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TABLE OF CONTENTS

I.    The Right Sunscreen for Rich Complexions ............................................................ 3
     A.   All-year Round Sun Safety Tips ........................................................................ 3
     B.   Understanding SPF ............................................................................................ 4
     C.   Using the Right Sunscreen Effectively .............................................................. 4
II. Mystifying Cases of Melanoma and Skin Cancer .................................................... 6
   A. Rich Complexions Sun Problem 1: Photo Aging and Photo Damage ....................... 7
   B. Rich Complexions Sun Problem 2: Melanin and How It Affects Scars .................... 8
   C. Rich Complexions Sun Problem 3: A Great Lifestyle Inevitably Revolves Around
   the Sun ........................................................................................................................ 8
III. EXTRASHADE: Superior Broad Spectrum Sunscreen with Unique Technology . 11
   The Promise of Sun Protection for Rich Complexions ................................................ 11
   The Sunscreen that Provides More than Just Sun Protection ...................................... 12
   Full Protection Full Nourishment ............................................................................... 14
   Discover the Calming Effect of Pomegranate............................................................. 15
IV. The Harmful Effects of Sustained Exposure to UV Radiation ............................... 16
   A.     Understanding your skin .................................................................................. 16
   B.     Premature Aging of the Skin ........................................................................... 17
   C.     The Prevalence of Melanoma, Its Risk Factors and Ramifications ................... 18
   D.     Non-Melanoma Skin Cancers .......................................................................... 18
   E.     How to Protect Your Skin and Help Reverse Signs of Damage ........................ 20
V. What is Known Today About the Risks of Ultraviolet Radiation? ......................... 22
   A.     UV Rays and How They Harm Humans .......................................................... 22
   B.     Getting Bombarded with UVR Even on a Rainy Day ...................................... 22
   C.     Is ozone thinning still a threat? The Latest Authoritative Word on the Ozone
   Layer.. ....................................................................................................................... 23
   References ................................................................................................................. 24




                                                                                                                                   2
      © 2010
I. The Right Sunscreen for Rich Complexions
  Healthy Sun protection begins with the right knowledge. The first step is to learn the
    most relevant and helpful eye-openers about Sun Care for Rich Complexions.




    A. All-year Round Sun Safety Tips

        Safety Tip # 1: The sun is up 365 days a year, summer and winter, on clear and
cloudy days both. Every minute of exposure adds to your total lifetime dose of UV
radiation. This is what counts toward your potential skin cancer quotient.

        Safety Tip # 2: Safety Tip # 2: If much of your workday is spent outdoors, lay
on the sunscreen every day. You need to shield yourself from UVR even if you are being
chauffeur driven to meetings all day long. Notice how you tan progressively and you get
squint lines from the sun’s glare? Along with visible light, you’re getting UV rays, too.

       Safety Tip # 3: Fun in the sun has its perils. Sunscreen is not just for the rather
infrequent times you hit the pool or go to the shore with friends or family. Even if much
of your day is spent in the classroom, inside the house or at your desk in the office, be
wary of your sports, hobbies and other leisure time activities. You may be wearing a hat
while pottering around in the garden but did you notice that a good deal of your face,
neck, chest, legs and arms are sunlit? The risk is much greater in the playing field.
Remember how often ―just half an hour‖ of basketball, tennis, or flag football turns into
hours and hours of sheer fun? Slather on the sunscreen beforehand and you won’t be
sorry years or decades later.
        Safety Tip # 4: Sure, jogging, trekking and biking help fulfill your cardio
workout quota. Surfing is healthy for forcing you to swim so much. So are skiing and
tobogganing in winter. Make it all even healthier by armoring yourself against UV rays.
Even if you think you’ll be outdoors for just 15 minutes. Remember how all those
reflective surfaces bounce back more UVR at you and effectively double your harmful
dose.
        Safety Tip # 5: The Skin Cancer Foundation couldn’t say it more bluntly, ―There
is no such thing as a healthy tan.‖ No matter how you cheated with a sun bed, went south

                                                                                           3
    © 2010
for spring break or want to show off your Caribbean cruise, a tan is your skin’s silent
     reminder that you had an overdose of UV radiation.
B.           Understanding SPF
             It’s more than about the sunburn protection factor (SPF) since single rated SPFs
     only defends against UV-B, rays that land on the skin’s outer part that cause sunburn
     when in fact UVA penetrates deep down to inflict damage. To round out your protection,
     bear these in mind:
            SPF Knowhow #1: SPF-loaded sunscreens are only part of your defense against
     the cumulative harm that UVR causes. Wearing hats, wraparound sunglasses and bright-
     colored, fairly thick fabrics actually offer more protection against the possibility of
     burning and DNA damage that could lead to melanoma in the future.
             SPF Knowhow #2: Chief medical officer Otis Brawley of the American Cancer
     Society cautions that SPF ratings are just averages. If you burn easily and have otherwise
     sensitive skin, an SPF 30 product may give the equivalent of just SPF 10 protection. For
     a skin Type VI, melano-protected person, on the other hand, the same sunscreen might be
     equal to SPF 50 in sunburn protection.
           SPF Knowhow #3: Both the Skin Cancer Foundation and the Food and Drug
     Administration (FDA) agree that SPF 50 is about the best that science can reliably test
     and measure. Anything higher is probably marketing hype.


C.           Using the Right Sunscreen Effectively

     Sunscreen Rule #1: Use at least SPF 15. The American Academy of Dermatology
     prefers to err on the side of caution, suggesting that both adults and children use a
     sunscreen with an SPF of at least 30.
     Sunscreen Rule #2: Choose a brand or formulation that has broad spectrum protection or
     screens both UV-A and UV-B.
     Sunscreen Rule #3: Make sure to apply enough. Down to bare essentials at the beach or
     pool, the sensible adult knows to apply at least an ounce to cover up from face to toes.
     That’s the equivalent of a shot glass. Using less is the same as going for lower SPF.
     Sunscreen Rule #4: Re-apply when the SPF limit has been reached. If you know you
     start to burn after just ten minutes outdoors when you don’t have sunscreen on, SPF 15
     has a theoretical protection limit of 15 times your ten-minute safety limit. In this case,
     that’s 150 minutes or two and a half hours. Spending all day at the beach, golf course or
     basketball court means you should apply at least four times.
     Sunscreen Rule #5: Re-apply more frequently, as often as necessary, in fact. Going into
     the water washes sunscreen off. So do sweating on the playing court and toweling off for
     any reason at all. Better safe than sorry later in life.



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         © 2010
Sunscreen Rule #6: Apply everywhere. At the beach, it’s easy to overlook your feet and
the back of your legs. Protect your lips, ears, nape, hands, and around the eyes, too. Got
too much testosterone? Put some on that bald spot, too.
Sunscreen Rule #7: Shop for the right sunscreen type. Children and adults with
sensitive skin should use fragrance-free variants. Outdoorsmen and playing field
―gladiators‖ may be pleased to learn about stick, water and sweat resistant or other sports
variants. As a general rule, use the product format that makes it easy for you to stay
protected from UV (Skin Cancer Foundation, 2010).

              Figure 1: The New Sunscreen Label to look for should conform to the
                             latest FDA sunscreen standards




                                                                                         5
    © 2010
II. Mystifying Cases of Melanoma and Skin Cancer
In Rich Complexions




       hose with Rich Complexions don’t believe they need to wear sunscreen. True

T      enough, most rich complexions such as the Asian, Latinos African Americans and
       Pacific Islanders, among others, are less likely to be afflicted with skin cancer. But
they are not cancer-proof. When melanoma and other forms of skin cancer do show up,
they can be deadlier than for Caucasians.

        Case #1: In 2008, a 69-year-old Hispanic lady was seen at the Department of
Dermatology, Mount Sinai Hospital in New York for treatment
of the left fourth toe. After the loss of the nail three months
previously, the nail bed refused to heal. The initial biopsy
                                                                Not even the
indicated that what looked like a freckle was a melanoma        Darkest Skin
already 4.8 mm. deep. The patient was in luck because the       Tone is Skin-
skin cancer had not metastasized (spread to other parts of her
body). However, the toe had to be amputated. Subsequently,
                                                                Cancer Proof
the pathologist found that the melanoma had already
penetrated 11 mm. into the bone marrow of the toe
(Kleinerman, Kriegel, Amir, Emanuel, & Markinson, 2010).

        Case #2: A 48-year-old African American male went to
the Dallas VA Medical Center after experiencing months of fatigue, fevers, and weight
loss of 50 pounds. At the same time, he had a massively swollen abdomen. Despite the
absence of any skin marks or lesions (or early signs of tumor), a CT scan and biopsy
confirmed that the palpable lumps in the lower abdomen was metastatic malignant
melanoma (Dowell, Shen, Harford & Lai, 2005).

