The controversy over sunlight benefit versus danger rumbles on, with new data on both sides of the question. From the American Academy of Dermatology meeting, two very different pieces of information stand out favoring cautious sunlight protection. A study recently reported showing an increase in the incidence of melanoma for people who had used tanning beds before the age of 35. Early damage from excessive light exposure shows up later.
Other studies reported showed that exposure to two times the MED (the minimal amount of light necessary to cause redness of the skin) caused 100 times the amount of messenger RNA for collagenase (the enzyme which breaks down collagen in skin.) Collagen is the fibrous substance which gives the skin its shape and strength.
Breakdown of collagen is associated with aging and wrinkles. One half the amount of sunlight necessary to cause redness increased the collagenase activity fourfold.
Furthermore, even one tenth the amount of sunlight exposure necessary to cause redness caused some increase in collagenase activity.
All of the data which was presented demonstrated the various aspects of the process of sun damage leading to aging, at the molecular level. The speaker is a respected authority on the science of skin aging, so the data appears valid. I have reviewed other studies in the past which show similar findings, which also lends credibility to his argument. I will discuss the benefits of sunlight and vitamin D production in later blogs, which inform the other side of this
controversy. If you sign up for my monthly newsletter, I will email you the top five tips to minimize the effects of solar damage.
Regardless of controversy, sun exposure is a double edged sword with both benefits and dangers. Living a full life exposes us to both those benefits and dangers; finding the right balance and using protective supplements and
topical antioxidants is the best we can do.To your health,
I’ve discussed measures for preventing sun damage and skin cancer previously in my blog. As I’ve said, as a holistic dermatologist, I believe prevention really is the best medicine.
So now let’s discuss exactly what happens when sun hits the skin. Packets of light energy known as “photons” hit chemical structures in your cells and activate them so that they transform chemically, often causing them to combine with chemicals next to them.
This includes causing chemical changes in the cells’ DNA, which can eventually change cells into to skin cancer.
When you apply a sunscreen, the energy from the sun is absorbed by that sunscreen chemical, changed, and then released as a hopefully less harmful energy. Sometimes it comes out as a different wavelength of light.
If the effects of that energy can be safely spread around and absorbed by the skin chemicals, there is little harm done.
LINES OF DEFENSE
Now think of it like a football game. The football represents the packet of light energy from the sun. When the team hikes the ball, the opposing team attacks, the front line acts as a barrier, and the football is passed back and forth by the team in the rear to keep it from being attacked.
The more the team behind the line passes it back and forth, the less likely a player with it will be attacked. We have a number of antioxidants in our skin both naturally present and from our diets and what we apply. If they are sufficient, balanced, and work well together like good linebackers, none of the team members will be attacked.
Antioxidants will help protect us to a degree, and work together with other forms of protection including sunscreens. One such external anti-oxidant is resveratrol, made from grape seeds and other plants. It can be ingested or applied to the skin or both, and there is evidence that it reduces sunburn cells and other measurements of sun damage in both mice and men.
There is even a patent for the use of resveratrol as a sun protectant, although one could argue that such use is apparent rather than unapparent, as required for being patentable in the first place.
Other anti-oxidants include vitamin C, Lipoic acid, glutathione, other biovflavinoids, carotinoids, and selenium. It is worthwhile to include these in your diet.
To your health,
-Dr. Alan M. Dattner, MD
As always, the content of this blog is for information and education purposes only, and should not be used to diagnose or treat illness; please see your physician for care.
We have an opportunity, to champion the health of the skin of the planet on which we live. The health of that layer affects all life on Earth, and subsequently the health of humans.
Many parallels can be drawn between the health of our environmental “skin” and the skin of the individual. By drawing on these parallels, we can make it easier to have a clear overview of environmental issues that affect the health of the human body and the skin in particular.
For example, we can look at how a “chemical burn” to the Ozone layer of the earth results in more danger of a sunburn to various layers of the skin. Exploring the causes of the “chemical burn” and the different ways to prevent it, educating ourselves and the public, and engaging everyone in finding a win-win solution to the problem makes this into an exciting game.
The goal is to improve health and well-being by improving conditions in the surface of the earth in which we live.
