skin care myths

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Skin Care Myths: Separating Fact from Fiction Vivianne C. Beyer, MD Dermatology

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Who doesn’t want to know the secrets behind beautiful looking skin? Dr. Beyer, Dermatologist for Springfield Clinic, reveals the truth about healthy skin care. So often, many people neglect to take care of their skin properly. Please join Dr. Beyer, dermatologist for Springfield Clinic as she discusses skin care myths and what you should and shouldn’t be putting on your skin.

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Page 1: Skin Care Myths

Skin Care Myths:Separating Fact from Fiction

Vivianne C. Beyer, MDDermatology

Page 2: Skin Care Myths

www.SpringfieldClinic.com/DoctorIsIn

Page 3: Skin Care Myths

Disclosures

• I have no conflicts of interest to declare

Page 4: Skin Care Myths

Objectives• Discuss common myths, misconceptions, old wives’ tales• Discuss the evidence that separates fact from fiction• The following topics will be discussed:

– Skin cancer and prevention– Tanning– Vitamin D controversies– Skin care and beauty tips– Acne myths

Page 5: Skin Care Myths

Your Skin: A Vital Organ• The largest organ• Regulates body temperature• Stores water and fat• Is a sensory organ• Prevents water loss and entry of bacteria

• It is essential to take care of this vital organ!

Page 6: Skin Care Myths

Myth # 1

• Skin cancer only happens in older people

Page 7: Skin Care Myths

Fact: – Melanoma is the most common form of cancer in

young adults 25-29 years old • Second most common form of cancer for 15-29 year-olds

– The incidence of nonmelanoma skin cancers, especially basal cell carcinoma, is rapidly rising in young adults

Source & photo: skincancer.org

Page 8: Skin Care Myths

Skin Cancer• Skin cancer is the most common form of cancer in the US• More than 3.5 million skin cancers are diagnosed annually

– There are more new cases of skin cancer each year than there are cancers of the breast, prostate, lung and colon combined

• One in five Americans will develop skin cancer in the course of a lifetime

Source: skincancer.org

Page 9: Skin Care Myths

Basal Cell Carcinoma• Basal cell carcinoma is the most

common form of skin cancer– Main risk factor is cumulative and

intense bursts of sun exposure– About 2.8 million cases are

diagnosed per year in the US – Rarely metastasize but can be locally

disfiguring/destructive

Photo: skincancer.org

Page 10: Skin Care Myths

Squamous Cell Carcinoma• The second most common form of skin cancer

– Main risk factor: cumulative UV exposure over the course of a lifetime– An estimated 700,000 cases of SCC are diagnosed each year in the US – Look like open sores, wart-like nodules, scaly red patches– Have higher rate of metastasis than BCC (5%)

Page 11: Skin Care Myths

Melanoma • One person dies of melanoma every 57 minutes

– About 76,000 cases of invasive melanoma are diagnosed every year in the United States

• More than 9,000 people died of melanoma in 2013 • Melanoma accounts for less than five percent of skin cancer cases, but the vast majority of

skin cancer deaths (75 percent)

• 1 in 50 men and women will be diagnosed with melanoma of the skin during their lifetime

Source: skincancer.org  

Page 12: Skin Care Myths

Myth # 2• Indoor tanning does not increase

your chance of developing skin cancer

Photo: skincancer.org

Page 13: Skin Care Myths

Tanning• Ultraviolet radiation (UVR) is a proven human carcinogen

• One indoor UV tanning session increases risk of developing :– squamous cell carcinoma by 67%– basal cell carcinoma by 29%– melanoma by 20% 

• 76% of melanoma cases among 18-to-29-year-olds are due to tanning bed use

• People who first use a tanning bed before age 35 increase their risk for melanoma by 75 percent 

  Source: skincancer.org

Page 14: Skin Care Myths

• “Whoa: Tanning beds cause more cancer than cigarettes!”

