin is sun-sensitive

Everyone wishes they had baby skin. It feels so soft and smooth; it’s perfectly adapted to induce us adults to want to clean their diaper, no matter how many times they dirty them. Like their big eyes and cute noses, baby skin it part of the whole package of being adorable. But like their eyes, their skin, however beautiful, is immature. Baby skin is thinner, has less natural moisturizers and has fewer pigment cells, making it more vulnerable to the environment than adult skin.

This is important especially in summer. How often do you see babies running around on the beach with just a diaper on? Although they seem indestructable, they are more vulnerable than the adult holding the pail and shovel.

Studies have shown that up to 83% of babies get sunburned their first year of life. This is our fault, not theirs. Sunburns at an early age can increase the risk for melanoma skin cancer on the trunk later in life. Sun exposure is also a poor way to get vitamin D for infants because most will get far more damaging sun than they need to make vitamin D — we adults tend to over cook them.

Here are five tips to keep your baby safe this summer:

1. Newborns up to 6 months should be kept out of the sun. Cover them up with light clothing and hats, and put the top down on the stroller.

2. Babies 6 months and older should not be exposed to the sun between 10am and 2pm. When they are outdoors, they should have sunscreen on all exposed skin. Because their immature skin can absorb chemicals more easily, choose sunscreens with zinc and titanium with an SPF of 30 or more. Chemical or spray sunscreens can burn their eyes which will be sure to make for a cranky baby at the beach.

3. Be sure to apply the sunscreen near their hairline, on their ears and at the edges of clothing — areas often missed by well meaning moms.

4. Choose sunscreens that are white or opaque; it’s easier to see where you’ve applied the sunscreen, and he’ll look cute anyway.

5. Be sure your baby is getting 400 IU of vitamin D everyday, then she won’t need any sun for her vitamin D.

Photo: Limaoscarjuliet, Flickr

Fall Is Here, Time To Change Skincare Products In Your Vanity

What I Wore: The Editor

Fall is finally here. It’s time to change the clothes in your wardrobe to knee-length pencil skirts, motorcycle leather jackets, and animal print handbags, says Vogue. It’s also time to change your skincare products, says @dermdoc.

Most of us associate changing seasons with changing wardrobes, but it’s also the time to evaluate your skincare routine. Humid, warm air will change to dry, cool air like greens to reds on maple trees. Your skin is a living organ and actively responds to these environmental changes.

  • Dry air means your skin will produce more oils to protect itself.
  • Cool air means that previously flushed skin will pale.
  • Less sun means that thick skin will shrink.
  • Less ultraviolet B light means that tanned skin will fade to allow for maximum vitamin D production.

When you start packing away your shorts and spaghetti strap dresses, remember that your skin needs you to pack away some of your summer products.

  • Dryer, thinner skin is more sensitive; consider exfoliating less frequently. Some scrubs or at-home microdermabrasions should be reduced to once every few days or week.
  • Some retinoids like Retin-A or Renova, can be reduced from every day to every other day to minimize irritation in fall and winter.
  • Listen to your skin. Is it increasingly red and stinging as the weather changes? You might have to stop some peels or toners completely until springtime.
  • Consider switching soapy facial washes to soothing or creamy facial cleansers.
  • Change from a lotion moisturizer to a cream moisturizer. If you haven’t moisturized every day, then you should start now.
  • Use a facial moisturizer, particularly if you’re prone to acne or have excessively dry facial skin.
  • Depending on how far north you live and on your skin tone, you might be able to cut back on sunscreen for winter. Although complete sun protection is the best way minimize all damage to your skin, wearing sunscreen year-round may not be necessary. If you’re not sure, talk to your dermatologist.
  • Remember that even in winter, at high altitudes and where the ground is covered with snow, ultraviolet light can be strong, more like summertime sun. So you always need sunblock when skiing or snowboarding.

Photo credit: FCC, Jessica Quirk

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?

Why Tanning Is An Unsafe Way To Get Vitamin D

I made this video while at the Lance Armstrong Foundation Headquarters in Austin, TX to help people understand why tanning is an unsafe way to get your vitamin D.

  • Your skin needs UVB to make vitamin D.
  • Many tannning beds use little or no UVB, so they wouldn’t increase your vitamin D levels.
  • Tanning beds increase your risk for melanoma, squamous cell carcinoma, and basal cell carcinoma skin cancers.
  • Vitamin D3 supplements at doses of 1,000 to 2,000 IU are readily available.
  • Supplements have been proven to safely increase and maintain high levels of vitamin D.

Make a donation to the Lance Armstrong Foundation and win a chance to see Lance in France at the Tour de France.

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