Have dreams of looking youthful well into middle age? Want to age gracefully and naturally? Well, hold onto your hat! The number one cause of premature aging of the skin is sun damage. As a holistic dermatologist, my first approach is always prevention.
From childhood, one should be protecting the skin from excessive sun. Unfortunately, the ozone layer’s natural sun protection has degraded due to an excess of carbon monoxide and chlorofluorocarbons–a sad environmental problem related to the “skin” of the earth.
Fortunately, there are still ways we can enjoy the sun and protect ourselves from wrinkles, skin cancer, and the release of free-radicals into the body.
avoid the sun at its strongest hours, 11 am to 3 pm, by staying indoors
when outside, wear light colored protective clothes covering limbs, wide-brimmed hats, and sunglasses for the eyes
folks who burn easily should use high SPF clothing, specifically made to protect from the sun
apply high-factor sunscreen (I like non-nano zinc oxide and titanium best) to the face, ears, exposed parts of the neck, and chest
re-apply sunscreen every two hours and again after going in the water
never stay in the sun long enough to burn (skin becoming pink is a sure sign)
take ample doses of anti-oxidants A, C, & E, and bioflavinoids, during sun exposure to help the body recover
Do spend up to ten minutes per day in the sun several times a week however to make sure your body makes enough vitamin D, and enjoy the summer!
If you’re looking for a way to balance out some of the negative effects of environmental toxins, a good way is to start eating more vegetables in the broccoli family. This includes cabbage, cauliflower, collard greens, kale, arugula, and brussels sprouts among others.
Recent studies have demonstrated that broccoli’s chemical composition could help reduce the risk of cancer and, I believe, acne as well, because of the neutralizing effect these chemicals have on acne-triggering estrogen.
Broccoli is rich in vitamin C, carotenoids (vitamin A-like substances), fiber, calcium, and folate as well as phytochemicals that may have anti-cancer properties.
For example, broccoli contains several compounds called isothiocyanates, including sulforaphane and indole-3-carbinol (I3C), which are being explored for possible anti-cancer agents. Some studies have also suggested they
may alter body estrogen levels, which might affect breast cancer risk. Some studies have shown these substances may act as antioxidants and may boost the body’s detoxifying enzymes.
Another chemical in broccoli called indole-3-carbinol (I3C), seems to alter estrogen levels and may also raise levels of protective enzymes in the body. Lab studies have shown it may slow or stop the growth of breast, prostate, and other cancer cell lines.
Some early studies in animals have shown similar results. Small studies in humans have found it may prevent the development of precancerous growths in the cervix, as well as growths (papillomas) in the throat. While more, larger studies need to be done to confirm and expand our knowledge of the benefits, I recommend that people eat more broccoli and foods in the brassicaceae family for good health.
Vitamin D is back in the news, with recent studies showing that fewer people need Vitamin D supplements, according to new FDA guidelnes. I disagree with these new guidelines because they’re based on a study I find sorely lacking:
For example, there was unfortunately no examination of Vitamin D and bone health in this study. Also, the effect of higher vitamin D levels on boosting immunity in such a way as to counteract autoimmune disorders was neither mentioned, nor investigated.
The studies also purport that lower levels of Vitamin D did not affect overall mortality in a totally mixed and kidney disease population. They even mention that Vitamin D was associated with kidney disease and some cancers.
Such studies with no regard for the complex underlying way a supplement acts on the human body (and specifically immune system and bones) can only serve to confuse physicians and the general population. Until I see careful studies of people with different illnesses, and studies that contradict what has been shown in the immune system, I will continue to consider the new lower vitamin D levels recommended as insufficient for certain individuals with disorders of the immune system.
What’s worse, this kind of study and the headline stories about the supposed conclusion of this meta-analysis in the press could harm hundreds of thousands of people who actually do need more vitamin D because of the condition they have or the condition of their immune system. For example, another recent study showed that people with pneumonia had better survival if they had higher Vitamin D levels, and that the benefits depend on the type of Vitamin D taken (Vitamin D3 possibly being superior to D2).
We will keep you up to date exploring the many aspects emerging on this important vitamin, Vitamin D, as it relates to the skin and the immune system.
