Skin Care Myths

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Who doesn’t want to know the secrets behind beautiful looking skin? Dr. Beyer, Dermatologist for Springfield Clinic, reveals the truth about healthy skin care. So often, many people neglect to take care of their skin properly. Please join Dr. Beyer, dermatologist for Springfield Clinic as she discusses skin care myths and what you should and shouldn’t be putting on your skin.

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  • increased by nearly 77 percent between 1992 and 2006.  
  • Often look like open sores, red patches, pink growths, shiny bumps, or scars
  • Other risk factors: immunosuppressions, chronic wounds, burns, arsenic exposure
  • Main risk factors: Intermittent, intense sun exposure, fair skin, family history , history of sunburns
    Melanoma risk DOUBLES if a person has more than five sunburns
  • Melanoma: and each additional session during the same year boosts the risk almost another two percent
    10 sessions: almost 50% risk
  • Meta-Analysis, 88 studies over past 20 years, 500,000 participants
  • However, to even get a tan you need to damage your skin: a tan is the body's response to damaged DNA in the skin cells — the skin darkens in order to prevent more damage, but the person's risk of skin cancer is already increased. So there is no such thing as a "safe" or "healthy" tan.
  • UVA accounts for 95% of UV rays that reach earth’s surface
  • If you use a sunscreen with a higher SPF, you do not need to reapply
  • SPF: f it takes 20 minutes for your unprotected skin to start turning red, using an SPF 15 sunscreen theoretically prevents reddening 15 times longer – about five hours.
  • SPF refers to how WELL the sunscren protects you form the sun, not how LONG
    I suggest products with SPFs no lower than 30 and no higher than 50. In addition to an SPF of 30+, your sunscreen should include some combination of the following UVA-blocking ingredients: zinc oxide, titanium dioxide, avobenzone, ecamsule, and oxybenzone.  Sunscreens with both UVA and UVB protection may be labeled multi spectrum, broad spectrum, or UVA/UVB protection.
  • Not just sunscreen: clothing, hats, sunglasses!!
  • Furthermore, the body can produce only a certain amount of vitamin D from UVR; after reaching that limit, additional UV exposure actually results in the breakdown of the vitamin!
  • vitamin D should not be obtained from unprotected exposure to ultraviolet (UV) radiation from the sun or indoor tanning devices, as UV radiation is a known risk factor for the development of skin cancer
  • If too high: diminished bone health
  • hormonal problems not true with oxybenzone (enodometriosis)
  • Would have to wear 15 times what the normal person wears to get the actual SPF value
  • Among African Americans and others of African descent, Asians, Hawaiians, and Native Americans
    Squamous cell carcinoma (SCC) is the most common skin malignancy among African Americans and Asian Indians, and the second most common skin cancer among Hispanics and Chinese/Japanese Asians
    UV light is not the primary risk factor for the development of squamous cell carcinoma in brown-skinned persons within the African Diaspora, and the head and neck are not the most common sites for squamous cell carcinoma. Among African Americans and native Africans, squamous cell carcinomas occur mainly on the legs, followed by the anogenital region (including both the anus and genitals) (Figure 2).6,8,21-23 Skin conditions that result in scarring or chronic inflammation, such as discoid lupus; leprosy; burn scars and non-healing skin ulcerations are the main risk factors, along with radiation therapy and physical or thermal trauma.6,8,21-23 Unlike the squamous cell carcinomas that most Caucasians develop, those occurring in people of African descent due to scarring or chronic inflammation can be aggressive, and have a higher tendency to lead to metastasis and death
  • 69 yo man; driven a delivery truck for 28 years
    Left side of face
    UVA rays
  • There is no clear evidence that DHA is harmful to humans if applied topically and used as directed. Concern about DHA arose recently when a study correlated use of highly concentrated amounts of DHA with production of free radicals, molecules that form naturally in the body due to oxygen use and can damage cells. However, concentrations used in sunless tanning preparations are considered non-toxic and noncarcinogenic — I personally use these products and recommend them to my patients as a safe alternative to traditional tanning.
