The Skinny on Skin       A Wellness Perspective    to Skin Health and Education         Brandon Fletcher    The Christ Hos...
Our Skin Protects our body from heat, injury, infection,  water loss and sunlight Regulates body temp Storage (H2O, fat...
Skin Anatomy  EPIDERMIS     DERMISHYPO-DERMIS
Skin Anatomy: Epidermis The Epidermis is the thin outer layer of the skin. The  epidermis itself is made up of three sub-...
Skin Anatomy (Cont.) The Dermis   contains connective tissue, nerves, vessels,    glands, and hair follicles      held ...
About Skin Cancer Skin cancer is the most common cancer and is  increasing at by 4% a year, which is faster than any othe...
Basal Cell CarcinomaLeast malignant and most common skin cancerStratum basale cells proliferate and invade the dermis an...
Squamous Cell CarcinomaArises from keratinocytesArise most often on scalp, ears, and lower lipGrows rapidly and metasta...
About MelanomaCurrently, the lifetime risk of developing invasive melanoma (US) is 1 in 62Melanoma is the most common ca...
About Melanoma Over 75% of skin cancer deaths are from  melanoma One American dies from melanoma every hour The causes ...
Melanoma Melanoma skin cancer starts in the melanocyte  cells of the skin Cancer of melanocytes is the most dangerous  t...
The Four Types of Melanoma Superficial, spreading or flat: grows outwards  in an irregular pattern with an uneven colour...
Sites of Melanoma Occurrence
Important to KnowMelanoma is not limited to the skin you  can seeMelanoma can also start in the mucous  membranes of the...
About MolesMalignant melanoma almost always starts as a mole, so get to know your skin  – A normal mole is round or oval,...
Know what to Look For How Do You Know Which One is Malignant?
Melanoma Detection Melanomas have the following characteristics  (ABCDE’S rule)   – A: Asymmetry; the two sides of the pi...
Using the ABCD’s of MelanomaAsymmetry: sides don’t match      Border: unevenColor: many shades        Diameter: Larger tha...
Melanoma Detection (Cont.)So, Pay Attention to:  – Any new growth or non-healing sores    on the skin  – Any change to yo...
The Rate of Skin Cancer isSignificantly Increasing. Why?Poor HealthGreater UV exposure  –   Changes in ozone layer  –   ...
The Skinny on Skin Cancer andthe Sun UV light causes skin cancer through the  combined effect of immune system suppressio...
About the Sun The sun produces 3 types of light: Ultraviolet  (UV), Visible and Infrared The shorter the wavelength, the...
About the Sun (Cont.)There are 3 types of UV lightUVA:  – UVA rays make up most of the sun’s natural    light. They can ...
About the Sun…UV Rays (Cont.)UVB: – Ultraviolet B rays (UVB) are the most visually   damaging to our skin – They are the ...
About the Sun…UV Rays (Cont.)UV rays can get through clouds, fog and haze. Water, sand, concrete and especially snow can r...
The Sun: The Bright SideSummer Enjoyment: flowers, trees, beachesOutdoor Sport and RecreationFood Production: fruits an...
The Sun: The Dark SideDNA Damage  – Skin CancerEye DamageWeakening of the Immune SystemPremature Aging of the Skin
Skin Cancer Risk Factors Sensitivity and Exposure to UV radiation (sun)   – Chronic better than intermittent Lots of mol...
Skin Cancer Risk Factors(Cont.) Previous history of melanoma Age   – People over the age of 50 have a greater chance of ...
Things You Cannot ChangeFair skin that tans poorly or burnsBlonde, red or light brown hairLight coloured eyes - blue, g...
Things You CAN Change Make Health and Wellness a Priority Nutrition   – Eat eco-friendly, fresh, local, colorful live fo...
Be Proactive Not Radioactive
Sunscreen SPF stands for Sun Protection Factor SPF refers to the ability of the product to protect  the skin from UVB ra...
The More SPF the Better…Right?No. Not necessarily. An SPF of 15 is NOT twice as effective as an SPF of 30.Actually, ther...
Is Bigger Necessarily Better?SPF vs. UVB Protection
SPF vs. UVB Protection (Cont.)
Choosing a SunscreenRead the labelCheck the ingredients for any allergiesEnsure the sunscreen has an SPF of 15 or highe...
Choosing a Sunscreen (Cont.) Check to see if sunscreen is water proof if you  will be using sunscreen in or near the wate...
Choosing a Sunscreen (Cont.)Spread liberally on all exposed skin (do not forget the ears, nose, neck and any bald spots)...