        Case #3: An even younger 41-year-old African American man also reported to the
Dallas VA Medical Center complaining of fatigue and dark stools experienced beginning
a week earlier. No masses could be felt on external physical examination nor did the
upper endoscopy, colonoscopy, and a small bowel series discovered what the source of
bleeding might be. On the other hand, the more thorough capsule endoscopy, followed
by exploratory surgery, showed sizeable lesions at several places in the small intestine.
On biopsy, these were confirmed as metastatic malignant melanoma. Thorough
examination of skin, nails, eyes, and mucous membranes yielded no primary site where
the melanoma might have originated. Here is one more case where the rich, dark
complexioned person may well have “protected” him from superficial melanoma. By the
time he sensed something wrong with himself, though, the cancer had already spread to
three sites in the small intestine (Dowell, Shen, Harford & Lai, 2005).



                                                                                           6
    © 2010
What is Essential to High Quality Living for Rich Complexions

It has everything to do with shunning the sun. Deadly cases of Melanoma, non-
Melanoma skin cancers, premature-aging, hyperpigmented, highly irritated dull, dry, ashy
skin are a great fraction of hindrances in living life to the fullest and one thing these all
have in common—they can all be traced to mindless sun exposure.


A Ruthless Risk Factor – Rich Complexions have a poorer survival rate
      when battling Melanoma because of the delayed prognosis


The threat of Skin Cancer Alone is already enough to Practice Sun Protection but there
are more problems ahead after inconsiderably facing the sun.

     A. Rich Complexions Sun Problem 1: Photo Aging and Photo Damage
        Photo aging can occur earlier in life. Owing to reckless exposure to UV radiation
from the sun, the areas that are usually exposed – face, neck, hands, arms, the décolleté
area – become less supple and flexible. This is the sign that UV-A has penetrated deep to
damage the collagen fibers in the deepest layers of the epidermis. When the damage is
severe, sagging occurs prematurely.


  Figure 2: Common signs of photoaging       Figure 3: Sun damage occurred on the side of
     include mottled skin with various       the face (A) that was exposed to the UVA light
 pigmented spots and general loss of skin    coming through the window. The other side of
 tone in sun-exposed areas as seen in this   her face (B) was not exposed to window light
      woman in her forties - Canadian        (Source: Moulin G, Thomas L, Vigneau M, et
     Dermatology Association. (CNW           al. A case of unilateral elastosis with cysts and
       Group/Canadian Dermatology            comedones: Favre-Racouchot syndrome. Ann
               Association)                  Dermatol Venereol. 1994;121:721-723.




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    © 2010
B. Rich Complexions Sun Problem 2: Melanin and How It Affects Scars
Melanin is a tough built-in defense but it’s not perfectly invincible against the sun. The
downside even is that a sun-activated melanin triggers an attack of acne flare-ups or other
moderately-inflamed wound. Regardless of how much time you spend outdoors or
basking in a tanning bed, melanin can cause ―Post-Inflammatory Hyperpigmentation‖
(PIH). PIH is our body’s natural reaction to inflammation, leaving behind discoloration
that ranges from pink (for the very light-skinned) to red, purple, brown or black,
depending on your skin tone and depth of the discoloration. PIH is especially common in
Rich Complexions. The discoloration is caused by excessive melanin being produced in
reaction to the inflammation. This side-effect always discolors by darkening, affecting
men and women alike.
    Figure 4: Post-Inflammatory Hyperpigmentation on a brown-

                                                                               
    skinned Pacific Islander American


                                                                        Melanin is a tough
                                                                       built-in defense but
                                                                         it’s not perfectly
                                                                      invincible against the
                                                                                sun.
                                                                               

    C. Rich Complexions Sun Problem 3: A Great Lifestyle Inevitably Revolves
    Around the Sun

    Rich Complexions represent a great variety of ethnic groups in every sizeable city.
    Outdoor life is just as enjoyable and necessary for all young and old alike.


   Figure 4: The Most Striking Variations in Child and Adult Skin Colors. From Left to Right:
               Central/South African, Indian, Mediterranean and North European




                                                                                                8
    © 2010
Baby Boomers Now Face the
                                      Problem of Youth Unwisely Spent
                                      Under the Sun


The ―Baby Boom‖ generations in all ethnicities are now in their 50s, struggling to
cope with the onset of degenerative conditions such as hypertension, cardiovascular
diseases, rheumatoid and other signposts of middle age. Another major problem
every baby boomer has to face is the inevitable aging of their skin.

For Rich Complexions, this is the critical stage in the life cycle when vitamin D
deficiency on one hand and decades of irresponsible exposure to UV radiation on the
other can cause unpleasant surprises. True, their melanin-rich status protects Rich
Complexions from the high incidence that assaults the pale-complexioned. Still, it
does not shield them from that earlier physical aging brought about by earlier days of
reckless sun exposure.

Moreover, this is the time to be wary about skin cancer showing up even in areas of
the body normally covered up and not directly subject to UV radiation. Annual
check-ups should include thorough inspection of the skin from scalp to sole. As we
have seen from the case studies that introduced this e-book, melanoma can show up
on nailbeds where the discoloration may be disguised by unkempt toenails. From
there, skin cancer can invade nearby bones or migrate to vital organs.
                   Figure 5: Life Outdoors for the Baby Boomers




                                                                                    9
© 2010
Baby boomers or not, spending time outdoors to enjoy family activities, sports or
leisure is one of the best ways to pass a
day.
                                                      The main problem:
Most engage in outdoor activities as it fit
their lifestyles. Many are unmindful of the
                                                      Rich complexions love
long hours they spend ―soaking up rays‖               outdoor activities
from overhead or that both UV-B and UV-               blissfully unaware that
A do harm to skin even on cloudy days.                they compound their
They forget how the sea and some surfaces             risk of getting skin
reflect sunlight upwards, compounding the             cancer that is more
potential damage to DNA close to the
surface of their faces, arms and bare legs.
                                                      deadly for their multi-
                                                      cultural heritage.




                    Figure 6: Common Activities Spent in the Sun




Totally avoiding the sun is not the obvious moral lesson here but only the fact that
Rich Complexions need proper sun care just as much as anyone else. There is a need
to strike the balance between a fulfilling lifestyle and healthy sun protection.




                                                                                    10
© 2010
III.   EXTRASHADE: Superior Broad Spectrum Sunscreen with Unique Technology



                                        The CHALLENGE:

                      The facts say it all. We have already witnessed how and
                      why people of multi-cultural heritage are at greater risk
                      for Skin Cancer and Post-Inflammatory
                      Hyperpigmentation (PIH). Those of brown skin
                      ethnicity are also afflicted by sensitive, easily irritated
                      skin, get blemishes more readily, suffer uneven skin
                      tone, and PIH. Most Americans with brown skin are of
                      Latino, multi-racial, South Asian, South Pacific,
                      Filipino and/or Native Indian ancestry. Broadly
                      speaking, therefore, the multi-cultural Rich
                      Complexions around the world have uncommonly
                      sensitive complexions that require specialized sun care
                      solutions.




                    The Promise of Sun Protection for Rich Complexions

       EXTRASHADE is a premium sun care brand with the primary focus on sun safety
       awareness and to protect adults and children from the UV rays of the sun. Sun Protection
       for Rich Complexions provides multi-functional protection for the health and wellness of
       people with tan to olive to dark skin tones. Sun Protection for Rich Complexions are
       formulated with select ingredients to defend daily against damaging UV-A and UV-B
       rays while helping maintain a smooth and even skin tone.

            Protects your skin from harmful UVA and UVB rays that cause premature aging,
          Hyperpigmentation and skin cancer

            Helps eliminate free radicals to noticeably minimize fine lines, wrinkles, freckles
             and brown spots and lessen the look of blotchy, uneven skin tone.

            Ideal for highly reactive and PIH-prone skin with a completely non-irritating
             formula


                                                                                             11
           © 2010
 Used regularly,     EXTRASHADE             even helps prevent dark spots from
        reappearing

     Enhances your looks, nourishing and hydrating skin to keep it smooth, supple,
        and young beyond your years.

         Figure 7: Beyond sun care, Sun Protection for Rich Complexions specializes
               in controlling Hyperpigmentation as seen on the varying cases




         The Sunscreen that Provides More than Just Sun Protection

EXTRASHADE Daily Defense Hydrating Sunscreen SPF 30
Great for everyday use, greater for skin in the long run—this is an ultra-gentle, uniquely
photo stabilize sunscreen for superior broad spectrum protection with continuous
hydration in one formula. This formulation comprehensively shields you from UVA and
UVB rays and helps improve the health of your skin at the same time because it is rich
with antioxidants.
This hydrating sunscreen provides maximum face and body protection for active
lifestyles by resisting water for long lasting defense. Daily Defense Hydrating Sunscreen
SPF 30 protects and enhances your rich complexion three more ways: by reducing


                                                                                         12
    © 2010
irritation and inflammation; combating free-radicals before they do you damage; and
deeply hydrates your skin to leave it soft and radiant without leaving a greasy or chalky
residue.

                            Figure 8: Who Stands to Benefit




EXTRASHADE Protect and Nurture Sunscreen SPF 30

                                            For Young Sensitive Skin—the young and
                                            gentle youth skin needs all the protection and
                                            nourishment it can get. The very same
                                            melano-protection advantage         of    Rich
                                            Complexions adults also works for their
                                            children. This is fortunate because over-
                                            exposure to UVR early in life is an important
                                            risk factor for skin cancer in middle age or
                                            later.
                                            Specially formulated for the unique needs of
                                            sensitive skin, this is an ultra-gentle product
                                            with       superior        broad       spectrum
                                            protection. Carrying the EXTRASHADE
                                            promise, Protect and Nurture Sunscreen has
an SPF 30 that helps protect and defend against UVA and UVB rays while nurturing their
skin without leaving any harsh effects, greasy or chalky residue. Its unique photo stability
provides maximum face and body protection by resisting water for long-lasting defense.




