Don’t Fall for These Skin Myths

Don’t fall for these skin myths

Think you know a lot about skin and skin care? You might be surprised at how much “common knowledge” about how to keep your skin clear and healthy is simply not true. Here, we debunk 10 common myths about skin.

1. The right skin cream can keep your skin looking young.
There are hundreds of skin treatments that claim to help you look younger or slow the aging process. For reducing wrinkles, the topical treatment with the best evidence behind it is retinoic acid (as in Retin-A). Many over-the-counter products contain retinoic acid as well, but it’s difficult to say if one is better than another. But the best ways to keep wrinkles at bay are using sunscreen and not smoking.

2. Antibacterial soap is best for keeping your skin clean.
Skin normally has bacteria on it. It’s impossible to keep your skin completely free of bacteria for any amount of time. In fact, many experts are concerned that the use of antibacterial soap could lead to more antibiotic-resistant bacteria. Antibacterial soap is not necessary for everyday use. Regular soap is fine. Thorough and consistent hand-washing, not antibacterial soap, is what helps prevent the spread of infection.

3. Eating chocolate or oily foods causes oily skin and acne.
The truth is that an oily substance called sebum causes acne. It’s made and secreted by the skin. In fact, there’s no evidence that any specific food causes acne.

4. Tanning is bad for you.
Spending an excessive amount of time in the sun or in a tanning booth can increase skin cancer risk, especially if sunscreen is not used. Skin cancer risk is correlated with total lifetime sun exposure and frequency of sunburns. Excessive tanning can also damage skin, causing it to wrinkle and age prematurely. But developing a light or gradual tan through repeated, but careful, sun exposure isn’t dangerous. As long as you’re taking precautions — such as using a sunscreen of at least SPF 30, applying it thoroughly and reapplying when necessary, and avoiding peak sun exposure times — a light tan with no burning isn’t a warning sign.

5. Tanning is good for you.
People often associate a dark tan with the glow of good health. But there’s no evidence that tanned people are healthier than paler people. Sun exposure does have a health benefit, though. Sunlight activates vitamin D in the skin. Vitamin D helps keep bones strong, and may also lower the risk of certain cancers and boost immune function. Depending on how much vitamin D you’re getting in your diet, a lack of sun exposure could increase your risk of vitamin D deficiency.

6. The higher the SPF of your sunscreen, the better.
Above a certain level, a higher sun protection factor (SPF) has little added benefit compared with a lower SPF. Experts generally recommend using sunscreen with an SPF of at least 30, which blocks out 97% of UVB radiation. It may be worth a higher SPF if you’re planning to be outside for more than two to three hours, especially during hours of peak sun exposure (10 a.m. to 2 p.m.). But in most circumstances, a higher SPF may not be worth the extra cost.

7. A scar that is barely noticeable is the mark of a good surgeon.
The true skill of a surgeon is demonstrated by what he or she does between making and closing the incision. While surgeons routinely pay more attention to incisions on the face (using thinner suture, making stitches closer together, or avoiding the use of sutures altogether if possible), the appearance of a scar tells you little about the skill of your surgeon.

8. Vitamin E will make scars fade.
There’s little evidence to support this claim. Talk to your surgeon or dermatologist if you have concerns about the appearance of a scar. There are many options for improving the appearance of scars, including laser treatments.

9. Crossing your legs causes varicose veins.
There are a number of risk factors for varicose veins, but crossing your legs is not one of them. Heredity is one of the most important — an estimated 80% of people with varicose veins have a parent with the same condition. Other things that make a person prone to varicose veins include smoking, inactivity, high blood pressure, pregnancy, obesity, and having a job that requires prolonged standing. If you already have varicose veins, elevating your legs and using compression stockings may be helpful. But keeping your legs “uncrossed” won’t prevent or improve the condition.

10. Scalp massage can prevent baldness.
There’s simply no evidence that scalp massage prevents baldness, tempting as it is to believe.
If you see something unusual on your skin or have concerns about how to keep your skin healthy, talk to your doctor or dermatologist. And if you hear someone repeating these skin myths, you can set them straight.

My Take: If you see something unusual on your skin or have concerns about how to keep your skin healthy, talk to your doctor or dermatologist. And if you hear someone repeating these skin myths, you can set them straight.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: Harvard Medical School HealthBeat 13 November 2014

Bob Marley’s Skin Cancer Type: Not Caused by Sun

What You Need to Know: Acral melanomas, the rare type of skin cancer that caused musician Bob Marley’s death, are genetically distinct from other types of skin cancer. Acral melanoma most often affects the palms of the hands, soles of the feet, nail-beds and other hairless parts of the skin. Unlike other more common types of melanoma, it’s not caused by UV damage from the sun. Acral melanomas, the rare type of skin cancer that caused musician Bob Marley’s death, are genetically distinct from other types of skin cancer.