-Headline from msn.healthyliving.com

Page 15: Skin Care Myths

• Results from a study published in JAMA Dermatology in January 2014:– Roughly 450,000 cases of skin cancer each year are due to indoor tanning– 360,000 cases of lung cancer are secondary to smoking

– In the US, 35% of adults and 55% of college students have tanned– On an average day, more than one million Americans use tanning salons

Wehner MR, Chren M, Nameth D, et al. International Prevalence of Indoor Tanning: A Systematic Review and Meta-analysis. JAMA Dermatology. 2014 Jan 19

Page 16: Skin Care Myths

Myth # 3

• It is a good idea to get a “base tan” before a sunny vacation

Page 17: Skin Care Myths

There is no “healthy” tan• Any tan is a sign of sun damage• Base tan only offer SPF 3-4

– Will not protect against burning

Photo: skincancer.org

Page 18: Skin Care Myths

UV radiation facts• UVA light penetrates deeper and causes

photoaging (wrinkling, solar lentigines, large pores, blood vessels)– Also contributes to development of skin

cancer– Intensity is constant throughout the day

• UVB light causes sunburn– Strongest from 10AM to 2PM

• Tanning is induced by UVA (mostly) and UVB light

Source & photo: skincancer.org

Page 19: Skin Care Myths

Source: skincancer.org

Page 20: Skin Care Myths

Myth # 4

• You don’t need sunscreen on a cloudy day

Page 21: Skin Care Myths

Don’t learn this the hard way!• Clear skies: 100% of UV light reaches Earth’s surface• Scattered clouds: 89%• Broken clouds: 73%• Overcast: 31%

• UVA light is not affected much by cloud cover– In addition, 50% of exposure to UVA occurs in the shade

Jansen R., Wang S., Burnett M. et al. Photoprotection: Part I. Photoprotection by naturally occurring, physical, and systemic agents. J Amer Acad Derm.69(6):853.e1-853.e12.2013 Dec.

Page 22: Skin Care Myths

Myth # 5

• Sunscreen only needs to be reapplied after sweating or swimming

Page 23: Skin Care Myths

Reapply!

• Every 2 hours• After sweating, swimming, toweling off• Regardless of how high the SPF is

Page 24: Skin Care Myths

How sunscreen works• Chemical sunscreens absorb UV rays before they

affect the skin

• Physical sunscreens reflect UV light away from skin– zinc oxide and titanium dioxide

Photo: skincancer.org

Page 25: Skin Care Myths

Sunscreen Facts• SPF value refers only to protection gainst UVB (and small amount

UVA)• To achieve the full advertised SPF, must use 2 mg/cm2 (shot glass for

entire body)– 1 teaspoon for face/head/neck– 1 teaspoon to each arm– 2 teaspoons total to trunk– 2 teaspoons to each leg

• Most people only use 25-50% of required amount

Source: skincancer.org

Page 26: Skin Care Myths

Myth # 6

• Using a higher SPF sunscreen means I can stay out in the sun longer

Page 27: Skin Care Myths

Chart of Sunscreen Efficacy

•An SPF 15 sunscreen blocks 93% of UVB radiation • SPF 30 sunscreen blocks nearly 97% • SPF 50 blocks 98%

– No suncreen blocks 100% of UV rays

http://mycpss.com/sunscreen/spf-rating-system

Page 28: Skin Care Myths

Sunscreen Buying Tips• Look for broad spectrum (UVA/UVB protection)

– For UVA protection, look for one of the following ingredients: avobenzone, titanium dioxide, ecamsule, oxybenzone, and zinc oxide

• SPF 30• Water resistant• Do not use if past expiration date • Store in cool spaceSource: AAD.org

Page 29: Skin Care Myths

aad.org

Page 30: Skin Care Myths

Myth # 7

• Sunscreen causes Vitamin D deficiency

Page 31: Skin Care Myths

Facts about Vitamin D• Vitamin D is important for skeletal health

– Current evidence does not support its role in the prevention of breast cancer, colorectal cancer, heart disease and stroke

• Institute of Medicine, 2010• There are 3 sources of Vitamin D:

– Diet• Foods: fatty fish (salmon), cod liver oil, and fortified milk, cereal, and orange juice)