                                                                                         13
    © 2010
Full Protection Full Nourishment

Because Sun Protection for Rich Complexions is created for highly reactive skin, what’s
in it is just as important as what is not in it.

Sun Protection for Rich Complexions is specifically formulated without fragrance,
lanolin, dye, alcohol or propylene glycol, these are irritants known to stimulate the
production of excessive melanin.
Innovatively photo stabilized Octyl methocycinnamate (Octinoxate) and Avobenzone
with unique technology create superior and effective broad spectrum protection and top
performance. Here is the purpose of some of the top ingredients so you can be confident
to wear it to protect and preserve your appearance.

Pomegranate: Soothes and calms inflammation that commonly affects highly reactive
skin
Hyaluronic Acid: Maintains hydrations levels in skin completely and gently
Hedychium Coronarium Root (White Ginger) Extract: Soothes inflammations and softens
the skin
Quillaja Saponaria Bark (Soap Bark) Extract: Heals and hydrates the skin safely
Actinidia Chinensis (Kiwi Fruit) Extract: antioxidant and hydrator that remarkably
reduces the appearance of fine lines, dark spots and wrinkles gently
Tocopheryl Acetate (Vitamin E) and Tertrahexyldecyl Ascorbate (vitamin C): the top sun
care Vitamins to provide a healthy and radiant complexion
Cocos Nucifera (Coconut) Extract: antibacterial and hydrator
Plantago Major Leaf (Plantain) Extract: heals wounds, renews cell and fights free radicals
Passion Flora Incarnata (Passion Flower) Extract: soothes and relaxes the skin

Unlocking the Hydrating and Repairing Power of Hyaluronic Acid

Hyaluronic acid can dramatically improve the overall health and beauty of your skin.
While many have dubbed it as the ―key to the fountain of youth‖ Extra Shade took this
                                 edge to make it a valuable skin anti-aging and
                                 hydrator.
                                    In the forefront, it is a naturally-occurring substance
                                    present in all types of human skin necessary for tissue
                                    repair and skin renewal. It has the unique amazing
                                    property of binding water up to 1,000 times its weight
                                    and as such can gently and completely hydrates even
                                    the most sensitive brown skin.




                                                                                        14
    © 2010
Fully absorbed, it becomes a hypoallergenic hydrator that      Sun Protection
has the ability to pull hydrants from the atmosphere and
trap it on the surface of the skin eliminating dry, dull and       for Rich
ashy skin. As such, Hyaluronic acid is the ultimate natural
hydrator to unlock a smooth skin tone.
                                                                Complexions
                                                                  offers the
     Discover the Calming Effect of Pomegranate
                                                                    unique
                                    Pomegranates       are
                                    among       the    top      Combination
                                    antioxidants in the             of Full
                                    world with shrubs
                                    originating in lands          Spectrum
                                    stretching from the
                                    northwestern region of       Protection
                                    India through Iran to         from UV
                                    North Africa, home to
most people of Rich Complexions.                               radiation, safe
Modern Science regard the fruit as symbol to long life but     emollients and
it is most revered by Aryuvedic medicine for more than a         hours-long
century now by its proven miracle to restore the skin’s
balance and enhance its youthful glow.                           hydration.
This is the perfect nourishment for rich complexions as its
rich flavanoid compounds stimulates collagen production,
soothes and calms inflammation and counter act the harsh
effects of oxidation and the damaging effects of the sun.

All in, Sun Protection for Rich Complexions offers the
unique combination of full-spectrum protection from UV
radiation, safe emollients, and hours-long hydration.




                                                                          15
    © 2010
Still not convinced? Let the Rest of the Facts
                                               Convince you to Wear Sun Protection, No matter
                                               your Complexion.



IV. The Harmful Effects of Sustained Exposure to UV Radiation

     A. Understanding your skin
The skin’s protective covering comprises just four very thin layers. Below the stratum
corneum is the thinner pigment layer which contains the melanocytes. For all the
melanin that characterizes people with skin of color and theoretically protect these ethnic
groups, it has a very thin shield that insufficiently protects against longer-wave UV-A
(Figure 9 overleaf). The melanocytes that produce melanin and therefore impart human
skin tone as well as produce the tanning characteristic of exposure to UVR are embedded
within the epidermis.
Figure 9: UVR and the Skin (Source: Epstein & Wang, 2010)




                                                The first sign of excessive exposure to UVR is a
                                                first-degree burn.
                                                Sunburn does not usually advance to third-
                                                degree burn because the severe redness and
                                                stinging of a second-degree burn alerts the
                                                victim soon enough to seek shade and first-aid
                                                treatment.




                              Figure 10: Sunburn Among Rich Complexions




                                                                                             16
     © 2010
More than the sunburn, UVR is implicated in other health risks as suppressing the
     immune system and cosmetic disfigurations as wrinkles and hyperpigmentation, e.g. age
     spots, freckles and melasma among others.

B.            Premature Aging of the Skin

             Constant and repeated exposure to UV
     radiation from the sun also causes premature aging.
     The least damage you can experience is cosmetic.                  That premature aging is
     Over time, your complexion becomes thicker, more                  inevitable is a
     wrinkled, and leathery than is the norm for people                misconception.
     your age, that’s why it’s called premature aging. In
     fact, solar radiation is reckoned to produce 90                   Premature aging
     percent of the signs of premature aging, more than                happens after an
     dehydration, smoking, and other poor health habits                accumulation of years
     (U.S. EPA).                                                       and decades of reckless
                                                                       exposure to the sun.
             Perversely enough, the other type of
     cosmetic damage UVR does to the skin is to make it
     thinner. Thinner skin shows up as many fine lines
     and bruises very easily. Either way, thinner or thicker, skin looks prematurely old.

     Figure 11: Look closely and you’ll see that even Rich Complexions form freckles from over Sun
                                                           exposure

                                                         UV-A penetrates so deep that it also
                                                         accelerates thinning in surface capillaries
                                                         and major blood vessels. This forms the
                                                         so-called ―spider veins‖ which makes the
                                                         UVR victim look like a drunk.

                                                                 More dangerously, the so-called
                                                         ―liver spots‖ are actually moles. The dark
                                                         ones are cause for worry especially if they
                                                         become irregularly shaped and textured,
                                                         growing slowly through time.              A
                                                         dermatologist must check very thoroughly
                                                         to be sure these are not the beginnings of
                                                         malignant melanoma.




                                                                                                     17
          © 2010
C. The Prevalence of Melanoma, Its Risk Factors and Ramifications
More menacing, however, is the fact that UVR is responsible for nine of ten cases of skin
cancer. Of the three types of skin cancer, basal cell cancer is the most readily curable,
squamous cell cancer is potentially life-threatening because of its propensity for growing
and spreading (―metastasizing,‖ as your GP and oncologist like to say), and malignant
melanoma the most deadly.



D
EPA).
        eadly Fact # 1: Skin cancer is rampant and growing steadily. In America, 1.5
        million newly-diagnosed cases each year outnumber new cases of breast,
        prostate, lung, and colon cancer combined (Spencer & Amonette, 1998; U.S.




D       eadly Fact # 2: Skin cancer is prevalent. At least one-fifth of all Americans will
        develop skin cancer in their lifetimes. For Americans 66 years or older, the
        lifetime incidence is 40% to 50% (U.S. EPA).



D       eadly Fact # 3: Skin cancer is deadly. Hour by hour, one American dies from
        some form or other of skin cancer (U.S. EPA). To these 8,750 deaths, the WHO
        adds another 50,000+ worldwide that die of excessive UVR exposure.



D       eadly Fact # 4: The single most preventable risk factor for skin cancer is
        exposure to UVR without shielding or protection of any kind (U.S. EPA).

        eadly Fact # 5: Staying indoors but resorting to tanning lamps, beds or booths


D       actually makes things worse. An Australian study showed that those who began
        artificial tanning in their youth were 75% more likely to develop malignant
        melanoma years or even decades later (Clinuvel Pharmaceuticals, 2010).



D       eadly Fact # 6: The global death toll due to malignant melanoma is around
        48,000 annually (American Cancer Society, 2009).




D        eadly Fact #7: According to the U.S. Department of Health and Human Services
         and the World Health Organization, excessive UV radiation damages the skin’s
         cellular DNA. The result is genetic mutations that can lead to skin cancer
        therefore UV is a proven human carcinogen.

    D. Non-Melanoma Skin Cancers

           True, non-melanoma skin cancers are less deadly than melanomas. Left
    untreated, however, they spread and create disfiguring growths everywhere.
    Between 40 and 50 percent of Americans who live to age 65 will have the two
    primary types of non-melanoma skin cancers – basal cell and squamous cell
    carcinomas – at least once.