Things to Remember AboutSunscreenNo sunscreen offers complete protection from the sunSunscreen is not just for sunny sum...
So, If I Use Sunscreen, I WillNot Get Skin Cancer…Right?No Evidence: In fact, there is no evidence that sunscreens protec...
It Remains Debatable Most chemical sunscreens contain from 2 to 5%  of benzophenone or its derivatives as their active  i...
So What Do We Do? Limit time in the sun between 11am-4pm and  when the UV index is 3 or higher Make use of the shade Cl...
Is That All?No. Most importantly, take care of yourself and your family  – Healthy Diet**  – Make Wellness a Priority
Skin Cancer Prevention:Nutrition and WellnessLow fat diet <20% of calories from fatAntioxidant vitamins and certain  min...
Antioxidants…Prevention:Nutrition and Wellness (Cont.) Vitamin C (citrus fruits, bell peppers, broccoli,  leafy greens, c...
Antioxidants…Prevention:Nutrition and Wellness (Cont.) Selenium (garlic, brown rice, whole grains, eggs,  seafood and Bra...
Antioxidants…Prevention:Nutrition and Wellness (Cont.)Omega-3 FAs/Alpha-Lipoic Acid, DMAE (oils of nuts, seeds {flax!}, a...
Antioxidants…Prevention:Nutrition and Wellness (Cont.)Other Recommendations: Cabbage, sprouts (especially broccoli), tea ...
So, What is the Controversy withSunscreen and Vitamin D? Vitamin D is a fat soluble vitamin that is found in  food and ca...
More about Vitamin D Active vitamin D functions as a hormone by  sending a message to the intestines to increase  the abs...
More about Vitamin DExperts are now concerned that many people are not getting enough vitamin DA few minutes a day of un...
Sources of Vitamin D Sun Fish (Salmon, Cod, Mackerel, Tuna, Sardines):  eco-minded Dairy: eco-minded Whole-Grain Cerea...
Hot Off The Press… Latest News onSkin Cancer Lip Balms and Glosses May Boost Skin Cancer  Risks  – Lips are more suscepti...
Hot Off The Press… Latest News onSkin Cancer Caffeine protects mice from UV-induced skin cancer  (Reuters Health)   – act...
Summary: What to DoMake Health and Wellness a PriorityNutritionBe Mindful of your mind: make room for good things by el...
LinksSunWise Web site www.epa.gov/sunwiseUV index listings https://enviroflash.epa.govwww.MelanomaKnowMore.comwww.ocea...
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  • Skin wellness

    1. 1. The Skinny on Skin A Wellness Perspective to Skin Health and Education Brandon Fletcher The Christ Hospital Research
    2. 2. Our Skin Protects our body from heat, injury, infection, water loss and sunlight Regulates body temp Storage (H2O, fat, Vit D) Consists of three layers  Epidermis (outermost layer)  Dermis (beneath the epidermis)  Hypodermis (deepest layer)
    3. 3. Skin Anatomy EPIDERMIS DERMISHYPO-DERMIS
    4. 4. Skin Anatomy: Epidermis The Epidermis is the thin outer layer of the skin. The epidermis itself is made up of three sub-layers: – stratum corneum (horny layer) This layer contains continually shedding, dead keratinocytes (the primary cell type of the epidermis). Keratin is a protein formed from the dead cells which protects the skin – keratinocytes (squamous cells) This layer contains living keratinocytes (squamous cells) – basal layer The basal layer is the lower layer of the epidermis containing basal cells. Basal cells continually form new keratinocytes and replace the old ones that are shed from the skins surface – The epidermis also contains melanocytes, which are cells that produce melanin (skin pigment).