  • Overproduction of oil (sebum)
    Irregular shedding of dead skin cells resulting in irritation of the hair follicles of your skin
    Buildup of bacteria
    Acne occurs when the hair follicles become plugged with oil and dead skin cells
  • Lancome is owned by Loreal
  • Vit A: by stimulating production of collage and hyaluronic acid
  • To treat: retinoids, vit C, vit E, peptides. Laser most effectve
  • Myth: Skin allergies only happen to NEW products
  • Allergies can develop over time
  • Skin Care Myths

    1. Skin Care Myths: Separating Fact from Fiction Vivianne C. Beyer, MD Dermatology
    2. www.SpringfieldClinic.com/DoctorIsIn
    3. Disclosures • I have no conflicts of interest to declare
    4. Objectives • Discuss common myths, misconceptions, old wives’ tales • Discuss the evidence that separates fact from fiction • The following topics will be discussed: – Skin cancer and prevention – Tanning – Vitamin D controversies – Skin care and beauty tips – Acne myths
    5. Your Skin: A Vital Organ • The largest organ • Regulates body temperature • Stores water and fat • Is a sensory organ • Prevents water loss and entry of bacteria • It is essential to take care of this vital organ!
    6. Myth # 1 • Skin cancer only happens in older people
    7. Fact: – Melanoma is the most common form of cancer in young adults 25-29 years old • Second most common form of cancer for 15-29 year-olds – The incidence of nonmelanoma skin cancers, especially basal cell carcinoma, is rapidly rising in young adults
    8. Skin Cancer • Skin cancer is the most common form of cancer in the US • More than 3.5 million skin cancers are diagnosed annually – There are more new cases of skin cancer each year than there are cancers of the breast, prostate, lung and colon combined • One in five Americans will develop skin cancer in the course of a lifetime Source: skincancer.org
    9. Basal Cell Carcinoma • Basal cell carcinoma is the most common form of skin cancer – Main risk factor is cumulative and intense bursts of sun exposure – About 2.8 million cases are diagnosed per year in the US – Rarely metastasize but can be locally disfiguring/destructive Photo: skincancer.org
    10. Squamous Cell Carcinoma • The second most common form of skin cancer – Main risk factor: cumulative UV exposure over the course of a lifetime – An estimated 700,000 cases of SCC are diagnosed each year in the US – Look like open sores, wart-like nodules, scaly red patches – Have higher rate of metastasis than BCC (5%)
    11. Melanoma • One person dies of melanoma every 57 minutes – About 76,000 cases of invasive melanoma are diagnosed every year in the United States • More than 9,000 people died of melanoma in 2013 • Melanoma accounts for less than five percent of skin cancer cases, but the vast majority of skin cancer deaths (75 percent) • 1 in 50 men and women will be diagnosed with melanoma of the skin during their lifetime Source: skincancer.org
    12. Myth # 2 • Indoor tanning does not increase your chance of developing skin cancer
    13. Tanning • Ultraviolet radiation (UVR) is a proven human carcinogen • One indoor UV tanning session increases risk of developing : – squamous cell carcinoma by 67% – basal cell carcinoma by 29% – melanoma by 20%   • 76% of melanoma cases among 18-to-29-year-olds are due to tanning bed use • People who first use a tanning bed before age 35 increase their risk for melanoma by 75 percent Source: skincancer.org
    14. • “Whoa: Tanning beds cause more cancer than cigarettes!” -Headline from msn.healthyliving.com
    15. • Results from a study published in JAMA Dermatology in January 2014: – Roughly 450,000 cases of skin cancer each year are due to indoor tanning – 360,000 cases of lung cancer are secondary to smoking – In the US, 35% of adults and 55% of college students have tanned – On an average day, more than one million Americans use tanning salons Wehner MR, Chren M, Nameth D, et al. International Prevalence of Indoor Tanning: A Systematic Review and Meta-analysis. JAMA Dermatology. 2014 Jan 19
    16. Myth # 3 • It is a good idea to get a “base tan” before a sunny vacation
    17. There is no “healthy” tan • Any tan is a sign of sun damage • Base tan only offer SPF 3-4 – Will not protect against burning Photo: skincancer.org
    18. UV radiation facts • UVA light penetrates deeper and causes photoaging (wrinkling, solar lentigines, large pores, blood vessels) – Also contributes to development of skin cancer – Intensity is constant throughout the day • UVB light causes sunburn – Strongest from 10AM to 2PM • Tanning is induced by UVA (mostly) and UVB light Source & photo: skincancer.org
    19. Source: skincancer.org
    20. Myth # 4 • You don’t need sunscreen on a cloudy day
    21. Don’t learn this the hard way! • Clear skies: 100% of UV light reaches Earth’s surface • Scattered clouds: 89% • Broken clouds: 73% • Overcast: 31% • UVA light is not affected much by cloud cover – In addition, 50% of exposure to UVA occurs in the shade Jansen R., Wang S., Burnett M. et al. Photoprotection: Part I. Photoprotection by naturally occurring, physical, and systemic agents. J Amer Acad Derm.69(6):853.e1-853.e12.2013 Dec.