                                                                                        18
    © 2010
Basal cell carcinomas are the most common type of skin cancer tumors. They
usually appear as small, fleshy bumps or nodules on the head and neck, but can occur on
other skin areas. This is one type of skin cancer that can penetrate to the bones and cause
a great deal of damage, including crippling and mutilation.

        Squamous cell carcinomas are tumors that appear in the beginning as nodules or
as red, scaly patches. This cancer can develop into large masses, and can spread to other
parts of the body (US EPA).

        The non-melanoma skin cancers (NMSC) are very prevalent. More than a million
new cases of basal cell carcinoma (BCC) are discovered annually in America. Squamous
cell carcinoma (SCC) turns up in from 250,000 to half a million Americans each year
(Epstein & Wang, 2010).

        At last count, mortality for all cancers among the two largest ethnicities and, in
particular, for those where UVR is implicated were as follows:

Table 1: Cancer as a Cause of Death for Ethnicities in the United States, 2007 (Source: CDC NVSS)
                                           Blacks    Hispanics American Asian/
                                                                Indian/  Pacific
                                                                Alaska  Islander
                                                                Native
All cancers                                64,049        27,660         2,561      12,326
Cancers of the lip, oral cavity,            1,062           364            43         242
pharynx
Skin                                          136           194            22           45

    Melanoma of the Skin           Death Rates* by Race/Ethnicity and Sex, U.S., 2007




                                                                                               19
     © 2010
Figure 12: Skin Cancer Incidents in Rich Complexions




 Sun Damage is Highly Deadly but is also Highly Preventable
E.           How to Protect Your Skin and Help Reverse Signs of Damage

            By in large rich complexions don’t do enough to protect themselves from the sun.
     Tens of millions plainly do not take such elementary precautions as wearing a wide-
     brimmed hat, covering up while in the sun, seeking shade, wearing wrap-around
     sunglasses, avoiding the sun during the hours of 10 a.m. to 4 p.m., and using sunscreen
     with a sun protection factor [SPF] of 15 or higher (Centers for Disease Control and
     Prevention, 2007). In short, do everything you can to shield the sensitive skin on your
     head, neck, and around the eyes because these are the most vulnerable to sun damage.

                      Use a sunscreen rated at least SPF15. You know what they say about
                  caution being the better part of valor. Even if you do not intend to
                  catch some rays and get a tan slather on the sunscreen for a stroll around
                  the campus, jogging around the neighborhood, and cycling or trekking
                  the trails in summer.




                                                                                         20
         © 2010
Opt for thin and light long sleeve shirts, comfortable lightweight
             pants.


Contrary to the common propensity for wearing gauzy and light-colored clothes in
summer (the better to avoid feeling sticky and sweaty), it is actually better to wear bright-
or dark-colored, lustrous clothes because these reflect more UV radiation than do pastels
and bleached cottons. Even loose-fitting styles are fine if one opts for densely-woven
fabrics because these are a better barrier against UV radiation.

                 Wear a hat when outdoors. Not a “cool” baseball cap, worn with the
             bill forward or reversed. A hat, with the widest brim you can find.

It’s good to remember that UV-A pass through the glass with ease. Car drivers should
feel protected only if they have already added UV-protective film to a car’s side and rear
windows. Home, office, and store windows should similarly have tinted film that blocks
up to 99.9 percent of UV radiation and lets in up to 80 percent of visible light (Epstein &
Wang, 2010).


                 Since the eyelids, nostrils, lips and inner ear do not contain pigment
             (the melanin that gives you your tan and protects somewhat against
             serious burns) and won’t tan well anyway, keep them shaded when
             outdoors.




                Finally, be sun aware. At this point when the climate is
    unpredictable, natural disasters are at an all time high and the rays are
      getting stronger more than Rich complexions can handle, it pays to
       know one of the disturbing culprits: the deterioration of the ozone
                                     layer.




                                                                                          21
    © 2010
V. What is Known Today About the Risks of Ultraviolet Radiation?


    A. UV Rays and How They Harm Humans

Among all other types, UVA and UVB are the forms of ultraviolet (UV) radiation that we
should be concerned about.

UVB radiation are shorter than UVA which explains why it can only affect the outer
layer of the skin and cause sunburn or the sun tan while UVA radiation can go deeper to
the innermost levels of the skin. Both rays are known to cause skin cancer, suppress the
immune system and speed up the aging process, among others.

  Figure 13: UVA and UVB a Constant Part of Radiation from the Sun (Source: Epstein & Wang,
                                            2010)




     B. Getting Bombarded with UVR Even on a Rainy Day
        UV rays are not confined to its natural source alone which is the sun; we are
constantly surrounded and bombarded by the artificial sources which are everywhere.
Artificial tanning beds, indoor lighting, copiers, computer screens, welding equipment,
germicidal and mercury arc lamps all give off UV radiation in varying levels.
        If you have sensitive skin and suffer from such conditions as solar urticaria, lupus,
porphyria, sun rash, sun hives, photosensitivity, sun allergy, rheumatoid arthritis,
xeroderma pigmentosum, albinism and other sun-related sensitivities, two hours under
the bright lights at Wal-Mart or any shopping mall can be equivalent to one hour under
direct sunlight (Support Group for Sun Sensitive People, 2006).




                                                                                          22
    © 2010
Low-Intensity                                      High-Intensity
     Fluorescent lighting                                Tanning beds, lamps and booths
     Compact fluorescent bulbs                           Halogen and high intensity discharge lights
     Incandescent bulbs, Computer monitors               Germicidal lamps
     Resin and paint curing lamps                        Arc lamps
     ―Black lights ―Phototherapy lamps found in          Copy machines
     nurseries                                           Electric/Arc welders, Ultraviolet lasers
     Sources: National Electrical Manufacturers Association (NEMA), Support Group for Sun Sensitive People

             As early as 1992, the American Journal of Epidemiology reported that fluorescent
     lights radiate ―10-30 times‖ more UV-B than natural sunlight. Even worse, such lamps
     emit almost the same intensity of both UV-B (380 nm) and UV-A (as much as 400nm)
     unless, of course, the fixtures are shielded. But since these facts are not widely known,
     there is no agitation to install shields at home, work and in malls.

C.          Is ozone thinning still a threat? The Latest Authoritative Word on the
     Ozone Layer

            Getting sunburned on a cloudy day is not the surprising news; it’s the fact that it’s
     the result of the UV rays advancing its penetration easier on the thinning ozone layer
     which is more alarming.

             Figure 14 below shows vividly how the ozone layer over Antarctica deteriorated
     to the bluest part of the spectrum in a span of two decades. This period coincided with
     the explosion in the automobile population worldwide and industrialization in newly-
     developed economies such as Taiwan, Thailand, India, the Philippines and the Middle
     East-North Africa in general.


                                  Figure 14: The Ozone “Hole” in September 2006, nearly two decades
                                  on, the slow progress of ratification and agreed replacement rates for
                                  CFC ensured that the damage to the ozone layer continued apace.

                                           On the other hand, the ozone layer over the Arctic has
                                  begun to deteriorate as well, at least according to a United
                                  Nations report released in 2006. On the best available
                                  evidence at hand –the unstable weather patterns are the culprit
                                  for ozone degradation over the North Pole – it may be 15 years
                                  at least before Arctic ozone depletion stops.

             With the damaged ozone layer here to stay, EXTRASHADE will protect you
     to be your best against the stronger penetration of UVA and UVB rays.



                                                                                                       23
          © 2010
References

American Cancer Society. (2009). Cancer facts and figures.

Bizzozero, J. (2006). Where is the indoor tanning industry heading? Indoor Tanning:

       State of the Industry Report. Retrieved August 24, 2010, from

       www.lookingfit.com/articles/indoor_tanning/6ah3011575723017.html.

Centers for Disease Control and Prevention. (2007). Sunburn prevalence among adults –

       United States, 1999, 2003, and 2004: Editorial note. Morbidity & mortality weekly

       report, 56 (21): 524-528.

Centers for Disease Control and Prevention. (2010). Key mortality statistics: Data for

       United States in 2007. National Vital Statistics Reports, 58 (19).

Clinuvel Pharmaceuticals (2010). Sunbeds and solariums. Retrieved August 21, 2010,

       from http://clinuvel.com/sun-a-skin/sunbeds-and-solariums.

Davis, K., Mitra, D., Kotapati, S., Ibrahim, R. & Wolchok, J. (2009). Direct economic

       burden of high-risk and metastatic melanoma in the elderly: Evidence from the

       SEER-Medicare linked database. Applied Health Economics and Health Policy, 7

       (1) 31-41.

Dowell, J. E., Shen, Y., Harford, W. V., & Lai, W. S. (2005). Difficult diagnostic cases:

       Case 1. melanoma in African Americans. Journal of Clinical Oncology, 23 (15)

       3622-3624. DOI: 10.1200/JCO.2005.04.132.

Epstein, J. H., MD & Wang, S. Q., MD (2010). UV information: Understanding UVA

       and UVB. Retrieved August 21, 2010, from http://www.skincancer.org/

       understanding-uva-and-uvb.html

                                                                                         24
    © 2010
Fischer, S. K., P. J. Hughes, P. D. Fairchild, C. L. Kusik, J. T. Dieckmann, E. M.

