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As derms tie themselves even tighter to pharmaceutical companies, should they come out of the dark regarding giving the general public the correct information regarding sunscreen safety? 

misleading but oh so profitableIt's one thing for derms to give their own opinions on sunscreen, but it's a different story when they actually sell the products in their office. Is it ethical to sell sunscreen products and claim they absolutely prevent cancer when organizations like the FDA and the National Cancer Institute have said otherwise?

So, How Much Sunscreen Is Needed During Winter? The beginning of 'Vitamin D' [deficient] Winter is a four-to-six month period where the days are shorter and sunshine is weak for people to create sufficient natural Vitamin D. During this time, obviously a serious sunburn is the least of concerns: studies suggest that 30-50% of people are Vitamin D deficient. Even so, I was at the dermatologist recently and she recommended that I reapply sunscreen every four hours. Is that really necessary when a majority of Americans are Vitamin D deficient?

This past summer, I went undercover into the world of dermatology. (It caused a bit of an online ruckus with the dermatology world.) I found something curious: Many derms sell expensive, private-label sunscreen products ($35 for less than 2 ounces of goop) and tell customers that their product prevents skin cancer. Due to regulations, sunscreen manufacturers and retailers are not permitted to claim that sunscreen alone prevents skin cancer. Despite this, that's exactly what many companies are doing.

Sure, dermatologists pimp a pharmaceutical company's SPF products, but how does it play out when they are also the retailers of sunscreen items? And what exact information are they providing to the public on sunscreen protection and safety? With Vitamin D deficiency season looming, I returned to the world of dermatology to find more scoop on their sunscreen goop.

Sunscreen Encounter #1

sunny moneyWhen I inquired about a good sunscreen I could purchase at the drug store, this San Francisco dermatology assistant strongly opposed the idea. What I got over the phone was a sales pitch.

Derm Rep: Actually, honestly, our doctor will not recommend a lot of the sunscreens at Walgreen's. They might be over-the-counter and easily available, but in terms of overall protection and skin irritation we do not recommend it. A lot of people break out and react to those sunscreen products.
Me: Then what do you recommend?
Derm Rep: I like to recommend a product we have in our office. It's called Z-Silc. That has the most amount of zinc incorporated. Zinc really helps with protection of the sun.
Me: Is that what makes the sunscreen better than the sunscreen they have at Walgreen's?
Derm Rep: Yes, yes, the concentration is what you want -- the highest possible. So I recommend Z-Silc for you especially if you are just going to be in and out of the sun.
Me: Do you recommend it to avoid cancer?
Derm Rep: Yes. Just a good rule of practice for sunscreen: wash your face, put on your moisturizer, then put on your sunblock before you leave the house. If you're out all day then I recommend reapplying every 3 to 4 hours.
Me: Every 3 to 4 hours?
Derm Rep: Uh-huh. And if you are going to be exercising, sweating, and playing in the sun all day, then I recommend putting it on at least every 2 hours.
Me: Is it dangerous to put on sunscreen so often?
Derm Rep: No. No. Not at all. Because of the quality of the protection factor, it gets absorbed into your system.
Me: (Pause.) OK.
Derm Rep: It's not a plastic sheet that you keep on your face forever; it's a lotion that you put on. It gets absorbed, so you have to reapply it.
ME: Okay gotcha. And that will prevent the cancer? That's my main concern.
DERM REP: I mean, I can't say 100% but that's the basic idea. That's why we're asking you to put it on.
ME: Can I only pick it up at your office or can I find it online?
DERM REP: I'm not quite sure if its carry elsewhere, but I do know that we carry at our office.
ME: How much does it go for?
DERM REP: $35 plus tax.

CONCLUSION: After my call, I went down to their office and purchased a 3.5-ounce tube of Z-Silc. As mentioned, their recommended sunscreen is a concentrate that gets absorbed into your system. Z-Silc's main component is the octinoxate. A quick Google search led me to studies that suggested the ingredient can lead to reproductive as well as developmental toxicity and produce estrogen-like effects. (Maybe you're better off putting a plastic sheet over your face?)
Though the derm assistant neglected to mention any safety concerns, she did claim that sunscreen prevents skin cancer, even though experts have said otherwise. Here's what The Food and Drug Administration stated: "FDA is not aware of data demonstrating that sunscreen use alone helps prevent skin cancer." The National Cancer Institute also concluded: "It is not known if protecting skin from sunlight and other UV radiation decreases the risk of skin cancer."
It also doesn't help matters when the Environmental Working Group (EWG) questions the safety of many common sunscreen ingredients, some of which appear to be toxic and carcinogenic. The group maintains that products containing specific chemicals have yet to undergone legitimate safety testing.
Is there concern when I'm told to apply a product that contains octinoxate on my face every 2 hours?


sunscreenI called a San Francisco dermatologist's office and asked for information on the various SPF levels of sunscreen products.

