The Risk of Using Sunscreen

Wearing sunscreen to prevent skin cancer seems like a no-brainer. Unfortunately when I put my mind to it I found out this statement is more literal than I thought. It turns out that there is more epidemiological evidence that shows an INCREASE in skin cancer with regular sunscreen use.¹  While there are some complexions, like those with freckles that may benefit from sunscreen use, the safe way to go seems to be using clothing, hats, and shade to reduce sun exposure without the risk of harmful chemicals.^2,4,5 In a quantitative review of the literature from 1966-2003 Dennis, Freeman, & VanBeek found that “no association was seen between melanoma and sunscreen use.”⁶ The authors also note that the long-term effects of new sunscreens may take decades to determine.⁶ Green, et al. found “no significant differences in the incidence of first new skin cancers between groups randomly assigned daily sunscreen and no daily sunscreen” particularly not with basal-cell carcinoma.⁷  Routine sunscreen use for 4.5 years does show some effect for cutaneous squamous-cell carcinoma prevention.⁷   

The Environmental Working Group just released an excellent sunscreen guide (updated link for 2011). After they reviewed 500 sunscreens they could only recommend 38 of them (in 2010). I highly recommend using those, or others that are comparable, especially since seemingly healthy ingredients like vitamin A have been recently shown to increase skin tumor growth and lesions.⁵  Just be sure that you do not increase your sun exposure because you are wearing sunscreen.  

It is also very important to note that what state of health your body is in is more important than what you put on it, or how well you shield your self from the sun’s also beneficial rays.^1,2,5 Eating a diet full of a wide variety of fresh fruits, vegetables, nuts and grains (that includes 7-9 servings of vegetables & fruits and plenty of properly preserved good fats) is an excellent way to start. Controlling stress through meditation, Qi Gong, Yoga, and exercise is also a very important component in preventing all types of cancer and disease. Cancer is a complex process that starts with an energy deficiency that gets the body’s complex dance of natural mechanisms out of balance, usually because of multiple compounding factors and including many external influences. Do what you can to reduce negative influences like stress, toxins and poor diet.  Another 2011 update: Sulforaphane used topically is showing great promise for skin cancer prevention as an after sun exposure lotion (the only lotion I found with this so far has antifreeze in it also... be careful).  You can also get sulforaphane in a pill.  I am not sure if this can be used topically, but I am looking into it!

Responsible exposure to the sun is vital to our health! Most people are aware that vitamin D is needed for the absorption of calcium in the gut, but did you know that a deficiency can increase: muscle weakness, cancer, type 1 diabetes in children, congestive heart failure, hypertension, schizophrenia, depression, and wheezing?3  In fact, “93% of persons 10 to 65 years of age who were admitted to a hospital emergency department with muscle aches and bone pain and who had a wide variety of diagnoses, including fibromyalgia, chronic fatigue syndrome, and depression, were deficient in vitamin D.”3  To get enough D you need to expose your bare skin to sun that is unencumbered by buildings during the peak hours of the day. Holick (2007) recommends that “exposure of arms and legs for 5 to 30 minutes (depending on time of day, season, latitude, and skin pigmentation) between the hours of 10 a.m. and 3 p.m. twice a week is often adequate. “3

Methods: I searched Pub Med using the MeSH terms "Sunscreening Agents"[Mesh] AND "Skin Neoplasms"[Mesh] and limited the search to Clinical Trials, Meta-Analysis, Randomized Controlled Trials, in humans, in English, in the Core clinical journals. I received 16 results, a shockingly low number. However, considering the difficulty of time factors epidemiological data seems to be the best source of information as shown in the Meta-Analysis and quantitative review. All relevant articles were reviewed and represented in this article. 