What’s New: Cancer Research UK scientists have discovered that acral melanomas — the rare type of skin cancer that caused reggae musician Bob Marley’s death — are genetically distinct from other more common types of skin cancer.

Background: Acral melanoma most often affects the palms of the hands, soles of the feet, nail-beds and other hairless parts of the skin. Unlike other more common types of melanoma, it’s not caused by UV damage from the sun.

Research: The team, from the Cancer Research UK Manchester Institute at The University of Manchester, sequenced the tumours of five patients with acral melanoma and combined this with data from three other patients. They then compared the pattern of genetic faults found in these eight tumours with that of more common types of skin cancer.

This revealed that the type of DNA damage found in acral melanoma is very different from other types of skin cancer. For example in acral melanomas, it was much more common to find large chunks of the DNA that had broken off and reattached elsewhere, as opposed to the smaller DNA changes typically found in more common types of skin cancer.

Study leader Professor Richard Marais, director of the Cancer Research UK Manchester Institute, at The University of Manchester, said: “Too much UV radiation from the sun or sunbeds can lead to a build-up of DNA damage that increases skin cancer risk. But acral skin cancer is different because the gene faults that drive it aren’t caused by UV damage. Pinpointing these faults is a major step towards understanding what causes this unique form of cancer, and how it can best be treated.”

Nell Barrie, senior science information manager at Cancer Research UK, said: “We hope that understanding the faults that drive acral melanoma will unlock better ways of treating this rare yet aggressive type of skin cancer. Our scientists are striving to improve survival for all cancer patients, including those with rarer forms of the disease.
“And this is why skin cancer will be a key research focus for the Manchester Cancer Research Centre.”

My Take: Not all skin cancer is linked to sun exposure. Still, most skin cancer is associated with solar exposure. So don’t forget to take reasonable precautions, including the use of sunscreen, hats and other protective clothing, and limiting exposure to the sun. No sunburns! I’m Dr. Michael Hunter, and I am off to get just a bit of sun today.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

References

  • Cancer Research UK. “Scientists learn more about rare skin cancer that killed Bob Marley.” ScienceDaily. ScienceDaily, 20 August 2014. <www.sciencedaily.com/releases/2014/08/140820123209.htm>.
  • Simon J. Furney, Samra Turajlic, Gordon Stamp, J. Meirion Thomas, Andrew Hayes, Dirk Strauss, Mike Gavrielides, Wei Xing, Martin Gore, James Larkin, Richard Marais. The mutational burden of acral melanoma revealed by whole-genome sequencing and comparative analysis. Pigment Cell & Melanoma Research, 2014; DOI: 10.1111/pcmr.12279

 

Rare skin cancer on palms, soles more likely to come back compared to other melanomas

melanoma mole

What You Need to Know: A rare type of melanoma (lentiginous) that disproportionately attacks the palms and soles and under the nails of Asians, African-Americans, and Hispanics, who all generally have darker skins, and is not caused by sun exposure, is almost twice as likely to recur than other similar types of skin cancer, according to results of a study in 244 patients.

The finding about acral lentiginous melanoma, as the potentially deadly cancer is known, is part of a study to be presented May 31 by researchers at the Perlmutter Cancer Center of NYU Langone at the annual meeting of the American Society of Clinical Oncology in Chicago.

Background: According to the NYU Langone researchers, acral melanoma is the form of cancer that in 1981 killed Jamaican reggae musician Bob Marley, whose malignancy developed under his toenail. Unusual for melanoma, the lentiginous type does not favor the fair-skinned and most commonly occurs on the palms of the hands and soles of the feet and under nails.

The Study: For the study, believed to be the first analysis of acral melanoma recurrence patterns, researchers checked tissue samples from 244 melanoma patients at NYU Langone whose disease was tracked from 2002 to 2012. Sixty-four patients had acral melanoma, and each was compared to three others who had a different form of melanoma but were of similar age, gender, ethnic origin, and severity stage of skin cancer. All patients had volunteered to share their health information as part of a cancer tissue database known as the Interdisciplinary Melanoma Cooperative Group, and all had their melanomas treated according to standard surgical guidelines of the National Comprehensive Cancer Network.