I just read a study evaluating the use of various vitamins and supplements and likelihood of getting skin cancer (squamous cell carcinoma of the skin) and wanted to let you know the exciting news about the results. The study was performed at the Kaiser Permenente Hospitals in San Francisco (where else?)
Here’s the scientific part: four hundred fifteen patients with squamous cell carcinoma (SCC) were age-matched with an equal number without cancer. They were questioned about their use of Vitamins A, C, D, and E, and grape seed extract. Grape seed extract (not to be confused with grapefruit seed extract) contains powerful anti-oxidants including “proanthocyanidins”. These neutralize “free radicals” generated by sunlight, and help prevent sun damage to the DNA that leads to cancer.
What it means for you: The study showed that there was a significant association between use of grape seed extract and reduced development of skin cancer. Multivitamin use was associated with a borderline significant reduction in SCC’s. Vitamins A, C, E, and D were not associated with any change in likelihood of developing SCC. The only unsettling variable in the study was the increased prevalence of blond and red hair in the SCC group (unsettling because this means that people with lighter complexions seemed to have more incidence of cancer.)
Although there were some potential faults in the study design, it does point to the potential protective effects of powerful antioxidants like grape seed extract in protecting against squamous cell cancer of the skin. It does not remove the need for sun protection, but may offer protective additional protection.
Prevention of sunburn may make be wise for your nest egg, not just for your skin. Melanoma, one of the fastest increasing forms of potentially deadly cancer, is related to sun damage to the skin. Once it goes beyond the local stage and spreads, the chances of survival are in the order of 15%.
The good news is that various genetic subtypes of melanoma are being identified, and targeted by specific drugs. More good news is that a new “biologic” drug has been developed by Genetech named Zelboraf which blocks a specific mutated protein found in certain melanoma known as BRAF 600 V. This protein can be identified by a mutation test to see if Zelboraf will be effective in their melanoma.
The bad news is that this drug is slated to cost $9800/month. Another related drug for late-stage melanoma recently approve named Yervoy costs $120,000/treatment course. If you think it will be easy to get your insurance to cover such treatment, just try to get them to pay for an out of network visit or lab test.
Especially for those with pale skin, lots of moles, and/or a family history of melanoma, this cost really questions the wisdom of overworking oneself to save money to reward oneself with sunburn vacations and weekends getting in the sun. Your wisest path, and most affordable path, is one of reasonable sun protection with hats and clothing as preventative investment. And don’t forget to get any suspicious lesions checked.To your health,
I recently read a report in March in the journal Drugs in Dermatology about a man with metastatic melanoma (spreading skin cancer,) who had a partial regression of internal melanoma spreading. It occurred after applying a cream to the skin that was prescribed for lesser skin cancers. The cream is Imiquimod, and was designed to stimulate the immune system to react against pre-cancers, warts, and occasionally, as in this patient, for basal cell carcinomas (the most common kind of skin cancer)
It works by stimulating a primitive form of the immune system, called “Toll-Like Receptors” (TLRs), which are a very primitive form division of the immune system that are present not only in other mammals, but also in other species including insects. Imiquimod works by stimulating a TLR called TLR 7, which then signals other branches of the immune system to join the battle and attack and destroy the tumor.
Interestingly, this patient could not tolerate other treatment he had been given, so, on his own, he used the Imiquimod prescribed to him for a lesser skin cancer on the superficial metastatic lesions on his tummy skin, and the internal melanoma in his liver went away completely, and other internal melanomas got smaller.
The point of this comment is not to suggest Imiqimod for melanoma treatment; it may only work in certain cases, but rather to show that the right kind of stimulation of the immune system can make a great difference in reducing the size of potentially deadly cancers like metastatic melanoma.
The literature contains numerous reports and case reports of melanoma getting smaller or disappearing with other immune stimulants including chemicals like dinitrochlorobenzene (DNCB) and diphencyprone, and microbial stimulants such as Bacillus of Calmette and Guerin (BCG).
Not everyone responds to any given stimulus, so the challenge is to identify what the most likely stimulus is to get a melanoma rejected, and what else is necessary to get someone’s immune system to be strong enough to fight it off.
These are questions that I have been wrestling with in laboratories from Sloane Kettering to the National Cancer Institute over the past 5 decades.