References:

1. Huncharek, M., & Kupelnick, B. (2002). Use of Topical Sunscreens and the Risk of Malignant Melanoma: A Meta-Analysis of 9067 Patients From 11 Case-Control Studies. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12084704

2. Gallagher, R., Rivers, J., Lee, T., Bajdik, C., McLean, D. & Coldman, A. (2000). Broad-spectrum sunscreen use and the development of new nevi in white children: A randomized controlled trial. JAMA 14;283(22), 2955-60. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10865273

3. Holick, M. (2007). The New England Journal of Medicine, 357, 266-81. Retrieved from http://www.vitamindhealth.org/?page_id=48

4. Glanz, K., Schoenfeld, E., & Steffen, A. (2010). A Randomized Trial of Tailored Skin Cancer Prevention Messages for Adults: Project SCAPE. American Journal of Public Health, 100(4), 745-741. Doi: 10.2105/AJPH.2008.155705

5. EWG’s Sunscreen Guide. In Environmental Working Group (ewg.org) Retrieved from http://www.ewg.org/2010sunscreen/?inlist=Y&utm_source=sunscreen&utm_medium=email&utm_content=first-link&utm_campaign=toxics

6. Dennis, L., Freeman, B., VanBeek, M. (2003). Sunscreen use and the risk for melanoma: a quantitative review. Ann Intern Med., 16:139(12), 966-78. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14678916

7. Green, A., et al. (1999). Daily sunscreen application and beta-carotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomized controlled trial. Lancet 354(9180), 723-9. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10475183

The Language of Acupuncture

Traditional oriental medicine is relatively new to our country, yet it is the oldest known continually practiced literate medicine in the world.  For 2,500 years the Chinese have been thoroughly recording their study of the human body in many ways that include but also extend beyond solid scientific evidence.  The discoveries have been eloquently sewn over time into a language that has a different premise than what we learn in our western culture, making it sound "fanciful" to some who still can not deny its power and influence over the world's health care system.  There is evidence that the same acupuncture points I use today for low back pain were used 5,000 years ago, long before recorded history.  This does not make acupuncture simple, or something you can write up in a cookbook for those who do not speak the language.  When we speak of the elements and how they relate to the seasons, or how metal rules the skin, and the lungs, we are not speaking about something abstract or not real.  We are describing biological pattens that have been carefully observed over centuries.  I use the metal example because a recent scientific discovery about the connection between eczema and asthma has shown proof of one of these biological connections to the western eye.  My first understanding of this came about a year into my acupuncture program while working in the emergency room on the weekends as a nurse.  I had been witnessing the conditions I was learning about the whole time, but it took an understanding of the language to really see that it was not esoteric descriptions but a thorough guide to the human body and how it interacts with it's environment.  It had taken me a year to get over my previous knowledge enough to see the eloquent connections that were so clear once you understood the meaning.  Now I like to say "science is catching up" because as we know, traditional oriental medicine has been time tested, and holds truths we are just beginning to understand.

In this language the seasons are associated with elements that in turn are associated with organs; Spring (Wood, Liver), Summer (Fire, Heart), Late Summer (Earth, Spleen), Fall (Metal, Lung), and Winter (Water, Kidney).  This spring I have been observing liver wind patterns arise out of a slightly yin deficient winter, making eczema, allergies, headaches, menstrual irregularity, pain that moves around, spasms, dizziness and even frustration and anger arise as our energy makes its way from deep in our bones out to the surface.  This complex language is not easily understood, so don't get caught up in the details but observe the flowing patterns of the generating sequence (metal, to water, to wood, to fire, to earth); this is what we as practitoners use to balance the body, and why we suggest certain foods or habits that can help your body stay in harmony.   I look forward to helping you understand your body in any way that I can because I believe you hold the power to your own health and well being.  I also sincerly hope that our culture can successfully foster this invaluable medicine through correct understanding and not lose what took centuries to discover by dissecting past the knowledge (we may have just discovered that acupuncture channels are tiny physical structures that have been missed previously because when you cut the skin they are obscured by clotting factors).  Please come to class where we experience these connections while I explain the patterns; come in for a treatment so I can go over your diagnosis for you, and always feel free to contact me with any questions.