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Sun worshippers won't want to hear it, but a new study says the best way to protect against cancer-causing ultraviolet rays is to avoid direct sunlight and wear protective clothing to keep exposure to a minimum.
Sunscreens are a poor second choice, but they're better than nothing, said the Swiss dermatologists who did the study.
The findings take on added urgency for residents of the northern hemisphere, where summer is approaching with its promise of long, lazy days spent at the beach or other outdoor play spots.
"Wearing sun-protective clothes and a hat and reducing sun exposure to a minimum should be preferred to sunscreens," Dr. Stephan Lautenschlager, of the Outpatient Clinic of Dermatology at Triemli Hospital in Zurich, wrote in the May 3 online edition of The Lancet.
But, this advice is felt to be "unacceptable in our global, outdoor society and sunscreens could become the predominant mode of sun protection for various societal reasons, for example healthiness of a tan, relaxation in the sun," the study authors added. "Nevertheless, sunscreens should not be abused in an attempt to increase time in the sun to a maximum."
One expert agrees with the recommendation.
"I am a proponent of the approach advocated by the [American] Cancer Society," said Dr. Martin Weinstock, a professor of dermatology at Brown University and chairman of the American Cancer Society's skin cancer advisory group. "It's called Slip-Slop-Slap. Slip on a shirt, slop on sunscreen, slap on a hat. That's the way to be safe during outdoor activities."
According to Lautenschlager's group, the type of clothing you wear can make a big difference in sun protection factor (SPF). For example, tightly woven, thick garments made of denim, wool or polyester offer the best protection, while cotton, linen and acetate are much less effective, they noted.
In terms of sunscreens, there are two kinds -- inorganic and organic. Inorganic sunscreens work by scattering UV light using zinc or titanium oxides. This type of sunscreen is well tolerated by the skin and produces few allergic effects. It is recommended for children, the study authors said.
Organic sunscreens absorb the UV rays, and are made up of complex organic molecules that are "photoprotective." Organic screens should be put on 15 to 30 minutes before going out in the sun.
And waterproof or water-resistant sunscreens should be used to reduce the need for reapplication after swimming followed by toweling, friction with clothing or sand, and sweating, Lautenschlager's group noted.
Weinstock thinks that SPF factor is the most important consideration when choosing a sunscreen. "I recommend SPF 30 or greater," he said.
Lautenschlager's group warned that while studies have found that sunscreens protect against acute UV skin damage and nonmelanoma skin cancers, it's not clear whether they help protect against melanoma, the most dangerous form of skin cancer.
"The population has to be advised how to best make use of sunscreens," the authors wrote. "The application of a liberal quantity of sunscreen is, by far, the most important factor for effectiveness of the sunscreen, followed by the uniformity of application and the specific absorption spectrum of the agent used."
Dr. Doris Day, a dermatologist at Lenox Hill Hospital in New York City, offers another safety rule to minimize your exposure to UV rays.
"There is a nice rule -- called the shadow rule -- that is very useful," Day said in a statement. "The shorter your shadow, the more dangerous the rays of the sun. So, for example, at noon when the sun is highest, you have little to no shadow, and that is the best time to try to stay indoors or in the shade."
Skin cancer -- including melanoma and nonmelanoma malignancies -- is the most common of all cancers, accounting for about half of all cancers. An estimated one million cases of nonmelanoma skin cancers are diagnosed annually in the United States. Most are basal cell -- about 800,000 to 900,000. Squamous cell cancer occurs less often -- perhaps 200,000 to 300,000 cases annually. People do not often die of these cancers. About 1,000 to 2,000 people die of nonmelanoma skin cancer each year in the United States, according to the American Cancer Society.
Melanoma, on the other hand, causes most skin cancer deaths, even though it accounts for just 3 percent of all skin cancer cases. The American Cancer Society estimates there will be 59,940 new cases of melanoma in the United States this year, and about 8,110 people will die of the disease.
HealthDay News, May 3, 2006.
By Ken Klein
Learn about the state of sunscreens in the United States today and how a better understanding of them can lead to enhanced customer service for your clients.
Fair-skinned people who yearn for a suntan -- even though they know it's hopeless and unhealthy -- may one day have cause for celebration.
Harvard scientists have discovered new information about how the skin tans or -- in the case of fair-skinned people -- stubbornly refuses to tan due to a genetic defect. Using a skin treatment, they have turned pale skin dark, while also protecting it from ultraviolet-induced.
"Darkening a person's skin may mimic the protective benefit seen in people who otherwise make a large amount of pigment," says researcher David E. Fisher, MD, PhD, director of the Melanoma Program at Dana Farber Cancer Institute in Boston. And that could translate into a reduction in the toll of the potentially deadly skin cancer melanoma, expected to be diagnosed this year in 62,000 people in the U.S. and to result in 8,000 deaths, according to American Cancer Society projections.