       McMahon, and N. Hobday. (1991). Energy and global warming impacts of CFC

       alternative technologies, executive summary. Washington, D.C.: Alternative

       Fluorocarbons Environmental Acceptability Study and U.S. Department of

       Energy.

Fitzpatrick Skin Type. Available at: www.nuskin.com/corp/library/pdf/charts/fitzpatrick.

Fourtanier A., Moyal D. & Seité S. (2008). Sunscreens containing the broad-spectrum

       UVA absorber, Mexoryl SX, prevent the cutaneous detrimental effects of UV

       exposure: a review of clinical study results. Photodermatol Photoimmunol

       Photomed., 24 (4):164-74.

Kleinerman, R, Kriegel, D., Amir, I., Emanuel, P. O. & Markinson, B. C. (2010, Feb.).

       Osteoinvasive subungual melanoma: a case and review. Journal of Drugs in

       Dermatology, 9: 159-163.

Kunar, V., Abbas, A, Fausto, N. & Aster, J. C. (2004). Pathologic basis of disease (8th

       ed.). Philadelphia, PA: Saunders/Elsevier.

Lupus Foundation of America (2010). Photosensitivity. Retrieved August 22, 2010, from

       http://www.lupus.org/webmodules/webarticlesnet/templates/new_aboutdiagnosis.

       aspx?a=94&z=15&page=2.

Markinson, B. C., DPM, FASPD. (2010, July 7). Recognizing amelanotic melanoma in

       the lower extremity. Podiatry Today, 23 (Jul 01 2010) Online journal. Retrieved

       August 22, 2010, from http://www.podiatrytoday.com/recognizing-amelanotic-

       melanoma-lower-extremity.



                                                                                          25
    © 2010
MedicineNet, Inc. (2010). Definition of intraocular melanoma. Retrieved August 26,

       2010, from http://www.medterms.com/script/main/art.asp?articlekey=40565.

O'Neil, D. (2009). Skin color adaptation. Retrieved August 28, 2010, from http://anthro.

       palomar.edu/adapt/adapt_4.htm.

Painter, K. (2009, April 19). Your health: Skin color matters in the vitamin D debate.

Phillpotts, B. A. MD, Sanders, R. J. MD, Shields, J. A. MD, Griffiths, J. D. MD,

       Augsburger, J. A. MD, & Shields, C. L. MD (1995). Uveal melanomas in black

       patients: A case series and comparative review. Journal of the National Medical

       Association, 87 (9) 709-714.

Polsky, D., MD & Wang, S. Q., MD. (2010). Skin cancer facts. Retrieved August 21,

       2010, from The Skin Cancer Foundation, http://www.skincancer.org/Skin-Cancer-

       Facts/.

Sinclair, C. (2003). Artificial tanning sunbeds: Risk and guidance. World Health

       Organization. Retrieved August 21, 2010, from www.who.int/uv/intersun

       programme/activities/uvartsunbeds/en/index.html.

Skin Cancer Foundation (2010). Guidelines: Year-round sun protection. Retrieved

       August 27, 2010, from http://www.skincancer.org/year-round-sun-

       protection.html.

Spencer, J. M. & Amonette, R. (1998). Tanning beds and skin cancer: Artificial sun + old

       sol = real risk. Clin Dermatol, 16: 487-501.

Support Group for Sun Sensitive People (2006). UV radiation from lighting, copiers,

       computer monitors etc. Retrieved September 11, 2010, from http://sun1.

       awardspace.com/Sun_Protection/lighting.htm.

                                                                                         26
    © 2010
Ullrich, S. E., Nghiem, D. X. & Khaskina, P. (2007). Suppression of an established

       immune response by UVA: A critical role for mast cells. Photochem Photobiol.

       83(5): 1095–1100. doi: 10.1111/j.1751-1097.2007.00184.x.

United Nations Environment Programme (2006). Ozone secretariat. Retrieved August

       21, 2010, from http://www.unep.ch/ozone/index.shtml.

U.S. Environmental Protection Agency (1995). Stratospheric ozone: research on

       replacement chemicals to protect the earth’s fragile ozone layer. Washington,

       DC: U.S. Environmental Protection Agency.

U.S. Environmental Protection Agency. (2010, July 2). Health effects of overexposure to

       the sun. Retrieved August 21, 2010, from http://www.epa.gov/sunwise/

       uvandhealth.html.

World Health Organization (2010a). What is the difference between UVA, UVB and

       UVC? Retrieved August 21, 2010, from http://www.who.int/uv/faq/whatisuv/

       en/index2.html.

World Health Organization (2010b). Disease and injury regional estimates for 2004.

       Retrieved September 21, 2010, from http://www.who.int/healthinfo/global_

       burden_disease/estimates_regional/en/index.html.