ME: What's the difference between the 15 and the 30 SPF? Why is that more protection? Does it prevent more cancer?
DERM REP: Yes. It's better to have the higher strengths for protection from the ultra-violet rays. Now they have the 45 and 90 SPF. The higher the SPF strength the better! I would stick with a minimum of 30 SPF. If you can find the 45 SPF then use it. Everyone should get used to wearing sunscreen because it's pretty important these days.
ME: Is that what prevents the cancer? Or is it the high SPF?
DERM REP: Well that helps. There's no guarantee of anything in life-nothing's for sure. Sometimes people have it genetically in their system. If you have a lot of detailed questions you have to come in and see the dermatologist because our doctors are certified dermatologists who went to medical school.
ME: I've been reading some things on sunscreen. Is it dangerous at all to put on so much sunscreen? Or are certain types of sunscreen dangerous?
DERM REP: No. No. Not at all.
ME: Okay, so it doesn't matter what type of sunscreen just reapply it every two hours?
DERM REP: Yes. If you're going outside the whole then it's better to reapply it every two hours.

CONCLUSIONS: This dermatology's office mantra: the higher the SPF the better. Surprisingly, the higher the SPF value the more expensive the product.
Here's what's not mention: the U.S. Food and Drug Administration has drafted rules to put the kibosh on uber-high SPF numbers like SPF 100. According to FDA the numerical values are "inherently misleading" because there was no assurance that the skyrocketing numerical claims are true.
More importantly, there's the issue of increased exposure to potentially hazardous chemical ingredients. High-SPF products contain a greater amount and concentration of potentially hazardous UV-absorbing chemicals that absorb directly into the skin. Do you really want to find out the long-term effects of 6% oxybenzone in an SPF100 sunscreen?
Despite health advocate warnings, high SPF sunscreens have become big business -- the fastest growing sector in the sunscreen market. In 2010, one in six sunscreen products were listed with a SPF of 50 or higher. (In 2009 the figure was only one in eight.) With sales on a steady rise, it's no wonder sunscreen companies are doing what they can to keep their SPF digits high.
Could dermatologists' recommendations be a factor?


sunblockWhen making a call to this dermatology office in Sacramento, I inquired about the hazards of various ingredients found in sunscreen. I was told that the only real difference in sunscreen products is the SPF factor. I was also told to keep reapplying sunscreen every other hour.

ME: Every other hour?
DERM REP: Uh-huh.
ME: And that's good for preventing cancer?
DERM REP: Yes. (Laughs.)

CONCLUSION: While dermatologists give a confirmation that sunscreens prevent cancer, the FDA, EWG, and even the National Cancer Institute say otherwise. On the flip side, no one is talking about the most obvious effect of chemical sunscreen use: blocking Vitamin D production in your skin.
Vitamin D is now widely recognized as the world's most powerful anti-cancer hormone. Limited exposure to sunlight can cause Vitamin D deficiency and sunscreen with a low SPF of 8 reduces your ability to produce Vitamin D by more than 95 percent. Using a sunscreen with an SPF of 15 reduces Vitamin D production by more than 99 percent.
Simply do the math on the effects of a 100 SPF sunscreen.


big bucksI made another call to question if certain sunscreens might be dangerous due to their specific chemical ingredients. Again, I got a response that surprised me.

DERM REP: No. Because they all are pretty much similar when it comes to sunscreen.
ME: Is there a certain SFP I should look for?
DERM REP: A certain SFP? It all depends if you want something higher. There's 15, 45, 90...
ME: What's the difference if the SPF is higher?
DERM REP: If it's higher there's more protection.
ME: Okay and it prevents more against cancer?
DERM REP: Right.