    5. 5. Skin Anatomy (Cont.) The Dermis contains connective tissue, nerves, vessels, glands, and hair follicles held together by a protein called collagen The Hypodermis (Subcutis) Contains a network of collagen and fat cells which help conserve the bodys heat and protects other organs from injury by acting as a "shock absorber
    6. 6. About Skin Cancer Skin cancer is the most common cancer and is increasing at by 4% a year, which is faster than any other type of cancer There Are Two Types of Skin Cancer: – Non-Melanoma (97% of all skin cancers): the most common are: • Basal cell cancer: (shiny or pearly surface) • Squamous cell cancer: (reddish and scaly) – Malignant Melanoma (3% of all skin cancers)
    7. 7. Basal Cell CarcinomaLeast malignant and most common skin cancerStratum basale cells proliferate and invade the dermis and hypodermisSlow growing and do not often metastasizeCan be cured by surgical excision in 99% of the cases
    8. 8. Squamous Cell CarcinomaArises from keratinocytesArise most often on scalp, ears, and lower lipGrows rapidly and metastasizes if not removedPrognosis is good if treated by radiation therapy or removed surgically
    9. 9. About MelanomaCurrently, the lifetime risk of developing invasive melanoma (US) is 1 in 62Melanoma is the most common cancer in young adults (25-29 yrs) and the 2nd most common cancer in adolescents and young adults (15-29 yrs)
    10. 10. About Melanoma Over 75% of skin cancer deaths are from melanoma One American dies from melanoma every hour The causes of melanoma are complex and involve interactions between genetic and environmental factors If detected in the early stages before it reaches the lymph nodes, melanoma has a 99% five-year survival rate
    11. 11. Melanoma Melanoma skin cancer starts in the melanocyte cells of the skin Cancer of melanocytes is the most dangerous type of skin cancer because it is: – Highly metastatic – Resistant to chemotherapy There are 4 main types, depending on their location, shape and whether they grow outward or downward into the dermis
    12. 12. The Four Types of Melanoma Superficial, spreading or flat: grows outwards in an irregular pattern with an uneven colour Nodular: lumpy and often blue-black in colour may grow faster and spread downwards Acral melanomas: occur on the palms of the hand, soles of the feet or nailbeds Lentigo maligna: usually on the faces of elderly
    13. 13. Sites of Melanoma Occurrence
    14. 14. Important to KnowMelanoma is not limited to the skin you can seeMelanoma can also start in the mucous membranes of the mouth, anus and vagina, in the eye or other places in the body where melanocytes are found
    15. 15. About MolesMalignant melanoma almost always starts as a mole, so get to know your skin – A normal mole is round or oval, usually flesh- coloured, pink, tan or brown and is flat or dome-shaped – The signs and symptoms of malignant melanoma are changes in the characteristics of a mole
    16. 16. Know what to Look For How Do You Know Which One is Malignant?
    17. 17. Melanoma Detection Melanomas have the following characteristics (ABCDE’S rule) – A: Asymmetry; the two sides of the pigmented area do not match – B: Border is irregular and exhibits indentations – C: Color (pigmented area) is black, brown, tan, and sometimes red or blue – D: Diameter is larger than 6 mm (size of a pencil eraser) – E: Elevation/Enlargement – S: Surface (raised,scaly,eroded)/Sensation (tender)
    18. 18. Using the ABCD’s of MelanomaAsymmetry: sides don’t match Border: unevenColor: many shades Diameter: Larger than a pencil eraser
    19. 19. Melanoma Detection (Cont.)So, Pay Attention to: – Any new growth or non-healing sores on the skin – Any change to your skin such as in shape, color, size or surface of a mole or birthmark – Use the ABCDE’S of melanoma – See a dermatologist to be sure
    20. 20. The Rate of Skin Cancer isSignificantly Increasing. Why?Poor HealthGreater UV exposure – Changes in ozone layer – Involvement in outdoor activities – Wearing skimpy clothing – Pursuit of a tan • Tanning bed use
    21. 21. The Skinny on Skin Cancer andthe Sun UV light causes skin cancer through the combined effect of immune system suppression and DNA damage 90% of non-melanoma skin cancer is thought to be related to UV radiation exposure (sun!) 65% of malignant melanoma skin cancer is thought to be related to UV radiation exposure
    22. 22. About the Sun The sun produces 3 types of light: Ultraviolet (UV), Visible and Infrared The shorter the wavelength, the higher the energy, and the more damaging to DNA
    23. 23. About the Sun (Cont.)There are 3 types of UV lightUVA: – UVA rays make up most of the sun’s natural light. They can penetrate deep into the skin causing wrinkles and aging, and are strongly absorbed by the melanocytes – UVA rays also have a depressing effect on the immune system
