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Breakell T, Kowalski I, Foerster Y, Kramer R, Erdmann M, Berking C, Heppt MV. Ultraviolet Filters: Dissecting Current Facts and Myths. J Clin Med 2024; 13:2986. [PMID: 38792526 PMCID: PMC11121922 DOI: 10.3390/jcm13102986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/11/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Skin cancer is a global and increasingly prevalent issue, causing significant individual and economic damage. UV filters in sunscreens play a major role in mitigating the risks that solar ultraviolet ra-diation poses to the human organism. While empirically effective, multiple adverse effects of these compounds are discussed in the media and in scientific research. UV filters are blamed for the dis-ruption of endocrine processes and vitamin D synthesis, damaging effects on the environment, induction of acne and neurotoxic and carcinogenic effects. Some of these allegations are based on scientific facts while others are simply arbitrary. This is especially dangerous considering the risks of exposing unprotected skin to the sun. In summary, UV filters approved by the respective governing bodies are safe for human use and their proven skin cancer-preventing properties make them in-dispensable for sensible sun protection habits. Nonetheless, compounds like octocrylene and ben-zophenone-3 that are linked to the harming of marine ecosystems could be omitted from skin care regimens in favor of the myriad of non-toxic UV filters.
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Affiliation(s)
- Thomas Breakell
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (T.B.); (I.K.); (Y.F.); (R.K.); (M.E.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN) and CCC Alliance WERA, 91054 Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), 91052 Erlangen, Germany
| | - Isabel Kowalski
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (T.B.); (I.K.); (Y.F.); (R.K.); (M.E.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN) and CCC Alliance WERA, 91054 Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), 91052 Erlangen, Germany
| | - Yannick Foerster
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (T.B.); (I.K.); (Y.F.); (R.K.); (M.E.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN) and CCC Alliance WERA, 91054 Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), 91052 Erlangen, Germany
- Department of Dermatology and Allergy Biederstein, Technical University (TU) Munich, 80802 Munich, Germany
| | - Rafaela Kramer
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (T.B.); (I.K.); (Y.F.); (R.K.); (M.E.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN) and CCC Alliance WERA, 91054 Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), 91052 Erlangen, Germany
| | - Michael Erdmann
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (T.B.); (I.K.); (Y.F.); (R.K.); (M.E.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN) and CCC Alliance WERA, 91054 Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), 91052 Erlangen, Germany
| | - Carola Berking
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (T.B.); (I.K.); (Y.F.); (R.K.); (M.E.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN) and CCC Alliance WERA, 91054 Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), 91052 Erlangen, Germany
| | - Markus V. Heppt
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (T.B.); (I.K.); (Y.F.); (R.K.); (M.E.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN) and CCC Alliance WERA, 91054 Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), 91052 Erlangen, Germany
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Martin-Gorgojo A, Gilaberte Y, Nagore E. Vitamin D and Skin Cancer: An Epidemiological, Patient-Centered Update and Review. Nutrients 2021; 13:4292. [PMID: 34959844 PMCID: PMC8709188 DOI: 10.3390/nu13124292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The current vitamin D deficiency epidemic is accompanied by an increase in endemic skin cancer. There are still multiple controversies. This review aims to give practical recommendations regarding vitamin D among people at risk or with a personal history of skin cancer. METHODS Narrative review including human research articles published between 2011 and 2021, elaborated bearing in mind an epidemiological, patient-centered approach. RESULTS Ultraviolet (UV) exposure (neither artificial nor natural) is not the ideal source to synthesize vitamin D. There is conflicting epidemiological evidence regarding vitamin D, non-melanoma skin cancer (NMSC), and cutaneous melanoma (CMM), confounded by the effect of sun exposure and other factors. CONCLUSIONS Current evidence is controversial, and there are no widely applicable strategies. We propose three practical recommendations. Firstly, sun protection recommendations should be kept among people at risk or with a personal history of skin cancer. Secondly, vitamin D should preferably be sourced through diet. In patients with melanoma or at risk of cutaneous cancer, serum vitamin D checks are warranted to detect and avoid its insufficiency.
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Affiliation(s)
| | - Yolanda Gilaberte
- Dermatology Department, Hospital Universitario Miguel Servet, IIS Aragon, 50009 Zaragoza, Spain;
| | - Eduardo Nagore
- Dermatology Department, Universidad Catolica de Valencia, 46001 Valencia, Spain;
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Feketea GM, Bocsan IC, Tsiros G, Voila P, Stanciu LA, Zdrenghea M. Vitamin D Status in Children in Greece and Its Relationship with Sunscreen Application. CHILDREN-BASEL 2021; 8:children8020111. [PMID: 33562659 PMCID: PMC7914486 DOI: 10.3390/children8020111] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/21/2021] [Accepted: 02/02/2021] [Indexed: 02/04/2023]
Abstract
The aim of this study was to characterize the prevalence and seasonal variation of vitamin D (vit D) deficiency/insufficiency in healthy children and adolescents in Greece, and to explore its relationship with the use of sunscreens. The serum level of 25-hydroxy-vitamin D (25(OH)D) was measured in 376 children and adolescents (184 males and 192 females) with a mean age of 7.6 ± 4.9 years, at different time points over a period of 13 months. The prevalence of low serum 25(OH)D level, including deficiency and insufficiency, was 66.2%. The lowest mean 25(OH)D was observed in the month of January (17.9 ± 6.8 ng/mL) and the highest in September, July, August, and October (34.6 ± 8.7, 33.0 ± 9.4, 30.1 ± 8.2, and 30.1 ± 10.6 ng/mL, respectively). Higher levels of serum 25(OH)D were detected in the children to whom sunscreens had been applied on the beach (p = 0.001) or off the beach (p < 0.001). The subjects with deficiency and insufficiency were significantly older than those with normal levels of 25(OH)D, but no significant differences were demonstrated according to gender. This study emphasizes the high prevalence of low serum levels of 25(OH)D and their seasonal variation in children living in a region characterized by many hours of sunshine. Our data suggest that the real-life use of sunscreens during the summer months allows sufficient sunlight to be received to enable production of vit D at a level adequate to maintain normal serum levels. Vit D supplements should be given to children during the months of lower sun exposure.
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Affiliation(s)
- Gavriela Maria Feketea
- Department of Hematology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (G.M.F.); (M.Z.)
- Department of Pediatrics, Hospital Unit of Amaliada, General Hospital of Ileia, Amaliada, 27200 Ileia, Greece
| | - Ioana Corina Bocsan
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Haţieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
- Correspondence:
| | - Georgios Tsiros
- Family Medicine Department, Health Center of Gastouni, 27300 Ileia, Greece;
| | - Panagiota Voila
- Clinical Chemistry Department, Private Laboratory Medicine, Amaliada, 27200 Ileia, Greece;
| | | | - Mihnea Zdrenghea
- Department of Hematology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (G.M.F.); (M.Z.)
- Department of Hematology, Ion Chiricuta Oncology Institute, 400010 Cluj-Napoca, Romania
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