CONCLUSION: According to this dermatology office, all sunscreens are similar. Here's something to put a chill in your tan: EWG noted that Vitamin A found in numerous sunscreens (and derivatives retinol and retinyl palmitate), might actually increase the speed which malignant cells develop and spread skin cancer. An FDA study also found some alarming vitamin A data: "Tumors and lesions developed up to 21 percent faster in lab animals coated in a vitamin A-laced cream than animals treated with a vitamin-free cream."
The major choice for sunscreen in this country is between those containing chemicals (which penetrate the skin and may disrupt the body's hormone system), and those with minerals (such as titanium dioxide which researchers believe holds serious health risks). Studies funded by sunscreen companies never bother to answer questions on the safety of chemical ingredients. (Oxybenzone is a hormone-disrupting chemical that penetrates the skin and enters the bloodstream.)
Back in May, the EWG released their report on vitamin A. They stated that ten years ago there was enough evidence for the FDA to caution consumers against vitamin A in sunscreens.
Somehow this information slipped through the cracks in regard to informing the public.

tube of sunscreenSUNSCREEN ENCOUNTER #5

I asked the receptionist at this San Diego dermatology office for a recommendation of a good over-the-counter sunscreen. He wasn't sure what to suggest at first. Then he offered a great solution.

DERM REP: We do have an online store. Our website has some recommendations of sunscreen that our dermatologist feel are very good and that she feels comfortable with.
ME: I'm on your website right now. So, these are the best products to prevent cancer?
DERM REP: Yes. These are what we have online and what we have in our offices as well.
ME: Oh! That sounds good.

CONCLUSION: I clicked onto the dermatology office's online store. Checking out the solar care section, they carried only Alyria sunscreen products. I was recommended to purchase Alyria Corrective Protection SPF 30 for $36. At that price I'd get a 1.75-ounce tube of goop. (That's more expensive than printer ink!) Alyria contains octinoxate. But there is some good news: since the tube is only 1.75 ounces it won't last very long.


applying sunscreenI once again asked for a good dermatologist recommended sunscreen with a call to this Los Angeles dermatology office. Immediately I was put on hold for several minutes and listened to a series of Botox and chemical peels ads. Finally, the dermatology rep came back on the line.

DERM REP: We recommend Amthelios. We carry it here.
ME: What's the difference between that and a sunscreen you would buy at Walgreen's?
(Long pause.)
DERM REP: What's the difference? (Pause.) Um, well the technology.
ME: The technology?
ME: Can you explain a little about the technology?
DERM REP: Okay... can you hold for a moment?
I found myself listening to more Botox and chemical peel ads. After a few more minutes, another dermatology rep came on the line to assist me.
DERM REP: Thank you for holding. This is Jordan how can I help you?
ME: I just wanted some information about the sunscreens you recommend.
DERM REP: Okay what we recommend-and what we sell at our office-is made by La Roche-Posay. It's a French company. It's called Amthelios. We carry the ultra-fluid sunscreen and it's SFP 60.
ME: And how often should I apply it?
DERM REP: We are supposed reapply sunscreen every 4 hours, but who does that? As long as you wear it in the morning, then reapply it again before you drive home you should be fine.
ME: So there's no danger from the long-term effects from the ingredients in the sunscreen? Or are there any ingredients we should avoid?
DERM REP: No. There was this thing going around online that sunscreen may cause cancer, but that's not true.
ME: Let's hope it's not true. But is this sunscreen is the best one for preventing cancer?
DERM REP: Yes. Uh-huh. And aging too.
ME: Oh great. How much is it?
DERM REP: I believe its $35.
ME: Perfect. And I could just pop down there and pick up.
CONCLUSION: The dermatology rep stated that the alleged dangers of sunscreen ingredients were false and that sunscreen prevents skin cancer-all in the same breath.

moneyAgain, it's one thing for derms to give their own opinions on sunscreen, but it's a different story when they actually sell the products in their office. Is it ethical to sell sunscreen products and claim they absolutely prevent cancer when organizations like the FDA and the National Cancer Institute have said otherwise?
As derms tie themselves even tighter to pharmaceutical companies, should they come out of the dark regarding giving the general public the correct information regarding sunscreen safety?


Article by By: Harmon Leon
San Francisco Chronicle
October 22 2010

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