The study appears in the Sept. 21 edition of the journal Nature. Fisher cautions that the study was done only in animals. Using a topical cream instead of the sun's rays, Fisher's team was able to switch on the tanning mechanism in the skin cells of fair-skinned mice, turning them into olive-skinned animals. "This has not been demonstrated in people and there is a lot that needs to be proven before it's ready for even a first attempt in clinical subjects," Fisher says.
Even so, the study was called intriguing by Meenhard Herlyn, DVM, PhD, a tumor biologist at The Wistar Institute, a research center on the campus of the University of Pennsylvania. "What he clearly has shown is ... you can induce a pigmentation, tanning, and the purpose is that people who are very susceptible to skin cancer, including melanoma, can be protected."
By Kathleen Doheny, WebMD, September 20, 2006
Unless it's continuously reapplied, sunscreen can actually attack the skin and leave it vulnerable to ultraviolet (UV) radiation, concludes a University of California, Riverside study.
The researchers found that, over time, molecules in sunscreen that block UV radiation can penetrate into the skin and leave the outer layer susceptible to UV, CBC News reported.
The study appears in an upcoming issue of the journal Free Radical Biology & Medicine.
"Sunscreens do an excellent job protecting against sunburn when used correctly," Kerry Hanson, a research scientist in the university's department of chemistry, said in a prepared statement.
"This means using a sunscreen with a high sun protection factor and applying it uniformly on the skin. Our data show, however, that if coverage at the skin surface is low, the UV filters in sunscreens that have penetrated into the epidermis can potentially do more harm than good," he said.
HealthNews Day, 8/29/06
American males aren't getting or heeding warnings on sun protection, researchers report, with the bulk of magazine ads for sunscreen appearing in publications aimed at women, not men.
A new U.S. study shows that 77% of the 783 sunscreen ads reviewed were published in women's magazines.
Researchers reviewed 579 magazines -- all May to September issues from 1997 to 2002 for 24 different publications.
While the average was about four ads for sunscreen per women's magazine, the average was less than one in each issue of parenting and family magazines. The average in outdoor and recreation magazines typically read by men was less than one per six issues.
"There's a huge opportunity to reach an untapped market," Alan Geller, an associate professor of research with the Boston University School of Medicine, said in a prepared statement. The ads should also better explain how to properly use sunscreen and other sun-care products, he said, as none of the ads contained the recommended guidelines for appropriate use of sunscreen.
His team published their findings in the May/June issue of the American Journal of Health Promotion.
"We know that men know much less about sun protection than women," Geller said, adding that "research has shown us that many, many people use sun protection products and still get burned." These advertisements provide a good opportunity to educate people on how to use sunscreen properly, he added.
"With my contacts, I've argued that advertising and communications should go on in boating, tennis and golf magazines," David J. Leffell, a professor of dermatology and surgery at the Yale School of Medicine, said in a prepared statement. Leffell was not involved in the study, but consults for a large U.S. manufacturer of sun-care products.
The results of the study show a need for working relationships between product marketing departments and advocates for skin cancer prevention, as well as more ads geared toward "potentially higher-risk groups such as children, men and outdoor recreation users," said Geller.
HealthDay News, May 29, 2006
Tanning's effects may be more than skin deep.
A new study finds that frequent users of tanning beds experience "feel-good" effects similar to those of some addictive drugs.
Researchers at Wake Forest University Baptist Medical Center say the ultraviolet (UV) light in tanning beds appears to trigger production of endorphins, brain chemicals linked to pain relief and euphoric feelings.
"We had previously shown that ultraviolet light has an effect on mood that tanners value," study lead author Dr. Mandeep Kaur said in a prepared statement. "Now, in this small study, we've shown that some tanners actually experience withdrawal symptoms when the 'feel-good' chemicals are blocked."
The study included eight frequent tanners (eight to 15 times a month) and eight infrequent tanners (no more than 12 times a year). The participants were given either a placebo or a drug (naltrexone) that blocks the effects of endorphins and other opioids. They then used both UV and non-UV tanning beds.
At higher doses of naltrextone (15 milligrams), frequent tanners showed a preference for UV tanning and four of the eight frequent tanners reported nausea or jitteriness. None of the infrequent tanners who took the drug reported these symptoms.
"The finding was unexpected and is consistent with the hypothesis that frequent tanning may be driven in part by a mild dependence on opioids, most likely endorphins. The nausea and jitteriness induced by the medication are consistent with symptoms of mild opiate withdrawal," senior researcher Dr. Steven Feldman, a professor of dermatology, said in a prepared statement.
The study appears in the April issue of the Journal of the American Academy of Dermatology.
HealthDay News, April 13, 2006