                                                                                       27
    © 2010

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E book extrashade

  • 1.
  • 2. TABLE OF CONTENTS I. The Right Sunscreen for Rich Complexions ............................................................ 3 A. All-year Round Sun Safety Tips ........................................................................ 3 B. Understanding SPF ............................................................................................ 4 C. Using the Right Sunscreen Effectively .............................................................. 4 II. Mystifying Cases of Melanoma and Skin Cancer .................................................... 6 A. Rich Complexions Sun Problem 1: Photo Aging and Photo Damage ....................... 7 B. Rich Complexions Sun Problem 2: Melanin and How It Affects Scars .................... 8 C. Rich Complexions Sun Problem 3: A Great Lifestyle Inevitably Revolves Around the Sun ........................................................................................................................ 8 III. EXTRASHADE: Superior Broad Spectrum Sunscreen with Unique Technology . 11 The Promise of Sun Protection for Rich Complexions ................................................ 11 The Sunscreen that Provides More than Just Sun Protection ...................................... 12 Full Protection Full Nourishment ............................................................................... 14 Discover the Calming Effect of Pomegranate............................................................. 15 IV. The Harmful Effects of Sustained Exposure to UV Radiation ............................... 16 A. Understanding your skin .................................................................................. 16 B. Premature Aging of the Skin ........................................................................... 17 C. The Prevalence of Melanoma, Its Risk Factors and Ramifications ................... 18 D. Non-Melanoma Skin Cancers .......................................................................... 18 E. How to Protect Your Skin and Help Reverse Signs of Damage ........................ 20 V. What is Known Today About the Risks of Ultraviolet Radiation? ......................... 22 A. UV Rays and How They Harm Humans .......................................................... 22 B. Getting Bombarded with UVR Even on a Rainy Day ...................................... 22 C. Is ozone thinning still a threat? The Latest Authoritative Word on the Ozone Layer.. ....................................................................................................................... 23 References ................................................................................................................. 24 2 © 2010
  • 3. I. The Right Sunscreen for Rich Complexions Healthy Sun protection begins with the right knowledge. The first step is to learn the most relevant and helpful eye-openers about Sun Care for Rich Complexions. A. All-year Round Sun Safety Tips Safety Tip # 1: The sun is up 365 days a year, summer and winter, on clear and cloudy days both. Every minute of exposure adds to your total lifetime dose of UV radiation. This is what counts toward your potential skin cancer quotient. Safety Tip # 2: Safety Tip # 2: If much of your workday is spent outdoors, lay on the sunscreen every day. You need to shield yourself from UVR even if you are being chauffeur driven to meetings all day long. Notice how you tan progressively and you get squint lines from the sun’s glare? Along with visible light, you’re getting UV rays, too. Safety Tip # 3: Fun in the sun has its perils. Sunscreen is not just for the rather infrequent times you hit the pool or go to the shore with friends or family. Even if much of your day is spent in the classroom, inside the house or at your desk in the office, be wary of your sports, hobbies and other leisure time activities. You may be wearing a hat while pottering around in the garden but did you notice that a good deal of your face, neck, chest, legs and arms are sunlit? The risk is much greater in the playing field. Remember how often ―just half an hour‖ of basketball, tennis, or flag football turns into hours and hours of sheer fun? Slather on the sunscreen beforehand and you won’t be sorry years or decades later. Safety Tip # 4: Sure, jogging, trekking and biking help fulfill your cardio workout quota. Surfing is healthy for forcing you to swim so much. So are skiing and tobogganing in winter. Make it all even healthier by armoring yourself against UV rays. Even if you think you’ll be outdoors for just 15 minutes. Remember how all those reflective surfaces bounce back more UVR at you and effectively double your harmful dose. Safety Tip # 5: The Skin Cancer Foundation couldn’t say it more bluntly, ―There is no such thing as a healthy tan.‖ No matter how you cheated with a sun bed, went south 3 © 2010
  • 4. for spring break or want to show off your Caribbean cruise, a tan is your skin’s silent reminder that you had an overdose of UV radiation. B. Understanding SPF It’s more than about the sunburn protection factor (SPF) since single rated SPFs only defends against UV-B, rays that land on the skin’s outer part that cause sunburn when in fact UVA penetrates deep down to inflict damage. To round out your protection, bear these in mind: SPF Knowhow #1: SPF-loaded sunscreens are only part of your defense against the cumulative harm that UVR causes. Wearing hats, wraparound sunglasses and bright- colored, fairly thick fabrics actually offer more protection against the possibility of burning and DNA damage that could lead to melanoma in the future. SPF Knowhow #2: Chief medical officer Otis Brawley of the American Cancer Society cautions that SPF ratings are just averages. If you burn easily and have otherwise sensitive skin, an SPF 30 product may give the equivalent of just SPF 10 protection. For a skin Type VI, melano-protected person, on the other hand, the same sunscreen might be equal to SPF 50 in sunburn protection. SPF Knowhow #3: Both the Skin Cancer Foundation and the Food and Drug Administration (FDA) agree that SPF 50 is about the best that science can reliably test and measure. Anything higher is probably marketing hype. C. Using the Right Sunscreen Effectively Sunscreen Rule #1: Use at least SPF 15. The American Academy of Dermatology prefers to err on the side of caution, suggesting that both adults and children use a sunscreen with an SPF of at least 30. Sunscreen Rule #2: Choose a brand or formulation that has broad spectrum protection or screens both UV-A and UV-B. Sunscreen Rule #3: Make sure to apply enough. Down to bare essentials at the beach or pool, the sensible adult knows to apply at least an ounce to cover up from face to toes. That’s the equivalent of a shot glass. Using less is the same as going for lower SPF. Sunscreen Rule #4: Re-apply when the SPF limit has been reached. If you know you start to burn after just ten minutes outdoors when you don’t have sunscreen on, SPF 15 has a theoretical protection limit of 15 times your ten-minute safety limit. In this case, that’s 150 minutes or two and a half hours. Spending all day at the beach, golf course or basketball court means you should apply at least four times. Sunscreen Rule #5: Re-apply more frequently, as often as necessary, in fact. Going into the water washes sunscreen off. So do sweating on the playing court and toweling off for any reason at all. Better safe than sorry later in life. 4 © 2010
  • 5. Sunscreen Rule #6: Apply everywhere. At the beach, it’s easy to overlook your feet and the back of your legs. Protect your lips, ears, nape, hands, and around the eyes, too. Got too much testosterone? Put some on that bald spot, too. Sunscreen Rule #7: Shop for the right sunscreen type. Children and adults with sensitive skin should use fragrance-free variants. Outdoorsmen and playing field ―gladiators‖ may be pleased to learn about stick, water and sweat resistant or other sports variants. As a general rule, use the product format that makes it easy for you to stay protected from UV (Skin Cancer Foundation, 2010). Figure 1: The New Sunscreen Label to look for should conform to the latest FDA sunscreen standards 5 © 2010
  • 6. II. Mystifying Cases of Melanoma and Skin Cancer In Rich Complexions hose with Rich Complexions don’t believe they need to wear sunscreen. True T enough, most rich complexions such as the Asian, Latinos African Americans and Pacific Islanders, among others, are less likely to be afflicted with skin cancer. But they are not cancer-proof. When melanoma and other forms of skin cancer do show up, they can be deadlier than for Caucasians. Case #1: In 2008, a 69-year-old Hispanic lady was seen at the Department of Dermatology, Mount Sinai Hospital in New York for treatment of the left fourth toe. After the loss of the nail three months previously, the nail bed refused to heal. The initial biopsy Not even the indicated that what looked like a freckle was a melanoma Darkest Skin already 4.8 mm. deep. The patient was in luck because the Tone is Skin- skin cancer had not metastasized (spread to other parts of her body). However, the toe had to be amputated. Subsequently, Cancer Proof the pathologist found that the melanoma had already penetrated 11 mm. into the bone marrow of the toe (Kleinerman, Kriegel, Amir, Emanuel, & Markinson, 2010). Case #2: A 48-year-old African American male went to the Dallas VA Medical Center after experiencing months of fatigue, fevers, and weight loss of 50 pounds. At the same time, he had a massively swollen abdomen. Despite the absence of any skin marks or lesions (or early signs of tumor), a CT scan and biopsy confirmed that the palpable lumps in the lower abdomen was metastatic malignant melanoma (Dowell, Shen, Harford & Lai, 2005). Case #3: An even younger 41-year-old African American man also reported to the Dallas VA Medical Center complaining of fatigue and dark stools experienced beginning a week earlier. No masses could be felt on external physical examination nor did the upper endoscopy, colonoscopy, and a small bowel series discovered what the source of bleeding might be. On the other hand, the more thorough capsule endoscopy, followed by exploratory surgery, showed sizeable lesions at several places in the small intestine. On biopsy, these were confirmed as metastatic malignant melanoma. Thorough examination of skin, nails, eyes, and mucous membranes yielded no primary site where the melanoma might have originated. Here is one more case where the rich, dark complexioned person may well have “protected” him from superficial melanoma. By the time he sensed something wrong with himself, though, the cancer had already spread to three sites in the small intestine (Dowell, Shen, Harford & Lai, 2005). 6 © 2010
  • 7. What is Essential to High Quality Living for Rich Complexions It has everything to do with shunning the sun. Deadly cases of Melanoma, non- Melanoma skin cancers, premature-aging, hyperpigmented, highly irritated dull, dry, ashy skin are a great fraction of hindrances in living life to the fullest and one thing these all have in common—they can all be traced to mindless sun exposure. A Ruthless Risk Factor – Rich Complexions have a poorer survival rate when battling Melanoma because of the delayed prognosis The threat of Skin Cancer Alone is already enough to Practice Sun Protection but there are more problems ahead after inconsiderably facing the sun. A. Rich Complexions Sun Problem 1: Photo Aging and Photo Damage Photo aging can occur earlier in life. Owing to reckless exposure to UV radiation from the sun, the areas that are usually exposed – face, neck, hands, arms, the décolleté area – become less supple and flexible. This is the sign that UV-A has penetrated deep to damage the collagen fibers in the deepest layers of the epidermis. When the damage is severe, sagging occurs prematurely. Figure 2: Common signs of photoaging Figure 3: Sun damage occurred on the side of include mottled skin with various the face (A) that was exposed to the UVA light pigmented spots and general loss of skin coming through the window. The other side of tone in sun-exposed areas as seen in this her face (B) was not exposed to window light woman in her forties - Canadian (Source: Moulin G, Thomas L, Vigneau M, et Dermatology Association. (CNW al. A case of unilateral elastosis with cysts and Group/Canadian Dermatology comedones: Favre-Racouchot syndrome. Ann Association) Dermatol Venereol. 1994;121:721-723. 7 © 2010
