Hi all

This is the first newsletter using our new template. Please let me know what you think.

I have just returned from the Skin Cancer conference and heard a great lecture by Dr Kerryn Greive from Ego Pharmaceuticals which I have summarised below:  

Sunscreen (SS) update - what's good and bad with sunscreen

Does SS stop skin cancer?

Increased exposure to sun does appear to be a risk factor for some types of skin cancer:

Solar Keratoes (sun spots):

Large studies have shown that regular use of SS does prevent the development of solar keratoses

Squamous cell carcinoma:

Regular use of SS does reduce the risk of developing SCC. This effect occurs even if SS use starts later in life

Basal Cell carcinoma:

Childhood sun exposure is the most important risk factor for CC. SS does reduce BCC development but studies have only been fairly short (4-5 years) and longer studies are required as there is a very long latent period with BCC after sun-exposure in childhood

Melanoma:

Some reports may show an increased risk of melanoma but a recent meta analysis shows both no increased and no reduced risk with SS use. But circumstantial evidence including evidence from solaria use and childhood sun exposure and sun burn does seem to indicate that exposure to UV rays is a risk factor for melanoma. The amount of naevi on the skin is a strong marker for melanoma and SS in kids has been shown to reduce the development of naevi and may therefore reduce the incidence of melanoma

So the answer is YES: SS reduces skin cancer  

What harm can SS do?

Nanoparticles:

There is some discussion whether nanoparticles in nanonised Zinc and Titanium are a health risk. Zinc and Titanium have been used in Australia for 15 years and longer overseas and there is currently absolutely no evidence for risk but there certainly is a large benefit

Chemical SS:

There has been some discussion about the effects of absorbed chemicals that are used in SS - there is no evidence of any harmful effects - SS have been used for over 50yrs. Theoretocally some compunds can penetrate the skin but this would only occur in very small amounts which would be metabolised quickly and excreted. Some people are concened about the estrogenic effects of some of these chemicals especially in young growing males - there have been some in vitro and animal studies showing an effect but this is thought to be very insignificant in humans compared to other sources of oestrogenic effects eg soya milk

Vitamin D:

This is now know to prevent lots of diseases and the sun producing UVB through the skin surface  makes Vitamin D. Studies in high risk individuals have shown that using SS does not cause Vitamin D deficiency nor osteoporosis. The bottom line is that skin cancer avoidance strategies and VItD nutrition are not contradictory The greatest harm a ss has is the harm of not using it. There is no evidence it is linked to any disease.

SS failures are not due to ss generally but are due to not using enough, not reapplying often enough or not reapplying after swimming.

Which SS is best?

The answer to this is essentially and SS the patient/customer is likely to use correctly.Public education is important.Sun protection by adolescence has declined over last 10 yrs due to lack of immediacy.In a 2005 and 04 summer study over a single weekend 18 % of adults reported getting sunburnt and 25 % of adolescents reported getting sunburnt.

The correct amnt of  SS to use is 2 mg/ cm2 which equates to 30-40ml to cover an adults body. This means that if one buys 125ml bottle the entire bottle should be used for 1 day on the beach per person.Approx 5ml or 1 teaspooon should be used on the face and neck. Most people do not use enough ss and use approx. 0.5-1.3mg per cm2. This dramatically reduces the effectiveness of the ss.

 SPF30+ broad spectrum is best but essentially any product the patient will use is good. eg. young males would prefer an alcohol spray or older females will prefer a ss with anti-ageing benefits and a moisturiser. 

What's new in sunscreen?

1. Dual protection anti UVA and UVB which means that a single chemical can do what multiple chemicals previously did.

2. Nicotinamide/niacin/vitB3. This is added to newer SSs.Helps reduce:damage caused by sun, improves skin barrier properties (helps sensitiive skin), helps oiliness, helps appearance of skin.

Finally:

Remember: Consumers can't be told the real SPF of SS but dr's can and therefore can recommend real higher SPF  but you need to get the real product informatiom from the rep.