    22. Myth # 5 • Sunscreen only needs to be reapplied after sweating or swimming
    23. Reapply! • Every 2 hours • After sweating, swimming, toweling off • Regardless of how high the SPF is
    24. How sunscreen works • Chemical sunscreens absorb UV rays before they affect the skin • Physical sunscreens reflect UV light away from skin – zinc oxide and titanium dioxide
    25. Sunscreen Facts • SPF value refers only to protection gainst UVB (and small amount UVA) • To achieve the full advertised SPF, must use 2 mg/cm2 (shot glass for entire body) – 1 teaspoon for face/head/neck – 1 teaspoon to each arm – 2 teaspoons total to trunk – 2 teaspoons to each leg • Most people only use 25-50% of required amount Source: skincancer.org
    26. Myth # 6 • Using a higher SPF sunscreen means I can stay out in the sun longer
    27. Chart of Sunscreen Efficacy •An SPF 15 sunscreen blocks 93% of UVB radiation • SPF 30 sunscreen blocks nearly 97% • SPF 50 blocks 98% – No suncreen blocks 100% of UV rays http://mycpss.com/sunscreen/spf-rating-system
    28. Sunscreen Buying Tips • Look for broad spectrum (UVA/UVB protection) – For UVA protection, look for one of the following ingredients: avobenzone, titanium dioxide, ecamsule, oxybenzone, and zinc oxide • SPF 30 • Water resistant • Do not use if past expiration date • Store in cool space Source: AAD.org
    29. aad.org
    30. Myth # 7 • Sunscreen causes Vitamin D deficiency
    31. Facts about Vitamin D • Vitamin D is important for skeletal health – Current evidence does not support its role in the prevention of breast cancer, colorectal cancer, heart disease and stroke • Institute of Medicine, 2010 • There are 3 sources of Vitamin D: – Diet • Foods: fatty fish (salmon), cod liver oil, and fortified milk, cereal, and orange juice) – Supplements – UVB radiation Source: skincancer.org
    32. Vitamin D Controversy • Scientific evidence has NOT shown that sunscreen use prevents adequate vitamin D production • Indoor tanning beds are primarily UVA, which does not increase Vitamin D production • Vitamin D production reaches its maximum after 5 minutes in summer midday sun Source: aad.org, skincancer.org
    33. Vitamin D • Studies have shown that people with sun-seeking behavior (Australian surfers) still have suboptimal Vitamin D levels (under 50nmol/l) • There is a significant genetic influence on Vit. D levels
    34. Vitamin D Guidelines • 400 International Units (IU) for infants under 12 months old • 600 IU for children and adults younger than 70 • 800 IU for those 70 and older
    35. Myth # 8 • Sunscreens cause cancer
    36. Do Sunscreens Cause Cancer? • Oxybenzone, retinyl palmitate, and nanoparticles have come under scrutiny – No studies have shown a cause and effect relationship Source: skincancer.org
    37. Myth # 9 • A product that combines sunscreen and insect repellant makes sense
    38. Buy 2 Separate Products • Combination products are problematic for a few reasons: – 1) The sunscreen ingredient is less effective (for example, when combined with DEET) – 2) The insect repellant is more toxic and more readily absorbed – 3) Application instructions differ for the 2 products Source: skincancer.org
    39. Myth # 10 • My makeup has sunscreen in it, so I do not need additional sunscreen
    40. Makeup and Sun Exposure • Facial foundations without sunscreen provide SPF of 2 to 6 • Better to layer foundation after sunscreen
    41. Myth # 11 • People with dark skin do not develop skin cancer
    42. Photo: Billboard.com
    43. Bob Marley – Acral lentiginous melanoma • Was dismissed as a soccer injury under his toenail • Metastasized to his brain and caused his death at age 36 Source: skincancer.org Photo: Bolognia Dermatology, 2nd edition
    44. Skin Cancer Affects Everyone • Dark-skinned patients who develop skin cancer have a higher mortality – Why? • Delay in diagnosis • Melanomas more likely to appear in mouth, on palms/soles, or under nails • So while skin cancer is much more common among lighter-skinned people, it tends to be more deadly among people of color Source: skincancer.org
    45. Myth # 12 • UV light does not go through windows
    46. Unilateral Dermatoheliosis Jennifer R.S. Gordon, M.D., and Joaquin C. Brieva, M.D. N Engl J Med 2012; 366:e25April 19, 2012
    47. Myth # 13 • Self tanners protect from burning