– Supplements– UVB radiation

Source: skincancer.org

Page 32: Skin Care Myths

Vitamin D Controversy• Scientific evidence has NOT shown that sunscreen use prevents

adequate vitamin D production

• Indoor tanning beds are primarily UVA, which does not increase Vitamin D production

• Vitamin D production reaches its maximum after 5 minutes in summer midday sun

Source: aad.org, skincancer.org

Page 33: Skin Care Myths

Vitamin D• Studies have shown that people with sun-seeking

behavior (Australian surfers) still have suboptimal Vitamin D levels (under 50nmol/l)

• There is a significant genetic influence on Vit. D levels

Photo: skincancer.org

Page 34: Skin Care Myths

Vitamin D Guidelines• 400 International Units (IU) for infants

under 12 months old• 600 IU for children and adults younger

than 70• 800 IU for those 70 and older

Source: AAD.org

Page 35: Skin Care Myths

Myth # 8

• Sunscreens cause cancer

Page 36: Skin Care Myths

Do Sunscreens Cause Cancer?• Oxybenzone, retinyl palmitate, and nanoparticles have come

under scrutiny – No studies have shown a cause and effect relationship

Source: skincancer.org

Page 37: Skin Care Myths

Myth # 9 • A product that combines sunscreen

and insect repellant makes sense

Photo: AAD.org

Page 38: Skin Care Myths

Buy 2 Separate Products• Combination products are problematic for a few reasons:

– 1) The sunscreen ingredient is less effective (for example, when combined with DEET)

– 2) The insect repellant is more toxic and more readily absorbed– 3) Application instructions differ for the 2 products

Source: skincancer.org

Page 39: Skin Care Myths

Myth # 10

• My makeup has sunscreen in it, so I do not need additional sunscreen

Page 40: Skin Care Myths

Makeup and Sun Exposure

• Facial foundations without sunscreen provide SPF of 2 to 6• Better to layer foundation after sunscreen

Page 41: Skin Care Myths

Myth # 11

• People with dark skin do not develop skin cancer

Page 42: Skin Care Myths

Photo: Billboard.com

Page 43: Skin Care Myths

Bob Marley– Acral lentiginous

melanoma• Was dismissed as a

soccer injury under his toenail

• Metastasized to his brain and caused his death at age 36

Source: skincancer.orgPhoto: Bolognia Dermatology, 2nd edition

Page 44: Skin Care Myths

Skin Cancer Affects Everyone• Dark-skinned patients who develop skin cancer have a higher mortality

– Why?• Delay in diagnosis• Melanomas more likely to appear in mouth, on palms/soles, or under nails

• So while skin cancer is much more common among lighter-skinned people, it tends to be more deadly among people of color

Source: skincancer.org

Page 45: Skin Care Myths

Myth # 12

• UV light does not go through windows

Page 46: Skin Care Myths

Unilateral DermatoheliosisJennifer R.S. Gordon, M.D., and Joaquin C. Brieva, M.D.N Engl J Med 2012; 366:e25April 19, 2012

Page 47: Skin Care Myths

Myth # 13

• Self tanners protect from burning

Page 48: Skin Care Myths

Not a True Tan!• Most self tanners contain the active ingredient

dihydroxyacetone (DHA), a sugar molecule that darkens the skin• Does not increase melanin pigment in skin, so MINIMAL

protection from UV light

Source: skincancer.org

Page 49: Skin Care Myths

Myth # 14

• Acne is caused by greasy foods and chocolate

Page 50: Skin Care Myths

Diet and Acne• Controversial• Recent studies have implicated:

– Skim milk– High glycemic index foods

Photo: skincancer.org

Page 51: Skin Care Myths

Myth # 15• Acne is due to dirty skin, so skin

must be scrubbed clean several times daily

Photo: aad.org

Page 52: Skin Care Myths

Skin Washing Tips• Overzealous washing can make acne worse!

