Several of my patients have recently asked me whether the benefits of going into the sun to obtain vitamin D outweigh the risk of developing skin cancer. Other patients have raised concerns about using sunscreen altogether, arguing that people have been out in the sun for thousands of years and only after the invention of sunscreen did people begin developing skin cancer. Could it be the chemicals in sunscreen, and not the sun, that are causing skin cancer?

I would like to share with you several facts that dispute these myths…

First, skin cancers have always existed. While there has been an increase in the lifetime risk of developing invasive melanoma (in 1935, the risk was 1 in 500; it is now 1 in 55), this can be attributed to a number of factors, including longer lifespans (the sun damage that leads to skin cancers generally accumulates over time);the thinning ozone layer, which allows greater amounts of harmful ultraviolet radiation (UVR) to penetrate the earth’s atmosphere; the increased popularity of outdoor activities; clothing styles that leave more skin exposed; and the advent and popularity of tanning booths. Improved diagnostic techniques also allow doctors to detect more skin cancers at an early stage.

Until the 1920s, a tan was not considered a desirable attribute. Fair, untanned skin indicated that a person did not have to work outdoors and enjoyed higher social standing. Fashionable people wore protective clothing, including hats, to avoid tanning. But in 1929, fashion and beauty magazines began promoting tans as signs of beauty, health, and affluence. The greater UV exposure that tanning entails, rather than the advent of commercial sunscreens, provides the most compelling explanation for the increase in skin cancers.

Current evidence points to the need to protect skin against the sun’s rays, regardless of skin type and ethnicity. Dermatologists recommend using sunscreens that protect against both ultraviolet A (UVA) and ultraviolet B (UVB) rays, in addition to other protective measures such as wearing a hat, sunglasses, and long-sleeved shirts and pants.

Regarding vitamin D, no convincing scientific evidence suggests that sunscreen use prevents adequate vitamin D production. Current vitamin D intake recommendations rise with increasing age, but everyday, incidental sun exposure manufactures sufficient vitamin D for most people, even with the use of sunscreens. For example, merely walking from your outdoor parking spot into a building gives you adequate exposure. Furthermore, the body can produce only a certain amount of vitamin D from sun exposure; after reaching that limit, additional UV exposure actually results in the breakdown of the vitamin!

Finally, sun exposure does not represent the only – or the best – source of vitamin D. Dietary sources such as fatty fish (salmon), cod liver oil, and fortified milk and orange juice provide substantial amounts of the vitamin, as do supplements, which are available at relatively low cost. Current evidence strongly suggests that detrimental effects of sun exposure far outweigh the benefits, especially since vitamin D can be obtained without risking your skin’s health!

Researchers at Vanderbilt University found that state laws meant to keep teenagers from suing tanning booths have been ineffective. In the medical journal, Cancer, researchers wrote that poor enforcement was a factor.

About 20 states currently have some law aimed at limiting minors’ use of indoor tanning. The laws allow young people to use tanning parlors provided they have parental consent, even just a note from a parent in some cases. Only California had a stricter laws, banning children 14 and under from using tanning facilities.

Dr. Stuart Kaplan believes that tanning salons are businesses that expose teenagers to carcinogens and increase their risk of melanoma and other skin cancers. Melanoma is the deadliest form of skin cancer and has been found to increase in people with a history of childhood sunburns. The Indoor Tanning Association estimates that 30 million Americans use tanning salons. The organization argues that indoor tanning, when done properly, can improve health.

Dr. Kaplan disagrees. Cases of melanoma of the skin have been increasing for decades. People who start tanning when they are young, or those who receive many sunburns have a higher risk of malignant melanoma. The good news is that melanoma is almost always curable if diagnosed early.

Tanning salons are often used by young women and girls, and as many as one in three girls use indoor tanning salons. Many researches believe the rates are even higher for female college students.

In another study from October 2008, researchers found that one-third of health officials in states with indoor tanning laws said they did not inspect tanning salons, while another third of the states inspected tanning salons less than once a year.

Dr. Kaplan feels that without proper inspections, the tanning booths themselves cannot be physically calibrated to measure the amount of UV radiation the machines emit. Also, the lack of inspections prevent salons having to show parental consents that would
be required for minors receiving tans

In the end, there is no such thing as a safe tan. Please understand the effects of UV radiation are cumulative; the more UV radiation you can avoid now, the more you decrease your risk of getting skin cancer later in life.

Dr. Kaplan’s Medical Website kaplanMD Skincare Products

A new study published August 14, 2008 revealed that Mineral Oil and Sodium Lauryl Sulphate, found in many common skin moisturizers, caused mice that were exposed to UV radiation to develop more, and larger skin cancer tumors.

This study is the work of Dr Allan Conney and researchers of Rutger University’s Susan Lehman Cullman Laboratory for Cancer Research. They exposed specially bred albino mice to UV radiation twice a week for 20 weeks to examine the development of Basal Cell and Squamous Cell Carcinomas, or non-melanoma skin cancers. Then a portion of the mice were treated with over-the-counter moisturizers, such as Eucerin, Dermabase, Dermovan and Vanicream.

What they found was that mice treated with the moisturizers had increased tumors, and larger tumors, which developed at a faster rate than mice that were not treated with moisturizers. After further research, they concluded that Mineral Oil and Sodium Lauryl Suphate may have caused the increase in skin cancer tumors.

However, these studies were performed on mice only. Drugs that have caused a certain reaction in animals do not always have similar effects in humans. Further, more research must be done to verify these results and its effect on human skin.

To help prevent skin cancer in the first place, always remember to practice good sun protection, like wearing a wide-brim hat and long sleeves, and using sunscreen with a minimum SPF 15. Apply sunscreen at least 30 minutes before going outdoors, and look for products containing physical sunscreens, such as Titanium Dioxide.

Note: No kaplanMD Skincare Product or kaplanMD LIP 20 lip treatment contains either mineral oil or sodium lauryl sulphate.

Dr. Stuart Kaplan has been in private practice in Beverly Hills for over 22 years, and also serves as an Assistant Clinical Professor at the UCLA Medical Center for over 20 years.

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