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Lisa's Daily Fitness Tip
According to the American Academy of Dermatology (AAD), more than one million new cases of skin cancer will be diagnosed in the United States this year. Melanoma, the deadliest form of skin cancer, will kill 7,910 people?that's nearly one person dying of melanoma every hour. In August 2005, a study published in the Journal of the American Medical Association found that the incidence of basal and squamous cell carcinomas, the two most common forms of skin cancer, more than doubled between 1976 and 2003 among women under the age of 40.
"The reasons for this [large number of new cases of skin cancer] are multifactorial," says Cheryl Citron, M.D., a dermatologist and past president of the New Jersey Dermatologic Society. "We have pollution, depletion of the ozone, unregulated tanning salons and people living longer?but the biggest factor is early sun exposure."
Protection, however, requires more than globbing sunscreens or sunblocks onto skin. "Sunscreens don't prevent skin cancer, they can only reduce the risk." according to Mark Chamberlain, PharmD at the University of Maryland School of Pharmacy. Dr. Chamberlain offers this example: If time spent in the sun remains the same, a person with a 50 percent chance of developing skin cancer will reduce his risk to only 20 percent with daily use of sunscreen. Two forms of solar radiation are of concern: Ultraviolet-A (UVA) which are long-wave solar rays that are less likely to cause sunburn, but penetrate the skin more deeply; and ultraviolet-B, short-wave solar rays responsible for sunburns and considered the leading cause of basal and squamous cell skin cancer, as well as a significant contributor to melanoma. There is increasing evidence of UVA causing photoaging and UVA is believed to exacerbate UVB's carcinogenic effects, contributing to cancers, especially melanoma. Dr. John Knowland of Oxford University explains that in using sunscreens that absorb UVB but not UVA, "you can encourage prolonged exposure, thereby getting a much higher dose of UVA, and perhaps increasing the risk of melanoma."
Avoiding the sun between 10 a.m. and 4 p.m., when the rays are most powerful, is the best option for protection against UV rays, dermatologists say. But when this is not practical, one should use sunblock creams and wear protective clothing. Below are some recommendations for how to pick the most effective of both.
Ingredients to Avoid
Overall, there are two basic types of skin cream or lotion protection: sunscreens, which absorb and deflect (or reflect) the sun's rays via a chemical reaction, and "blocks"?zinc oxide and titanium dioxide?which create a physical barrier against rays. Most commercial products offer a combination of the two, but when possible avoid the following ingredients:
? PABA: Though rarely used now in sunscreens, beware of products that contain the ingredient. Forty percent of the population is sensitive to it, experiencing red, itchy skin.
? Benzophenone (benzophenone-3), homosalate, and octy-methoxycinnamate (octinoxate): These chemicals are of more concern because they have shown estrogenic activity in lab tests. Dr. Margret Schlumpf of the University of Zurich's Institute of Pharmacology and Toxicology says they have been shown to disrupt hormones, affecting the development of the brain (particularly the hypothalamo-pituitary-gonadal system) and reproductive organs in laboratory rats. Because people are exposed simply by eating fish (where benzophenone accumulates in the fat), using sunscreen containing these chemicals unduly increases the exposure. Based on her studies, Dr. Schlumpf advises people avoid products containing benzophenone and the related chemicals above.
? Parabens (butyl-, ethyl-, methyl-, and propyl-): Parabens may also mimic estrogen, but because they are common in sunscreens, avoiding them may prove difficult.
? Padimate-O and Parsol 1789 (2-ethylhexyl-4-dimethylaminobenzoic acid and avobenzone): These two chemicals have the potential to damage DNA when illuminated with sunlight. On the skin's surface, these chemicals do protect from UV damage; however, once absorbed into the skin, these same chemicals can prove destructive. Dr. Knowland's research indicates that Padimate-O and Parsol 1789 "are excited by the UV energy which they absorb and become reactive, acquiring the potential to attack cellular components, including DNA." Knowland cautions that "DNA damage inflicted by an excited sunscreen is much less capable of being repaired by naturally occurring repair mechanisms than the DNA damage inflicted by UV alone."
? Although insect repellents with sunscreen may seem like an easy option, Dr. Best recommends avoiding them because of the dangers of overexposure to DEET, which can cause eye and skin irritations, headaches, nausea, when the product is reapplied after swimming or exercise.