– Use a gentle, alcohol-free cleanser – Use your fingertips to apply cleanser; avoid hot water – Do not scrub your skin – Rinse with lukewarm water; pat dry with a soft towel– Apply moisturizer if your skin is dry or itchy (oil-free)

• Even oily skin needs moisturizer– Limit washing to twice daily and after sweating

Source: aad.org

Page 53: Skin Care Myths

Myth # 16

• Only teenagers have acne

Page 54: Skin Care Myths

Acne Contributors• Hormone fluctuations• Stress (increased androgens)• Family history• Hair and skin care products • Certain medications • Certain medical conditions

Page 55: Skin Care Myths

Myth # 17 • Anti-aging products can erase all signs of aging

Photo: aad.org

Page 56: Skin Care Myths

Skin Care Products

• If it sound too good to be true, it probably is!• For a product to truly be anti-aging, it MUST contain UVA

and UVB protection

Page 57: Skin Care Myths

Anti-Aging Tips• Protect your skin from the sun every day • Avoid repetitive facial expressions

– Sleep on your back• Eat a healthy, well-balanced diet• Stop smoking, and drink less alcohol• Exercise • Cleanse your skin gently (twice daily and after sweating)• Avoid irritating skin care products• Be patient!!

aad.org

Page 58: Skin Care Myths

Source: skincancer.org

Page 59: Skin Care Myths

Myth # 18

• When it comes to skin care products, “you get what you pay for”

Page 60: Skin Care Myths

Not True!

• More affordable drugstore products often work just as well, if not better than expensive “luxury” brands– Often paying for package, smell, feel of product- but not

active ingredient and efficacy

Page 61: Skin Care Myths

Budget Skin Care• Sunscreen, sunscreen, sunscreen!• Apply moisturizer to damp skin to lock in moisture• Petroleum jelly is a great moisturizer for rough, cracked skin• Don’t overdo it• Consider a moisturizer WITH sunscreen • Look for key ingredients

Page 62: Skin Care Myths

Ingredients• Look for products with Vitamins A, C, or E

– Antioxidants- prevent formation of free radicals that can lead to skin aging and skin cancers

– Vitamins C and E can decrease sun damage and improve skin texture

– Vitamin A derivatives (retinoids)• soften fine lines and correct uneven skin tone

Source: AAD.org

Page 63: Skin Care Myths

Other Ingredients

• Alpha hydroxy acids– Glycolic acid

• For dark spots: hydroquinone, retinol, kojic acid, soy, niacinamide, ellagic acid, lignin peroxidase, arbutin, licorice

Source: aad.org

Page 64: Skin Care Myths

Take Your Vitamins!• Vitamins A, B, C, D, E, and K• Essential fatty acids (alpha-linolenic and linoleic acids)• Folic acid • Zinc and selenium• Biotin for hair and nails

Source: aad.org

Page 65: Skin Care Myths

Myth # 19• Cocoa butter prevents stretch marks

Page 66: Skin Care Myths

Sadly, no

• Genetics play a huge role• Hormonal changes during puberty and pregnancy

contribute

Page 67: Skin Care Myths

Myth # 20

• Smoking is not a major cause of wrinkles

Page 68: Skin Care Myths

This photo says it all…

Facial changes caused by smoking: a comparison between smoking and nonsmoking identical twins. Okada HC1, Alleyne B, Varghai K, Kinder K, Guyuron B. Plast Reconstr Surg. 2013 Nov;132(5):1085-92.

Page 69: Skin Care Myths

Myth # 21

• If the label says “all natural” or “botanical” ingredients, it must be good for my skin

Page 70: Skin Care Myths

Not Always True

• Heavily fragranced products can be very irritating• Allergies can develop over time• “Natural” or “botanical” does NOT mean hypoallergenic• “Unscented” is not the same as “Fragrance-Free”

Page 71: Skin Care Myths

Conclusions

• Sunscreen, Sunscreen, Sunscreen!• You do not need to break the bank to take care of your

skin• Don’t believe everything you hear• Take care of yourself and your skin will thank you• See you dermatologist for any concerning lesions and

annually for skin exams

Page 72: Skin Care Myths

References

• Skincancer.org• AAD.org• Springfieldclinic.com• Bolognia et al. textbook of Dermatology 2nd edition• Journal of the American Academy of Dermatology• JAMA Dermatology• msn.healthyliving.com

Page 73: Skin Care Myths

Thank you!

Questions?