As a young medical student, I once sat in the corner of a doctor's office when an oncologist assessed a 30-year-old woman with terminal skin cancer.
A year earlier she had noticed a small, flat area of red, brown, and black pigmentation on the skin above her right shoulder blade. It turned out to be a malignant melanoma, and despite a relatively early diagnosis and treatment it had spread to her lungs, liver and bones.
When I saw her, she was just given to live between six and twelve months.
& # 39; He left me alone & # 39 ;, she sobbed. & # 39; He let me die! & # 39;
Her story gradually appeared in the midst of her tears. Twenty-two years earlier, when she was eight years old, her family had gone to Spain on a summer vacation.
But could a bad sunburn as a child really have caused the woman's terminal cancer? The statistics are sobering
& # 39; We were wearing very little sunscreen, & # 39; she explained. & # 39; Mother wanted to look nice and Dad said a tan was healthy.
& # 39; On the first afternoon we went maybe four or five hours to the beach. When we finally returned to the hotel in the evening, the sunburn here was so bad – it was blistering and bleeding – that I had to see a doctor. & # 39;
She pointed to the place where she first saw the melanoma that emerged two decades later.
But could a bad sunburn as a child really have caused the woman's terminal cancer? The statistics are sobering.
Current research suggests that while many people who are severely burned when children never develop skin cancer, one blister burn of the sun increases the risk of melanoma later in life by 50 percent.
Another study suggests that white women who get five or more severe sunburns in their teens have the double risk of developing melanoma.
After the woman left that day, the oncologist turned to me. & # 39; As humans, we are notoriously poor at risk assessment, especially when it comes to our future health, & # 39; he remarked. & # 39; But when it comes to someone under your care … I think a bad sunburn on a child is nothing less than child abuse. & # 39;
He didn't exaggerate. Especially in the western world, the explosion of skin cancer in recent decades – partly caused by cheap holidays to countries with hot climates such as Spain and Greece – is now a major public health crisis.
Treatment for skin cancer alone is predicted to cost the National Health Service £ 500 million a year in 2025. Meanwhile, the increase in cases of the disease is testing the capacity of dermatological departments to the limit.
While Britain settles into the hottest weekend of the year so far, and Europe beats record temperatures for June, I'll tell you why, as a physician and author of The Remarkable Life Of Skin, I think the dangers of exposure to the the sun is greatly underestimated by terrifying numbers of people.
My studies at a leading dermatology laboratory and my travels around the world researching all aspects of skin health have taught me that when it comes to our largest and most visible organ, there is so much that we don't know . I will reveal:
- The overwhelming evidence that skin damage – even from mild brown tans – is accumulating over the years;
- Why we should wear sunscreen much more regularly – most days, even when it is cloudy and we think we are safe from the sun;
- How eating carrots can give you a healthy shine that looks better than a tan;
- That there is only one anti-aging ingredient that actually works;
- Why sunlight can be addictive, with some sun worshipers showing symptoms of dependence similar to those of substance abusers.
ULTRAVIOLET VILLAINS THAT WE MUST FEAR
As most of us know, the particles of sunlight that affect our skin are invisible, ultraviolet (UV) rays: UVA and UVB. However, what is less well understood is the different kind of danger that each of them poses. Of the two, UVB is the notorious one. It is this double-edged solar sword that delivers both the pain and the gain of the sun.
As a highly energetic particle, UVB hits the outer epidermis of the skin and immediately damages the DNA, creating chemical bonds that bend the DNA strand out of its normal form.
The immediate reaction of the skin is inflammation seen in redness, swelling and blistering – the classic signs of sunburn. But UVB radiation is one of our most important sources of vitamin D, which is essential for health – to keep our bones strong and our immune system functioning.
Tanning is like a medicine – you can really get addicted to it
It is intriguing that psychological studies into sun care campaigns show that appealing to our vanity is often more effective than tackling our health.
When people get photos of skin cancer and are told that sun damage will affect their physical well-being in the future, it seems that this is not changing their behavior.