Choose Sun Blocks Zinc oxide, which lies on the skin without being absorbed, is completely safe. Unfortunately, its most common form is lifeguard white which can make it an unattractive choice. Dr. Kazutaka Hirakawa of Shizuoka University has shown that when injected into tumor cells to test its usefulness in fighting cancer, titanium dioxide (TiO2) has shown phototoxicity (or the capability to damage skin upon exposure to light), but as a sunscreen appears to be safe, based on what is known so far. Dr. Hirakawa explains that "titanium dioxide itself is an effective sunscreen and does not show phototoxicity in a normal condition as a sunscreen. A protective action of TiO2 for UV light may be much greater than its phototoxic effect on human skin." Most titanium dioxide used in sunscreens is coated with materials that reduce its photoactivity. Dr. Knowland says that according to current evidence titanium dioxide is much less likely than other chemical sunscreens to penetrate human skin. Note that on sunscreen labels companies rarely distinguish between sunscreens and sunblock, and instead use the term "sunscreen" for both. Look for zinc oxide or titanium dioxide as the active ingredient when choosing.
Biodegradable Sunscreens Not all sunscreens are biodegradable, however, and ones that are may still contain chemicals to avoid. Dr. Schlumpf warns that chemicals washed off with water are then put into the environment where they can negatively affect other animals. Lavera, Aubrey, Kiss My Face, and JASON Naturals all make biodegradable sunscreens, but check ingredients before purchasing any product.
Protective Clothing The right clothing can protect against the sun's harmful rays. Sunglasses and wide-brimmed hats are obvious choices, but it is equally important to consider the rest of your clothing. Claims of sun protectiveness factors, however, are not reliable here: Dana Best, M.D., a pediatrician at the Children's National Medical Center and member of the American Academy of Pediatrics Committee on Environmental Health, warns that "sun-protective clothing and fabrics are not regulated by any government agency." So consider these factors when choosing appropriate clothing (most important factors are listed first): weave (tighter is best), color (darker fabrics let less light through than lighter), weight (the heavier, the better) and stretch (stretch clothing loses UV protection as the item stretches out). If this has you imagining yourself in a black wool sweater in the middle of an August heat wave, fear not. You'll be well-protected wearing unbleached cotton or high-luster polyester or satiny silk, which reflect radiation. Clothes made from polyester crepe, bleached cotton or viscose offer little protection because they are transparent to UV rays. You can also consider investing in ultraviolet protection factor (UPF) clothing. Clothes with UPF, which is similar to SPF, are increasing with many lines emerging from Australia. Coolibar, the only clothing brand recommended by the Skin Cancer Foundation, offers fashions for men, women and children from clothing to hats and swimwear. All of Coolibar's clothing is made to maximize sun protection, with many pieces using microfibers containing titanium dioxide to diffuse 98% of UV rays. The Skin Cancer Foundation also endorses SunGuard, a laundry additive made by the company that makes Rit dyes. The product claims to block 96% of harmful rays, with the active ingredient being a blocking agent called Tinosorb. Ciba Specialty Chemicals, which manufactures Tinosorb, says that the sunscreen particles are too large to be absorbed through the skin, making the chemical relatively benign. Also, a 2001 study published in the journal Regulatory Toxicology and Pharmacology found that the chemical posed no risks of hormone disruption. SunGuard contains no fragrances or petrochemicals, but the product is not for children 2 years or under.
Proper Use of Sunscreen Dr. Knowland, like Dr. Chamberlain, warns against assuming that sunscreens allow us to remain in the sun without increasing our risk of skin cancer. The report "Sunscreens," published by the International Agency for Research on Cancer (a branch of the World Health Organization) in 2001 states that "sunscreens should not be used as a means of extending the duration of solar exposure, such as prolonging sunbathing." Instead, they are best used as protection against unavoidable exposure, for instance when engaged in sports such as golf or softball, which can take so long you're inevitably out during some of the strongest UV periods, and surfing, when wave conditions may sometimes be best during peak sun hours. And, Dr. Best notes, sunscreen should be used correctly:
? Cover all exposed skin liberally.
? Remember ears, backs of knees, feet and hands.
? Apply sunscreen BEFORE going outdoors.
? Use sunscreen even on cloudy days.
? Re-apply after swimming, sweating, and at least every two hours.
? If a child develops a reaction to a specific brand, try using a PABA-free brand or zinc oxide or titanium oxide.
Dr. Best also recommends that infants younger than 6 months be kept out of direct sunlight and dressed in "cool, comfortable clothing and wear hats with brims." She adds, "There is no evidence that suggests that use of sunscreen after 6 months is associated with any long-term harm. However, it is prudent to wash off sunscreen once the exposure period is over." And for those inevitable moments when you are caught outside without sunscreen and no shade in sight, don't panic. Ten to 15 minutes of sunshine three times a week is actually healthy?sunlight helps our body manufacture vitamin D, a vitamin associated with strong bones, a major factor in osteoporosis, and the reduced risk of breast, prostrate, and colon cancers. Studies have also linked vitamin D with mood improvement, endorphin release and libido function. Perhaps that's what John and Paul were thinking when they wrote, "I need to laugh and when the sun is out/I've got something I can laugh about."
Re: Lisa's Daily Fitness Tip