  • 8. B. Rich Complexions Sun Problem 2: Melanin and How It Affects Scars Melanin is a tough built-in defense but it’s not perfectly invincible against the sun. The downside even is that a sun-activated melanin triggers an attack of acne flare-ups or other moderately-inflamed wound. Regardless of how much time you spend outdoors or basking in a tanning bed, melanin can cause ―Post-Inflammatory Hyperpigmentation‖ (PIH). PIH is our body’s natural reaction to inflammation, leaving behind discoloration that ranges from pink (for the very light-skinned) to red, purple, brown or black, depending on your skin tone and depth of the discoloration. PIH is especially common in Rich Complexions. The discoloration is caused by excessive melanin being produced in reaction to the inflammation. This side-effect always discolors by darkening, affecting men and women alike. Figure 4: Post-Inflammatory Hyperpigmentation on a brown-  skinned Pacific Islander American Melanin is a tough built-in defense but it’s not perfectly invincible against the sun.  C. Rich Complexions Sun Problem 3: A Great Lifestyle Inevitably Revolves Around the Sun Rich Complexions represent a great variety of ethnic groups in every sizeable city. Outdoor life is just as enjoyable and necessary for all young and old alike. Figure 4: The Most Striking Variations in Child and Adult Skin Colors. From Left to Right: Central/South African, Indian, Mediterranean and North European 8 © 2010
  • 9. Baby Boomers Now Face the Problem of Youth Unwisely Spent Under the Sun The ―Baby Boom‖ generations in all ethnicities are now in their 50s, struggling to cope with the onset of degenerative conditions such as hypertension, cardiovascular diseases, rheumatoid and other signposts of middle age. Another major problem every baby boomer has to face is the inevitable aging of their skin. For Rich Complexions, this is the critical stage in the life cycle when vitamin D deficiency on one hand and decades of irresponsible exposure to UV radiation on the other can cause unpleasant surprises. True, their melanin-rich status protects Rich Complexions from the high incidence that assaults the pale-complexioned. Still, it does not shield them from that earlier physical aging brought about by earlier days of reckless sun exposure. Moreover, this is the time to be wary about skin cancer showing up even in areas of the body normally covered up and not directly subject to UV radiation. Annual check-ups should include thorough inspection of the skin from scalp to sole. As we have seen from the case studies that introduced this e-book, melanoma can show up on nailbeds where the discoloration may be disguised by unkempt toenails. From there, skin cancer can invade nearby bones or migrate to vital organs. Figure 5: Life Outdoors for the Baby Boomers 9 © 2010
  • 10. Baby boomers or not, spending time outdoors to enjoy family activities, sports or leisure is one of the best ways to pass a day. The main problem: Most engage in outdoor activities as it fit their lifestyles. Many are unmindful of the Rich complexions love long hours they spend ―soaking up rays‖ outdoor activities from overhead or that both UV-B and UV- blissfully unaware that A do harm to skin even on cloudy days. they compound their They forget how the sea and some surfaces risk of getting skin reflect sunlight upwards, compounding the cancer that is more potential damage to DNA close to the surface of their faces, arms and bare legs. deadly for their multi- cultural heritage. Figure 6: Common Activities Spent in the Sun Totally avoiding the sun is not the obvious moral lesson here but only the fact that Rich Complexions need proper sun care just as much as anyone else. There is a need to strike the balance between a fulfilling lifestyle and healthy sun protection. 10 © 2010
  • 11. III. EXTRASHADE: Superior Broad Spectrum Sunscreen with Unique Technology The CHALLENGE: The facts say it all. We have already witnessed how and why people of multi-cultural heritage are at greater risk for Skin Cancer and Post-Inflammatory Hyperpigmentation (PIH). Those of brown skin ethnicity are also afflicted by sensitive, easily irritated skin, get blemishes more readily, suffer uneven skin tone, and PIH. Most Americans with brown skin are of Latino, multi-racial, South Asian, South Pacific, Filipino and/or Native Indian ancestry. Broadly speaking, therefore, the multi-cultural Rich Complexions around the world have uncommonly sensitive complexions that require specialized sun care solutions. The Promise of Sun Protection for Rich Complexions EXTRASHADE is a premium sun care brand with the primary focus on sun safety awareness and to protect adults and children from the UV rays of the sun. Sun Protection for Rich Complexions provides multi-functional protection for the health and wellness of people with tan to olive to dark skin tones. Sun Protection for Rich Complexions are formulated with select ingredients to defend daily against damaging UV-A and UV-B rays while helping maintain a smooth and even skin tone.  Protects your skin from harmful UVA and UVB rays that cause premature aging, Hyperpigmentation and skin cancer  Helps eliminate free radicals to noticeably minimize fine lines, wrinkles, freckles and brown spots and lessen the look of blotchy, uneven skin tone.  Ideal for highly reactive and PIH-prone skin with a completely non-irritating formula 11 © 2010
  • 12.  Used regularly, EXTRASHADE even helps prevent dark spots from reappearing  Enhances your looks, nourishing and hydrating skin to keep it smooth, supple, and young beyond your years. Figure 7: Beyond sun care, Sun Protection for Rich Complexions specializes in controlling Hyperpigmentation as seen on the varying cases The Sunscreen that Provides More than Just Sun Protection EXTRASHADE Daily Defense Hydrating Sunscreen SPF 30 Great for everyday use, greater for skin in the long run—this is an ultra-gentle, uniquely photo stabilize sunscreen for superior broad spectrum protection with continuous hydration in one formula. This formulation comprehensively shields you from UVA and UVB rays and helps improve the health of your skin at the same time because it is rich with antioxidants. This hydrating sunscreen provides maximum face and body protection for active lifestyles by resisting water for long lasting defense. Daily Defense Hydrating Sunscreen SPF 30 protects and enhances your rich complexion three more ways: by reducing 12 © 2010
  • 13. irritation and inflammation; combating free-radicals before they do you damage; and deeply hydrates your skin to leave it soft and radiant without leaving a greasy or chalky residue. Figure 8: Who Stands to Benefit EXTRASHADE Protect and Nurture Sunscreen SPF 30 For Young Sensitive Skin—the young and gentle youth skin needs all the protection and nourishment it can get. The very same melano-protection advantage of Rich Complexions adults also works for their children. This is fortunate because over- exposure to UVR early in life is an important risk factor for skin cancer in middle age or later. Specially formulated for the unique needs of sensitive skin, this is an ultra-gentle product with superior broad spectrum protection. Carrying the EXTRASHADE promise, Protect and Nurture Sunscreen has an SPF 30 that helps protect and defend against UVA and UVB rays while nurturing their skin without leaving any harsh effects, greasy or chalky residue. Its unique photo stability provides maximum face and body protection by resisting water for long-lasting defense. 13 © 2010
  • 14. Full Protection Full Nourishment Because Sun Protection for Rich Complexions is created for highly reactive skin, what’s in it is just as important as what is not in it. Sun Protection for Rich Complexions is specifically formulated without fragrance, lanolin, dye, alcohol or propylene glycol, these are irritants known to stimulate the production of excessive melanin. Innovatively photo stabilized Octyl methocycinnamate (Octinoxate) and Avobenzone with unique technology create superior and effective broad spectrum protection and top performance. Here is the purpose of some of the top ingredients so you can be confident to wear it to protect and preserve your appearance. Pomegranate: Soothes and calms inflammation that commonly affects highly reactive skin Hyaluronic Acid: Maintains hydrations levels in skin completely and gently Hedychium Coronarium Root (White Ginger) Extract: Soothes inflammations and softens the skin Quillaja Saponaria Bark (Soap Bark) Extract: Heals and hydrates the skin safely Actinidia Chinensis (Kiwi Fruit) Extract: antioxidant and hydrator that remarkably reduces the appearance of fine lines, dark spots and wrinkles gently Tocopheryl Acetate (Vitamin E) and Tertrahexyldecyl Ascorbate (vitamin C): the top sun care Vitamins to provide a healthy and radiant complexion Cocos Nucifera (Coconut) Extract: antibacterial and hydrator Plantago Major Leaf (Plantain) Extract: heals wounds, renews cell and fights free radicals Passion Flora Incarnata (Passion Flower) Extract: soothes and relaxes the skin Unlocking the Hydrating and Repairing Power of Hyaluronic Acid Hyaluronic acid can dramatically improve the overall health and beauty of your skin. While many have dubbed it as the ―key to the fountain of youth‖ Extra Shade took this edge to make it a valuable skin anti-aging and hydrator. In the forefront, it is a naturally-occurring substance present in all types of human skin necessary for tissue repair and skin renewal. It has the unique amazing property of binding water up to 1,000 times its weight and as such can gently and completely hydrates even the most sensitive brown skin. 14 © 2010
  • 15. Fully absorbed, it becomes a hypoallergenic hydrator that Sun Protection has the ability to pull hydrants from the atmosphere and trap it on the surface of the skin eliminating dry, dull and for Rich ashy skin. As such, Hyaluronic acid is the ultimate natural hydrator to unlock a smooth skin tone. Complexions offers the Discover the Calming Effect of Pomegranate unique Pomegranates are among the top Combination antioxidants in the of Full world with shrubs originating in lands Spectrum stretching from the northwestern region of Protection India through Iran to from UV North Africa, home to most people of Rich Complexions. radiation, safe Modern Science regard the fruit as symbol to long life but emollients and it is most revered by Aryuvedic medicine for more than a hours-long century now by its proven miracle to restore the skin’s balance and enhance its youthful glow. hydration. This is the perfect nourishment for rich complexions as its rich flavanoid compounds stimulates collagen production, soothes and calms inflammation and counter act the harsh effects of oxidation and the damaging effects of the sun. All in, Sun Protection for Rich Complexions offers the unique combination of full-spectrum protection from UV radiation, safe emollients, and hours-long hydration. 15 © 2010