    48. Not a True Tan! • Most self tanners contain the active ingredient dihydroxyacetone (DHA), a sugar molecule that darkens the skin • Does not increase melanin pigment in skin, so MINIMAL protection from UV light Source: skincancer.org
    49. Myth # 14 • Acne is caused by greasy foods and chocolate
    50. Diet and Acne • Controversial • Recent studies have implicated: – Skim milk – High glycemic index foods Photo: skincancer.org
    51. Myth # 15 • Acne is due to dirty skin, so skin must be scrubbed clean several times daily
    52. Skin Washing Tips • Overzealous washing can make acne worse! – Use a gentle, alcohol-free cleanser – Use your fingertips to apply cleanser; avoid hot water – Do not scrub your skin – Rinse with lukewarm water; pat dry with a soft towel – Apply moisturizer if your skin is dry or itchy (oil-free) • Even oily skin needs moisturizer – Limit washing to twice daily and after sweating Source: aad.org
    53. Myth # 16 • Only teenagers have acne
    54. Acne Contributors • Hormone fluctuations • Stress (increased androgens) • Family history • Hair and skin care products • Certain medications • Certain medical conditions
    55. Myth # 17 • Anti-aging products can erase all signs of aging Photo: aad.org
    56. Skin Care Products • If it sound too good to be true, it probably is! • For a product to truly be anti-aging, it MUST contain UVA and UVB protection
    57. Anti-Aging Tips • Protect your skin from the sun every day • Avoid repetitive facial expressions – Sleep on your back • Eat a healthy, well-balanced diet • Stop smoking, and drink less alcohol • Exercise • Cleanse your skin gently (twice daily and after sweating) • Avoid irritating skin care products • Be patient!! aad.org
    58. Source: skincancer.org
    59. Myth # 18 • When it comes to skin care products, “you get what you pay for”
    60. Not True! • More affordable drugstore products often work just as well, if not better than expensive “luxury” brands – Often paying for package, smell, feel of product- but not active ingredient and efficacy
    61. Budget Skin Care • Sunscreen, sunscreen, sunscreen! • Apply moisturizer to damp skin to lock in moisture • Petroleum jelly is a great moisturizer for rough, cracked skin • Don’t overdo it • Consider a moisturizer WITH sunscreen • Look for key ingredients
    62. Ingredients • Look for products with Vitamins A, C, or E – Antioxidants- prevent formation of free radicals that can lead to skin aging and skin cancers – Vitamins C and E can decrease sun damage and improve skin texture – Vitamin A derivatives (retinoids) • soften fine lines and correct uneven skin tone Source: AAD.org
    63. Other Ingredients • Alpha hydroxy acids – Glycolic acid • For dark spots: hydroquinone, retinol, kojic acid, soy, niacinamide, ellagic acid, lignin peroxidase, arbutin, licorice Source: aad.org
    64. Take Your Vitamins! • Vitamins A, B, C, D, E, and K • Essential fatty acids (alpha-linolenic and linoleic acids) • Folic acid • Zinc and selenium • Biotin for hair and nails Source: aad.org
    65. Myth # 19 • Cocoa butter prevents stretch marks
    66. Sadly, no • Genetics play a huge role • Hormonal changes during puberty and pregnancy contribute
    67. Myth # 20 • Smoking is not a major cause of wrinkles
    68. This photo says it all… Facial changes caused by smoking: a comparison between smoking and nonsmoking identical twins. Okada HC1, Alleyne B, Varghai K, Kinder K, Guyuron B. Plast Reconstr Surg. 2013 Nov;132(5):1085-92.
    69. Myth # 21 • If the label says “all natural” or “botanical” ingredients, it must be good for my skin
    70. Not Always True • Heavily fragranced products can be very irritating • Allergies can develop over time • “Natural” or “botanical” does NOT mean hypoallergenic • “Unscented” is not the same as “Fragrance-Free”
    71. Conclusions • Sunscreen, Sunscreen, Sunscreen! • You do not need to break the bank to take care of your skin • Don’t believe everything you hear • Take care of yourself and your skin will thank you • See you dermatologist for any concerning lesions and annually for skin exams
    72. References • Skincancer.org • AAD.org • Springfieldclinic.com • Bolognia et al. textbook of Dermatology 2nd edition • Journal of the American Academy of Dermatology • JAMA Dermatology • msn.healthyliving.com
    73. Thank you! Questions?

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