    24. 24. About the Sun…UV Rays (Cont.)UVB: – Ultraviolet B rays (UVB) are the most visually damaging to our skin – They are the main cause of sunburns as they are nearly 1000 times stronger than UVA raysUVC: – (short-wave radiation) rarely reach the earth’s surface because the atmosphere filters them out
    25. 25. About the Sun…UV Rays (Cont.)UV rays can get through clouds, fog and haze. Water, sand, concrete and especially snow can reflect, and even increase, the suns burning raysUVA Rays penetrate glass and most sunscreensUVB Rays are blocked by glass and most sunscreens
    26. 26. The Sun: The Bright SideSummer Enjoyment: flowers, trees, beachesOutdoor Sport and RecreationFood Production: fruits and vegetablesVitamin D synthesis – Most of the bodys vitamin D supply, about 75% of it, is generated by the skins exposure to UVB rays
    27. 27. The Sun: The Dark SideDNA Damage – Skin CancerEye DamageWeakening of the Immune SystemPremature Aging of the Skin
    28. 28. Skin Cancer Risk Factors Sensitivity and Exposure to UV radiation (sun) – Chronic better than intermittent Lots of moles Family history of melanoma Blond or red hair Fair or freckled complexion Severe and/or chronic childhood sunburn – Before age of 20/ 5 burns=2x risk
    29. 29. Skin Cancer Risk Factors(Cont.) Previous history of melanoma Age – People over the age of 50 have a greater chance of getting skin cancer (why?) Many people develop skin cancer without any of these risk factors
    30. 30. Things You Cannot ChangeFair skin that tans poorly or burnsBlonde, red or light brown hairLight coloured eyes - blue, grey, or greenFreckle easilyLarge number of molesFamily history of skin cancer
    31. 31. Things You CAN Change Make Health and Wellness a Priority Nutrition – Eat eco-friendly, fresh, local, colorful live foods – Supplement the rest Be Mindful of your mind: make room for good things by eliminating that which is not Sun exposure: minimize
    32. 32. Be Proactive Not Radioactive
    33. 33. Sunscreen SPF stands for Sun Protection Factor SPF refers to the ability of the product to protect the skin from UVB rays only Some sunscreens offer protection from some UVA rays as well. These “Broad-Spectrum” sunscreens are highly recommended Two types: – Chemical (absorb the rays) – Physical (reflect the rays, generally metallic)
    34. 34. The More SPF the Better…Right?No. Not necessarily. An SPF of 15 is NOT twice as effective as an SPF of 30.Actually, there is very little difference between an SPF of 15 (93% protection) and one with an SPF of 30 (97% protection)
    35. 35. Is Bigger Necessarily Better?SPF vs. UVB Protection
    36. 36. SPF vs. UVB Protection (Cont.)
    37. 37. Choosing a SunscreenRead the labelCheck the ingredients for any allergiesEnsure the sunscreen has an SPF of 15 or higherEnsure the sunscreen protects against both UVA and UVB rays – “Broad Spectrum”Check the expiration date
    38. 38. Choosing a Sunscreen (Cont.) Check to see if sunscreen is water proof if you will be using sunscreen in or near the water Follow manufacturer’s instructions and patch test first for irritation Apply sunscreen before insect repellant (as the repellant may reduce the effectiveness of sunscreen) Apply 20 – 30 min. before exposure
    39. 39. Choosing a Sunscreen (Cont.)Spread liberally on all exposed skin (do not forget the ears, nose, neck and any bald spots)Reapply often and regularly, especially after swimming, towel drying and heavy perspirationDo not forget your SPF > 15 lip balm**
    40. 40. Things to Remember AboutSunscreenNo sunscreen offers complete protection from the sunSunscreen is not just for sunny summer days but also for cloudy days and in winterSunscreen is only one part of a comprehensive approach to skin health and cancer wellness
    41. 41. So, If I Use Sunscreen, I WillNot Get Skin Cancer…Right?No Evidence: In fact, there is no evidence that sunscreens protect you from malignant melanoma, the deadliest form of skin cancer, even though sunburns have been linked with the development of melanomaChemicals used are being linked to skin cancer
    42. 42. It Remains Debatable Most chemical sunscreens contain from 2 to 5% of benzophenone or its derivatives as their active ingredient. Benzophenone is one of the most powerful free radical generators known to man. It is used in industrial processes to promote cross-linking and is activated by……….. yes, ultraviolet light. My recommendation: physical sunscreen and benzophenone free chemical sunscreens
    43. 43. So What Do We Do? Limit time in the sun between 11am-4pm and when the UV index is 3 or higher Make use of the shade Clothing (SPF type, loose fitting, tightly weaved) Hat (the wider the brim the better) Sunglasses (UVA+UVB protection) Wrap around style provides increased protection
    44. 44. Is That All?No. Most importantly, take care of yourself and your family – Healthy Diet** – Make Wellness a Priority