  • 16. Still not convinced? Let the Rest of the Facts Convince you to Wear Sun Protection, No matter your Complexion. IV. The Harmful Effects of Sustained Exposure to UV Radiation A. Understanding your skin The skin’s protective covering comprises just four very thin layers. Below the stratum corneum is the thinner pigment layer which contains the melanocytes. For all the melanin that characterizes people with skin of color and theoretically protect these ethnic groups, it has a very thin shield that insufficiently protects against longer-wave UV-A (Figure 9 overleaf). The melanocytes that produce melanin and therefore impart human skin tone as well as produce the tanning characteristic of exposure to UVR are embedded within the epidermis. Figure 9: UVR and the Skin (Source: Epstein & Wang, 2010) The first sign of excessive exposure to UVR is a first-degree burn. Sunburn does not usually advance to third- degree burn because the severe redness and stinging of a second-degree burn alerts the victim soon enough to seek shade and first-aid treatment. Figure 10: Sunburn Among Rich Complexions 16 © 2010
  • 17. More than the sunburn, UVR is implicated in other health risks as suppressing the immune system and cosmetic disfigurations as wrinkles and hyperpigmentation, e.g. age spots, freckles and melasma among others. B. Premature Aging of the Skin Constant and repeated exposure to UV radiation from the sun also causes premature aging. The least damage you can experience is cosmetic. That premature aging is Over time, your complexion becomes thicker, more inevitable is a wrinkled, and leathery than is the norm for people misconception. your age, that’s why it’s called premature aging. In fact, solar radiation is reckoned to produce 90 Premature aging percent of the signs of premature aging, more than happens after an dehydration, smoking, and other poor health habits accumulation of years (U.S. EPA). and decades of reckless exposure to the sun. Perversely enough, the other type of cosmetic damage UVR does to the skin is to make it thinner. Thinner skin shows up as many fine lines and bruises very easily. Either way, thinner or thicker, skin looks prematurely old. Figure 11: Look closely and you’ll see that even Rich Complexions form freckles from over Sun exposure UV-A penetrates so deep that it also accelerates thinning in surface capillaries and major blood vessels. This forms the so-called ―spider veins‖ which makes the UVR victim look like a drunk. More dangerously, the so-called ―liver spots‖ are actually moles. The dark ones are cause for worry especially if they become irregularly shaped and textured, growing slowly through time. A dermatologist must check very thoroughly to be sure these are not the beginnings of malignant melanoma. 17 © 2010
  • 18. C. The Prevalence of Melanoma, Its Risk Factors and Ramifications More menacing, however, is the fact that UVR is responsible for nine of ten cases of skin cancer. Of the three types of skin cancer, basal cell cancer is the most readily curable, squamous cell cancer is potentially life-threatening because of its propensity for growing and spreading (―metastasizing,‖ as your GP and oncologist like to say), and malignant melanoma the most deadly. D EPA). eadly Fact # 1: Skin cancer is rampant and growing steadily. In America, 1.5 million newly-diagnosed cases each year outnumber new cases of breast, prostate, lung, and colon cancer combined (Spencer & Amonette, 1998; U.S. D eadly Fact # 2: Skin cancer is prevalent. At least one-fifth of all Americans will develop skin cancer in their lifetimes. For Americans 66 years or older, the lifetime incidence is 40% to 50% (U.S. EPA). D eadly Fact # 3: Skin cancer is deadly. Hour by hour, one American dies from some form or other of skin cancer (U.S. EPA). To these 8,750 deaths, the WHO adds another 50,000+ worldwide that die of excessive UVR exposure. D eadly Fact # 4: The single most preventable risk factor for skin cancer is exposure to UVR without shielding or protection of any kind (U.S. EPA). eadly Fact # 5: Staying indoors but resorting to tanning lamps, beds or booths D actually makes things worse. An Australian study showed that those who began artificial tanning in their youth were 75% more likely to develop malignant melanoma years or even decades later (Clinuvel Pharmaceuticals, 2010). D eadly Fact # 6: The global death toll due to malignant melanoma is around 48,000 annually (American Cancer Society, 2009). D eadly Fact #7: According to the U.S. Department of Health and Human Services and the World Health Organization, excessive UV radiation damages the skin’s cellular DNA. The result is genetic mutations that can lead to skin cancer therefore UV is a proven human carcinogen. D. Non-Melanoma Skin Cancers True, non-melanoma skin cancers are less deadly than melanomas. Left untreated, however, they spread and create disfiguring growths everywhere. Between 40 and 50 percent of Americans who live to age 65 will have the two primary types of non-melanoma skin cancers – basal cell and squamous cell carcinomas – at least once. 18 © 2010
  • 19. Basal cell carcinomas are the most common type of skin cancer tumors. They usually appear as small, fleshy bumps or nodules on the head and neck, but can occur on other skin areas. This is one type of skin cancer that can penetrate to the bones and cause a great deal of damage, including crippling and mutilation. Squamous cell carcinomas are tumors that appear in the beginning as nodules or as red, scaly patches. This cancer can develop into large masses, and can spread to other parts of the body (US EPA). The non-melanoma skin cancers (NMSC) are very prevalent. More than a million new cases of basal cell carcinoma (BCC) are discovered annually in America. Squamous cell carcinoma (SCC) turns up in from 250,000 to half a million Americans each year (Epstein & Wang, 2010). At last count, mortality for all cancers among the two largest ethnicities and, in particular, for those where UVR is implicated were as follows: Table 1: Cancer as a Cause of Death for Ethnicities in the United States, 2007 (Source: CDC NVSS) Blacks Hispanics American Asian/ Indian/ Pacific Alaska Islander Native All cancers 64,049 27,660 2,561 12,326 Cancers of the lip, oral cavity, 1,062 364 43 242 pharynx Skin 136 194 22 45 Melanoma of the Skin Death Rates* by Race/Ethnicity and Sex, U.S., 2007 19 © 2010
  • 20. Figure 12: Skin Cancer Incidents in Rich Complexions Sun Damage is Highly Deadly but is also Highly Preventable E. How to Protect Your Skin and Help Reverse Signs of Damage By in large rich complexions don’t do enough to protect themselves from the sun. Tens of millions plainly do not take such elementary precautions as wearing a wide- brimmed hat, covering up while in the sun, seeking shade, wearing wrap-around sunglasses, avoiding the sun during the hours of 10 a.m. to 4 p.m., and using sunscreen with a sun protection factor [SPF] of 15 or higher (Centers for Disease Control and Prevention, 2007). In short, do everything you can to shield the sensitive skin on your head, neck, and around the eyes because these are the most vulnerable to sun damage. Use a sunscreen rated at least SPF15. You know what they say about caution being the better part of valor. Even if you do not intend to catch some rays and get a tan slather on the sunscreen for a stroll around the campus, jogging around the neighborhood, and cycling or trekking the trails in summer. 20 © 2010
  • 21. Opt for thin and light long sleeve shirts, comfortable lightweight pants. Contrary to the common propensity for wearing gauzy and light-colored clothes in summer (the better to avoid feeling sticky and sweaty), it is actually better to wear bright- or dark-colored, lustrous clothes because these reflect more UV radiation than do pastels and bleached cottons. Even loose-fitting styles are fine if one opts for densely-woven fabrics because these are a better barrier against UV radiation. Wear a hat when outdoors. Not a “cool” baseball cap, worn with the bill forward or reversed. A hat, with the widest brim you can find. It’s good to remember that UV-A pass through the glass with ease. Car drivers should feel protected only if they have already added UV-protective film to a car’s side and rear windows. Home, office, and store windows should similarly have tinted film that blocks up to 99.9 percent of UV radiation and lets in up to 80 percent of visible light (Epstein & Wang, 2010). Since the eyelids, nostrils, lips and inner ear do not contain pigment (the melanin that gives you your tan and protects somewhat against serious burns) and won’t tan well anyway, keep them shaded when outdoors. Finally, be sun aware. At this point when the climate is unpredictable, natural disasters are at an all time high and the rays are getting stronger more than Rich complexions can handle, it pays to know one of the disturbing culprits: the deterioration of the ozone layer. 21 © 2010
  • 22. V. What is Known Today About the Risks of Ultraviolet Radiation? A. UV Rays and How They Harm Humans Among all other types, UVA and UVB are the forms of ultraviolet (UV) radiation that we should be concerned about. UVB radiation are shorter than UVA which explains why it can only affect the outer layer of the skin and cause sunburn or the sun tan while UVA radiation can go deeper to the innermost levels of the skin. Both rays are known to cause skin cancer, suppress the immune system and speed up the aging process, among others. Figure 13: UVA and UVB a Constant Part of Radiation from the Sun (Source: Epstein & Wang, 2010) B. Getting Bombarded with UVR Even on a Rainy Day UV rays are not confined to its natural source alone which is the sun; we are constantly surrounded and bombarded by the artificial sources which are everywhere. Artificial tanning beds, indoor lighting, copiers, computer screens, welding equipment, germicidal and mercury arc lamps all give off UV radiation in varying levels. If you have sensitive skin and suffer from such conditions as solar urticaria, lupus, porphyria, sun rash, sun hives, photosensitivity, sun allergy, rheumatoid arthritis, xeroderma pigmentosum, albinism and other sun-related sensitivities, two hours under the bright lights at Wal-Mart or any shopping mall can be equivalent to one hour under direct sunlight (Support Group for Sun Sensitive People, 2006). 22 © 2010
  • 23. Low-Intensity High-Intensity Fluorescent lighting Tanning beds, lamps and booths Compact fluorescent bulbs Halogen and high intensity discharge lights Incandescent bulbs, Computer monitors Germicidal lamps Resin and paint curing lamps Arc lamps ―Black lights ―Phototherapy lamps found in Copy machines nurseries Electric/Arc welders, Ultraviolet lasers Sources: National Electrical Manufacturers Association (NEMA), Support Group for Sun Sensitive People As early as 1992, the American Journal of Epidemiology reported that fluorescent lights radiate ―10-30 times‖ more UV-B than natural sunlight. Even worse, such lamps emit almost the same intensity of both UV-B (380 nm) and UV-A (as much as 400nm) unless, of course, the fixtures are shielded. But since these facts are not widely known, there is no agitation to install shields at home, work and in malls. C. Is ozone thinning still a threat? The Latest Authoritative Word on the Ozone Layer Getting sunburned on a cloudy day is not the surprising news; it’s the fact that it’s the result of the UV rays advancing its penetration easier on the thinning ozone layer which is more alarming. Figure 14 below shows vividly how the ozone layer over Antarctica deteriorated to the bluest part of the spectrum in a span of two decades. This period coincided with the explosion in the automobile population worldwide and industrialization in newly- developed economies such as Taiwan, Thailand, India, the Philippines and the Middle East-North Africa in general. Figure 14: The Ozone “Hole” in September 2006, nearly two decades on, the slow progress of ratification and agreed replacement rates for CFC ensured that the damage to the ozone layer continued apace. On the other hand, the ozone layer over the Arctic has begun to deteriorate as well, at least according to a United Nations report released in 2006. On the best available evidence at hand –the unstable weather patterns are the culprit for ozone degradation over the North Pole – it may be 15 years at least before Arctic ozone depletion stops. With the damaged ozone layer here to stay, EXTRASHADE will protect you to be your best against the stronger penetration of UVA and UVB rays. 23 © 2010
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