& # 39; Tanorexia & # 39; is a real phenomenon, where exposure to sunlight induces a certain type of endorphins that enters the bloodstream and causes an opioid-like effect
But when they see images of wrinkles and freckles caused by sun damage, they stick much more to health guidelines.
In addition to the social pressure to look tanned, sunlight can literally be addictive. Just like a medicine, it has both positive and negative effects on the body and, just like a medicine, it can also become addicted to us.
& # 39; Tanorexia & # 39; is a real phenomenon, where exposure to sunlight induces a certain type of endorphins that enters the bloodstream and causes an opioid-like effect (opioids belong to the same pain-relieving and addictive family as morphine and heroin).
In fact, 20 percent of beach visitors show signs of sun dependence that would meet the symptom criteria for addiction and substance abuse.
This makes UVB rays our friend and foe at the same time. Unfortunately, there is no definitive answer to how long we have to stay in the sun to maximize the effects of vitamin D, without exposing ourselves to the dangers of UVB rays.
For people in Northern Europe, it appears that sufficient vitamin D intake can be achieved by exposing the forearms, hands and legs to the sun for 10 to 30 minutes a day (or about half the time required to make your skin red. between 11:00 and 15:00, two to three times a week between April and September.
However, there are two important comments about this advice. First, this regime depends on many variables, including equator distance, cloud cover, skin pigmentation, and sunscreen use.
Secondly, it is important to note that even these short exposure periods can lead to DNA damage that can cumulatively lead to skin cancer.
Theoretically, by damaging our DNA, these waves of UVB radiation should leave us all with relentless skin cancer and early graves. So what's on their path? The answer is the modest melanocyte.
These small cells have octopus-like tendrils and live on the bottom of the epidermis (the outermost layer of the skin).
Just like octopuses, they spewed out ink called melanin. This remarkable pigment gives our skin color in the sun and acts as our natural sunscreen. But despite the excellent work of melanocytes to protect us against UVB, a tan in itself is not a realistic form of protection – in fact it offers a sun protection factor (SPF) of just 3.
Contrary to what is often thought, a pre-holiday supplement to a sunbed is almost nothing to protect the skin.
VIEW FOR THE AGING FLOWS
And what about UVB & # 39; s underrated partner, UVA? In my opinion, the dangers are much greater than was previously recognized. Although it contributes to tanning, UVA is not responsible for sunburn and it was originally thought that it did not cause cancer. That is why it is traditionally used in sun beds.
But new evidence is now beginning to show that UVA can actually initiate and accelerate the development of skin cancer and accelerate the aging process.
UVA rays are weaker but can travel further than UVB rays, which dig deeper into the most important support structures of our skin and harmful cells in the areas where most skin cancers occur, such as hands and face.
They also play an important role in skin deterioration and wrinkles, a process that is also called photoage.
Among the harmful effects of UVA are the slowing down of collagen production (a vital protein in the skin that decreases with age) and the breakdown of blood vessels, resulting in & # 39; varicose veins & # 39; that are often visible on the cheeks and nose.
And, disturbingly enough, we don't have to be burned by the sun, or even noticeably tanned, to inflict age damage on our skin. UVA rays can penetrate glass, while UVB cannot. So while you are unlikely to get sunburn through a window, the skin aging effect will last as long as you are exposed to sunlight.
For example, it is not common for older truck drivers traveling through the American Midwest to leave one side of their face hanging and wrinkling, while the other half looks two decades younger.
The aging or liver spots are also the harbinger of aging skin. These dark brown spots are often said to be the cause of our hands giving away our age. The name & # 39; age spot & # 39; however, it is somewhat misleading because the markers are directly related to sun exposure, not age.
Sunlight is certainly the biggest cause of skin aging – probably more than all other factors combined, including time itself. That is why I have come to the conclusion for many years that the key to youthful skin is sun protection – and that the most effective anti-aging cream is sunscreen.
BEWARE OF THE FAILURE OF SQREAM LABELS
However, to be protected against the risk of skin cancer and premature aging, a quick smear of sunburn on our nose and cheeks is not nearly enough.