    45. 45. Skin Cancer Prevention:Nutrition and WellnessLow fat diet <20% of calories from fatAntioxidant vitamins and certain minerals (in food or supplements) – neutralize damaging free-radical molecules produced as a byproduct of normal metabolism and by ultraviolet light – important in protecting against skin cancers
    46. 46. Antioxidants…Prevention:Nutrition and Wellness (Cont.) Vitamin C (citrus fruits, bell peppers, broccoli, leafy greens, cauliflower) internal/external- ~>1000mg-3g/d Vitamin A/Beta-carotene (carrots, sweet potatoes, broccoli) internal/external-~30mg/d – Caution to smokers Vitamin E (vegetable oils, nuts, seeds, olives, spinach, and asparagus) is shown to reduce the development of UV light-induced tumors in animals- internal/external-~400-800IU/d
    47. 47. Antioxidants…Prevention:Nutrition and Wellness (Cont.) Selenium (garlic, brown rice, whole grains, eggs, seafood and Brazil nuts) internal/external-200microg/d In studies in JAMA in 1996, researchers showed that skin cancer patients who ingested 200 micrograms of selenium per day had: – 37% fewer malignancies – 50% reduced risk of death from skin cancer – 17% decrease in overall mortality
    48. 48. Antioxidants…Prevention:Nutrition and Wellness (Cont.)Omega-3 FAs/Alpha-Lipoic Acid, DMAE (oils of nuts, seeds {flax!}, and cold water, deep sea fish) is powerful antioxidant, 100xs more potent that either vitamin C or E – deactivates the power of free radicals caused by harmful exposures – stabilizes the membrane around the outside of each cell so that assaults from sun damage are greatly reduced-I/E
    49. 49. Antioxidants…Prevention:Nutrition and Wellness (Cont.)Other Recommendations: Cabbage, sprouts (especially broccoli), tea (black, green, white), naturally pigmented fruits and vegetables and turmeric to name just a few
    50. 50. So, What is the Controversy withSunscreen and Vitamin D? Vitamin D is a fat soluble vitamin that is found in food and can also be made in your body after exposure to ultraviolet (UV) rays from the sun Sunshine is a significant source of vitamin D because UVB rays from sunlight trigger vitamin D synthesis in the skin comprising about 75% of the body’s supply A low blood level of vitamin D is known to increase the risk for the development of breast and colon cancer and may also accelerate the growth of melanoma
    51. 51. More about Vitamin D Active vitamin D functions as a hormone by sending a message to the intestines to increase the absorption of calcium and phosphorus Vitamin D is needed for healthy bones and muscles, especially in children and the elderly There is growing evidence that vitamin D may reduce the risk of osteoporosis and some types of cancer, particularly colorectal, breast and prostate
    52. 52. More about Vitamin DExperts are now concerned that many people are not getting enough vitamin DA few minutes a day of unprotected sun exposure is usually all that is needed for some people to get enough vitamin D.You don’t need a tan to get benefits from the sun
    53. 53. Sources of Vitamin D Sun Fish (Salmon, Cod, Mackerel, Tuna, Sardines): eco-minded Dairy: eco-minded Whole-Grain Cereals Vitamin D supplements – Due to a poor average American diet, a Vitamin D supplement may be needed (talk to your doctor or nutritionist) 200-1000IU/d
    54. 54. Hot Off The Press… Latest News onSkin Cancer Lip Balms and Glosses May Boost Skin Cancer Risks – Lips are more susceptible than skin to aging from chronic sun damage and also more prone to developing serious cancers – Shiny lip balms and glosses may attract ultraviolet rays and increase the risk of skin cancer by increasing light penetration through the lip surface (Baylor University Medical Center) – A 30 SPF Broad Spectrum (metallic) lip balm is recommended
    55. 55. Hot Off The Press… Latest News onSkin Cancer Caffeine protects mice from UV-induced skin cancer (Reuters Health) – acts as sunscreen to UVB when given before exposure or corrects the DNA damage after exposure when applied directly Resveratrol (found in red wine and dark grapes) protects the skin cells from UVB related damages that may lead to the development of cancer (Ahmad, University of Wisconsin) (Immunogenic as well) Perillyl alcohol (found naturally in tart cherries, mint and citrus fruits) as well as broccoli sprouts inhibit the growth of both UVB-induced non-melanoma and melanoma (ACC, Tuscon)
    56. 56. Summary: What to DoMake Health and Wellness a PriorityNutritionBe Mindful of your mind: make room for good things by eliminating chaotic thoughts that lead to stress and anxietySun exposure: be wise and minimize
    57. 57. LinksSunWise Web site www.epa.gov/sunwiseUV index listings https://enviroflash.epa.govwww.MelanomaKnowMore.comwww.oceansalive.orgwww.care2.com

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