Results: Acral melanoma was more likely to come back in the same spot or another nearby part of the body than other melanoma tumors, at 49 percent and 30 percent, respectively. Survival rates for acral melanoma patients over the course of the study decade were also half those of patients with non-acral melanomas.

“Physicians and their patients need to recognize acral melanomas as a potentially dangerous, aggressive, and recurring form of skin cancer, especially in minorities with dark skin,” says study senior investigator Jennifer Stein, MD, PhD, an assistant professor at NYU Langone. “Our study results document that people with acral melanomas are more likely to have recurrences in the skin surrounding their original malignancy.”

She adds: “People concerned about persistent, growing lesions on their hands or feet need to consult their physician and be on guard for this type of skin cancer, which is estimated to account for 1 percent to 2 percent of all melanomas.”

Among the study’s other key findings was that acral melanoma tumors smaller than 2 millimeters in thickness or diameter, even after removal, were more aggressive malignancies, and far more likely to recur (28 percent of the time) than similarly sized tumors in all other kinds of skin cancer (10 percent). The recurrence rate, they note, for larger-sized acral melanomas was 64 percent, while larger, non-acral melanomas came back 47 percent of the time.

Study lead investigator and NYU Langone research fellow Priyanka Gumaste, BA, says the findings also offer evidence that current surgical guidelines about the size of surgical margins — or safety buffers of additionally removed skin immediately surrounding the tumor — need to be re-examined.

“The high recurrence rate among small acral melanoma tumors warrants further investigation,” says Gumaste, who is also a medical student at Rutgers University in New Jersey. “Our results raise the question of whether surgical guidelines for removing melanomas need to be different for acral melanomas, or even type-specific to small and large melanoma tumors,” she adds.

Dr. Stein cautions that revising surgical guidelines to potentially widen excised skin margins is “not a matter to be taken lightly,” as the hands and feet are particularly sensitive areas of the body, where “every effort must be made to remove all tumor cells without taking unnecessary amounts of skin, and reducing the potential for complications, such as risk of infection and pain associated with surgery.”

Dr. Stein says genetic mutations are likely behind the high acral recurrence rates, with cancer-triggering mutations activating tumor growth in a much larger area than previously thought. Ms. Gumaste says any revisions to guidelines will likely require a multicenter randomized trial in which some patients have larger amounts of tissue around tumors removed to see if this makes a difference in recurrence patterns.

I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Sunscreen Tips

beach sun summer ocean sea

SPF 30 is the new 15

  • SPF 15 blocks 93% of UVB rays
  • SPF 30 blocks 97% and SPF 50 blocks 98%.

Doctors now typically recommend at least SPF 30 — at least being the key words. If you have a family history of skin cancer or are vacationing in a tropical spot (where the sun is especially intense), go for 50 or even 70. No sunscreen provides 100% protection. So to be safe as possible, you still need to reapply every two hours and after a swim, even if you used the water-resistant kind, says Dr. Joshua Zeichner, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. And remember:

  • Sunscreen becomes less effective about three years after you open the container.
  • Check labels for the term broad-spectrum: The sunscreen provides protection against both UVA (wrinkle- and cancer-causing) and UVB (burning) rays. So if you’re shopping and there’s no broad-spectrum mention, check the ingredients for zinc or avobenzone, the only two that provide top-notch UVA coverage.

Layer it on
Think you apply enough? Almost no one does.

“Several big studies show that most people rub in only about a fourth of what’s needed to reach the labeled SPF — it’s faster and easier to put on just a bit,” notes Dr. Jeffrey Dover, clinical associate professor of dermatology at Yale University.

Instead of that old advice to use a shot glass-size dose, all our experts recommend applying two coats. Squeeze a line of lotion down your arms and legs and rub in, then do it again. Ditto for spray formulas: hold the nozzle close to your skin and spray, moving slowly up and down until you see a sheen, then go back over the area.

For your face, apply a pea-size drop to each cheek, your forehead and your chin, then smear in. Repeat!

Don’t forget your nose
It’s the number one sunburn-spot, dermatologists say.

“People apply sunscreen to their face, but either skip or speed over their nose — especially if they wear glasses, because they don’t want to take them off,” Dr. Steven Wang, director of dermatologic surgery and dermatology at Memorial Sloan-Kettering Cancer Center says. Dr. Ronald Moy, a dermatologist and spokesperson for the Skin Cancer Foundation. adds, “80% of the skin cancers I remove are on the nose.”

Other commonly missed areas include the feet, hair part, ears and chest, as well as the backs of hands and legs. Use a sunscreen stick to spot-apply.