For the best possible defense against the ravages of the sun, the exposed skin (such as the face, arms and hands) of an average-sized adult should be covered with 35 to 45 ml of broad-spectrum sun protection that protects against both UVA and UVB, with an SPF of at least 15.
A simple rule of thumb is about two teaspoons when your head, arms and neck are exposed and two tablespoons when you are on the beach and need full body coverage.
In the UK, however, studies show that there is enormous confusion about labeling sunscreen products.
SPF is only responsible for UVB radiation; a separate one-to-five-star system indicates the protection of an awning against UVA.
On the positive side, one country has shown that sun protection becomes second nature and therefore really has a preventive effect. Many Australians are of British descent, their ancestors with pale skin moved from their rainy home on the shores of Northern Europe to a hot continent on the other side of the world.
Not surprisingly, Australia is the capital of skin cancer worldwide. But in the last 30 years it is also the only country that has lowered rates for skin cancer.
Nevertheless, the gap between public knowledge of sun damage and the actual use of sun protection shows that it takes a lot to change our attitude to health.
A 2017 study on sun protection behavior of 20,000 people from 23 countries has found that although nine out of ten people are aware of the link between sun exposure and skin cancer, almost half of respondents do not take measures to improve their skin. protect on vacation.
THE CREEPY CRAWLIES LIVING IN OUR SKIN
It is not only the effects of sun damage that have intrigued me in my career, I am also fascinated by the organisms that live on our skin.
Perhaps not something we want to think about all too often, but it is an inevitable fact that every person hosts more than 1,000 different types of bacteria – not to mention fungi, viruses and mites: up to 100 trillion individual organisms per person.
Even as you read this, Demodex mites, which have the tail of a worm and a body halfway between that of a spider and a crab, may run over your face and cling to the hair follicles of your eyebrows.
Eating carrots gives the skin a golden shine
It is not just bad news … for those who want them to get a tan without the UV-induced side effects of premature skin aging and skin cancer, there is an unexpected solution.
It sounds incredible, but a diet rich in colorful carotenoids containing vegetables such as carrots and tomatoes can marginally (but noticeably) give off a golden glow.
It sounds incredible, but a diet rich in colorful carotenoids containing vegetables such as carrots and tomatoes can marginally (but noticeably) give off a golden glow
Better yet, studies have shown that the perceived attractiveness of a person's skin after eating a carotenoid-rich diet is higher than for someone with a mild sun tan lotion.
A breakthrough was made in 2017 that really is a & # 39; real fake tan & # 39; could yield.
A small molecule called SIK inhibitor has been shown to activate the production of melanin – the pigment that gives the skin its color – in skin cells.
There is still a long way to go, but if this succeeds, it can ultimately give rise to the holy grail of a completely natural, safe and sunless color.
The stuff of horror movies? Yet these far-away-beautiful inhabitants of our bodies have an invaluable function for us, by eating as much dead skin as they can during their short lives.
It is easy to imagine the bacteria as insects that live on a flat layer of skin, but in fact they are small organisms, thousands of a millimeter long, hidden in the gaps and cracks of our surface.
Then there are the lice – the comparative giants of the microscopic world.
About ten percent of British school children would be infected with head lice at any time. Although head lice are harmless, their itchy nuisance and their inaccurate handling of impurity have made them subject to regular school eradication campaigns.
Their cousin, the louse, is a more dangerous creature and evolves to lay eggs in human clothing instead of her.
A 2018 study revealed that a human-to-clothes-to-human spread of body lice might even have been the primary route of Black Death transmission in the 14th century, challenging traditional theory for the first time in decades. that rats on rats were to blame.
Whether we like it or not, when we start living close to someone, we also begin to share their microbiome (the micro-organisms that live in a certain environment).
A 2017 study found that cohabiting partners could be identified from a group of random individuals in nine out of ten cases, based solely on their skin microbiome profiles.
The study found that couples shared the most microbial similarity on their feet and had the least in common on their thighs.
These microbial signatures from households can even be extended to entire cities.
One study measured the microbial composition of different offices – including the skin of office workers – in three different cities in North America.
