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Dr. Hausner’s Bio | Q&A Archive
Skin cancer; Squamous cell cancer; Basal cell cancer; Actinic keratosis; Nonmelanoma skin cancer
The best way to lower your risk of skin cancer is to protect your skin from the sun and UV light. That means avoiding excess sun exposure, especially in midday when the sun is strongest.
Wear sunscreen. The use of sunscreens is complex, and everyone should understand how and when to use them. Follow instructions closely and reapply as directed after swimming or sweating. The bottom line is not that people should avoid sunscreens or sunblocks, but that they should always use them in combination with other sun-protective measures.
Many parents are now taking effective steps to protect their children, although experts worry that they are relying too much on sunscreen and less on other protective measures.
The best way to prevent skin damage in any case is to avoid excessive sun exposure. The following are some specific guidelines:
Wear protective clothing, sunglasses, and a hat to shield your face from the sun's rays. Special clothing can block out UV rays. This clothing is rated using sun protection factor (SPF) or a system called the ultraviolet protection factor (UPF) index, with 50 UPF being the highest. (According to one study, this is a very reliable indicator of protection.) The clothing is expensive, however.
When choosing a sunscreen, look at the ingredients. Preparations that help block UV radiation are sometimes classified as sunscreens or sunblocks, according to the substances they contain. In general, sunscreens contain organic formulas and sunblocks inorganic formulas. However, the term sunblock is used less and less as sunscreens increasingly contain both kinds of ingredients:
Inexpensive products with the same ingredients work as well as expensive ones. The FDA continues to work toward improved use and label guidelines for manufacturers.
The safety and efficacy of combination sunscreen and insect repellant remains unclear. While suncreen should be re-applied frequently, insect repellant applied too often could pose toxicity.
Organic formulas and inorganic microfine oxides do not protect against visible light, which is a problem for people who have light-sensitive skin conditions, including actinic prurigo, porphyria, and chronic actinic dermatitis.
Calculating SPF. SPF is a ratio based on the amount of UVB radiation needed to turn sunscreen- or sunblock-treated skin red compared to non-treated skin. For instance, people who sunburn in 5 minutes and who want to stay in the sun for 150 minutes might use an SPF 30 sunscreen. The formula would be: 30 (the SPF number) times 5 (minutes to burn) = 150 minutes in the sun.
Protection offered by sunscreens may be classified as follows:
Although some sunscreens claim their SPF is higher than 30, the added protection at such higher levels is insignificant.
SPF Levels by Age Group. Although sunscreens are safe in most toddlers and children, they should not be the first and only lines of defense. All young children should be well-covered with clothing, sunglasses, and hats. Children should be kept out of the sun during peak sunlight periods. Do not use sunscreens on babies younger than 6 months without consulting a doctor.
Older children and adults (even those with darker skin) benefit from using SPFs of 15 and over. Some experts recommend that most people should use SPF 30 or higher on the face and 15 or higher on the body. Adults who burn easily instead of tanning and anyone with risk factors for skin cancer should use SPF 50+.
Timing and Amount of Application. Apply sunscreen or sunblock liberally as follows:
Possible Hazards of Sunscreens, Sun Avoidance, or Both. When used generously and appropriately, sunscreen products and sun avoidance help reduce the severity of many aging skin disorders, including squamous cell cancers. There are certain concerns, however. Sunscreens do not appear to protect against melanoma and some basal cell cancers. In fact, some studies have reported a higher association with sunscreen use and these skin malignancies, though not all studies report such negative results.
The reasons for this possible increased risk are unclear, though some theories include:
Chemoprevention is the use of a substance to prevent or reduce your risk of cancer. Certain drugs have been used to help block the development of skin cancers, including melanoma. These include:
Chemopreventive drugs under investigation that show promise for skin cancer include:
Antioxidants are chemicals or drugs that help prevent cell damage from unstable molecules called free radicals. Antioxidants promoted to protect the skin include vitamins C and E, and coenzyme Q10 (CoQ10).
There are wide claims about the benefits of antioxidants for wrinkles when used in skin creams. To date, only skin products containing vitamins E and C, and selenium have been shown to help reduce sun damage to the skin. However, most available brands contain very low concentrations of these antioxidants. In addition, the antioxidants are not well absorbed by the skin, so the effect may be short-term. Plus there is no evidence that they prevent skin cancer.
Warning: A wide range of herbal products may contribute to skin problems. Some Chinese herbal creams have been found to contain corticosteroids. Mercury or arsenic contaminants have been found in some Ayurvedic therapies. In addition, several oral herbal remedies used for medical or emotional conditions may produce irritation in reaction to sunlight (photosensitivity). They include, but are not limited to, St. John's wort, kava, and yohimbe.
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