Get antioxidant insurance
Since rays can still get through sunscreen, companies are now including antioxidants such as vitamins C and E and green tea to help mitigate damage.
If you don’t want to bother applying a serum that contains them beneath your moisturizer or sunscreen (Wang’s first choice), try a souped-up SPF pick.
Realize that sunscreen is only one part of a sun-smart plan

“The hierarchy of sun protection should be avoidance first, then seek shade and wear a wide-brim hat and protective clothing, then use sunscreen — but most people have that sequence backward,” Wang points out.

Consider hitting the beach or pool in the morning instead of midday (when sun is strongest), and bring an umbrella and a tightly woven long-sleeve shirt.

Know that it’s never too late to start safe habits
So you baked in the sun as a teen with little or no sunscreen. While regular tanning or getting several bad burns when you’re young raises your risk of skin cancer, Moy says, what’s critical is that you put on sunscreen these days.

“Since skin’s ability to repair itself decreases with age, your risk is even greater if you burn now.”

Good thing you’re using it!

I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: Health.com by Beth James (updated 23 June 2014)

Alcohol and Skin Melanoma

melanoma mole

What You Need to Know: Alcohol intake may increase sunburn severity, a major risk factor for cutaneous melanoma (CM). Several epidemiological studies have investigated the relation between alcohol consumption and CM, but the evidence is inconsistent. The current study combines studies (meta-analysis) to provide some clarity: Alcohol consumption is positively associated to the risk of skin melanoma.

Details, details: The present meta-analysis included 16 studies (14 case-control and 2 cohort investigations) with a total of 6,251 CM cases. The pooled relative risk (RR) for any alcohol drinking compared with non/occasional drinking was 1.20 (95% confidence interval (CI), 1.06-1.37). This means that the risk for a drinker is 1.2x greater than that of a non-drinker. For lint drinkers, the risk is 1.1x baseline, while for moderate to heavy drinkers it is 1.27x that of a non-drinker. Overall, after adjusting for sun exposure, the risk was 1.15x increased overall.

My Take: No evidence of publication bias was detected. For me, this simply reminds me to use precautions (hats, limit sun exposure, sunscreen, etc.), whether I drink or not. A single sunburn can be enough to increase your risk of melanoma, regardless of your race or skin color. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: Rota et al. British J of Medicine; http://www.mdlinx.com/oncology/newsl-article.cfm/5088940/ZZ91C8F1B353954CB6B0809685C5A40D7C/?news_id=2206&newsdt=021914&utm_source=cme-rev&utm_medium=newsletter&utm_content=cme-rev-article&utm_campaign=article-section

Common Types of Skin Cancer Raise Risk for Subsequent Primary Cancers

skin mole on back - doctor examining patient

Individuals with a history of non-melanoma skin cancer (NMSC) have an increased risk of subsequent primary cancers, according to a study published in the March issue of Cancer Epidemiology, Biomarkers & Prevention.

The Evidence: Eugene Liat Hui Ong, BMBCh, from the University of Oxford in the United Kingdom, and colleagues used data from an all-England record-linked hospital and mortality dataset from 1999 to 2011 to examine the risk of primary malignant cancers in individuals with a history of NMSC.

Two cohorts were constructed: one including 502,490 people with a history of NMSC and a second that included people without a history of NMSC. The cohorts were followed electronically to ascertain the observed and expected numbers of people with subsequent primary cancers. The researchers found that the standardized relative risk for all subsequent malignant cancers was 1.36 for the NMSC cohort versus the non-NMSC cohort.

Results: For 26 of the 29 cancer types studied, the relative risks were significantly increased (P < 0.05), in particular for salivary gland, melanoma, bone, and upper gastrointestinal tract cancers. Younger people with versus those without NMSC had particularly high relative risks.

“NMSC is strongly associated with a broad spectrum of other primary cancers, particularly in younger age groups,” the researchers wrote. “The pattern suggests a genetic or early-acquired etiologic association.”

My Take: I am not sure this data is yet actionable. Still, it reminds me of two things: 1) Protect yourself against excessive sun exposure; 2) If you have a history of skin cancer, do the recommend cancer screening, don’t drink to excess, and don’t use tobacco! I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad:  Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

References

  1. Ong ELH, Goldacre R, Hoang U, et al. Subsequent Primary Malignancies in Patients with Nonmelanoma Skin Cancer in England: A National Record-Linkage Study. Cancer Epidemiol Biomarkers Prev. 2014; 23(3):490-498.