Intriguingly, each city left its own microbial signature with its employees, even across different offices in the city, so that the city where an employee lived and worked could easily be determined by examining their skin microbiome.
© Monty Lyman, 2019
- The Remarkable Life Of Skin, by Monty Lyman, was published by Bantam Press on July 11, priced at £ 20.
There is one anti-aging cream that has been proven to work
From sunburn to wrinkles, anti-aging ingredients and acne remedies, the beauty industry is bombarding us with so many miraculous healings and advice that it's hard to know what to believe.
But after years of research at Oxford University and helping patients with problematic skin, I started to learn what really works – and which & # 39; revolutionary & # 39; new treatments are simply ridiculous. Here I expose some of the most common skin care myths …
There is no evidence that drinking liters of water helps
Despite the endless recommendations for drinking water for healthy skin, very little research has been done on this area.
This may not be surprising: water cannot be patented, so pharmaceutical companies have little to gain from financing such activities.
What we can be sure is that a shortage of water is bad for our skin, but that does not mean that drinking above average levels is particularly good.
It is safe to say that drinking recommended daily amounts of water is healthy: about 2.5 liters per day for men and two liters for women (70 to 80 percent from drinks and the rest from food).
But because this varies depending on a person's size, activity level and temperature, it is not an exact science.
Our body has a very reliable internal meter: we must drink water when we are thirsty.
Do not trust expensive moisturizers
Fad facials are nothing new, even ancient Romans bathed in crocodile manure to preserve their youth.
We laugh at such stories, but we have been brainwashed by the beauty industry to think that the more expensive or dramatic the treatment, the better. But this is simply not the case, with some studies suggesting that cheap moisturizers have exactly the same effect as their expensive, & # 39; anti-aging & # 39; counterparts.
In the food industry, if you want to make a health claim about an ingredient, it must (rightly) be supported by a number of scientific evidence.
Such regulation, at least in the UK, does not apply to skin products. And smart cosmetics companies can easily be frugal with the truth.
The cream packaging states that it is & # 39; clinically proven to reduce wrinkles & # 39 ;. This could be true, but a & # 39; clinical & # 39; change could only be seen under the microscope and never visible to the human eye.
And what about the claim that it is & # 39; dermatologically tested & # 39; is? In theory it could have been tried on the skin of just one participant for a few days.
If the product has a list of & # 39; active ingredients & # 39; may have been easily tested in vitro (in the laboratory) and their effects may never have been observed on human skin.
The blue light from Kourtney may not be such a smart idea
In 2016, a photo of reality TV star Kourtney Kardashian, a face darkened by a somewhat frightening white mask that radiated a deep blue glow, was seen by her 35 million Instagram followers and soon brought LED light therapy into the public arena .
In 2016, a photo of reality TV star Kourtney Kardashian, a face darkened by a somewhat frightening white mask that radiated a deep blue glow, was seen by her 35 million Instagram followers and soon brought LED light therapy into the public arena
The theory is that wavelengths of & # 39; high energy & # 39; blue and purple light the Cutibacterium acnes bacteria can kill, one of the causes of acne.
However, it seems that visible light therapy is more than cure. Although it is certainly true that high levels of blue light kill certain bacteria in the laboratory, there is no evidence that it can treat acne.
A systematic review, in which the effectiveness of 71 light therapy studies on acne was statistically combined, found that there is currently no high-quality evidence that blue light therapy works.
… and finally, the potion that really works
I heard that if you already have wrinkles, nothing will improve them. But this is not necessarily true. There is one ingredient with proven benefits.
After sunscreens, retinoic acid is probably the only anti-aging cream with robust evidence behind its claims.
In 1960, American dermatologist Albert Kligman discovered that a derivative called tretinoin (which he burned Retin A) was incredibly effective in treating moderate and severe acne.
About ten years later, he realized that retinoic acid has a different, even more lucrative potential: it increases collagen production, crucial because collagen is the protein in our skin that naturally decreases as we age. It also thickens the dermis and exfoliates the outer epidermis, noticeably smoothing out wrinkles.
. (TagsToTranslate) Dailymail (t) health