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Pastor-Nieto MA, Gatica-Ortega ME, Borrego L. Sensitisation to ethylhexyl salicylate: Another piece of the frontal fibrosing alopecia puzzle. Contact Dermatitis 2024; 90:402-410. [PMID: 38010086 DOI: 10.1111/cod.14463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND There is speculation that some environmental factors may be impacting the increasing incidence of frontal fibrosing alopecia (FFA). In a recent publication, sensitisation to benzyl salicylate was shown to be prevalent among 36 patients with FFA. Ethylhexyl salicylate (EHS), a light stabiliser, ultraviolet (UV) B absorber and UV filter, frequently found in photoprotectors/cosmetics and, rarely reported as a sensitiser, was not patch tested in said research. METHODS From January 2021 to February 2022, 33 patients with FFA were patch-tested with the European Photopatch Series, including EHS 10% pet. in two hospitals. In addition, we conducted a literature review and a market survey. RESULTS Patch test reactions to EHS were identified in 9 of 33 (27.3%). Four of nine also reacted to their personal sunscreens (containing EHS). All involved women with a mean age of 54 (30-65). Five patients had been diagnosed with FFA before the patch tests; and, four were diagnosed with FFA during the patch test investigations. CONCLUSION Sensitisation to EHS was frequently found in a selected population of patients with FFA. We propose to expand the spectrum of contact allergens described in patients with FFA to include EHS and discuss the possible need for optimization of the patch test preparation.
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Affiliation(s)
- María Antonia Pastor-Nieto
- Dermatology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
- Dermatology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Medicine and Medical Specialties Department, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Spain
- Universidad de Castilla-La-Mancha, Toledo, Spain
| | - María Elena Gatica-Ortega
- Universidad de Castilla-La-Mancha, Toledo, Spain
- Dermatology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Leopoldo Borrego
- Dermatology Department, Universidad de Las Palmas de Gran Canaria, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
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2
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Badaoui A. Allergic contact dermatitis to aluminium in a sunscreen. Contact Dermatitis 2023; 89:305-307. [PMID: 37493188 DOI: 10.1111/cod.14387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/08/2023] [Accepted: 07/14/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Antoine Badaoui
- Dermatology Department, Military Teaching Hospital, Paris, France
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3
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Kim PJ, Lansang RP, Ko E, Abu-Hilal M. Incidence of melanoma and non-melanoma skin cancer in patients with celiac disease: a systematic review and meta-analysis. Eur J Dermatol 2023; 33:506-513. [PMID: 38297926 DOI: 10.1684/ejd.2023.4565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
There is conflicting observational evidence regarding the association between skin cancer and celiac disease (CD). The purpose of this review was to investigate the incidence rate ratio (IRR) of skin cancer incidence between patients with and without CD. MEDLINE and EMBASE databases were searched on October 27th, 2021 and eight articles were identified for review. Quality assessment was conducted using the Newcastle Ottawa Scale. Seven articles were included in meta-analysis for a pooled estimate of IRR across all skin cancers, malignant melanoma (MM), and non-melanoma skin cancers (NMSC). In total, 74,860 CD patients were followed for 710,214 person-years in the meta-analysis. Overall combined incidence was 99.8 cases per 100,000 person-years. Meta-analysis of all skin cancer incidence showed no significant difference in CD patients compared to controls (IRR: 1.06; 95% CI: 0.95, 1.17; p=0.29; I2: 0%). Five studies reported on MM incidence; there was no significant difference in incidence compared to controls (IRR: 0.87, 95% CI: 0.72, 1.06; p=0.22; I2: 9%). Five studies reported on NMSC incidence, revealing a significantly increased risk of NMSC in CD patients (IRR: 1.14; 95% CI: 1.01, 1.28; p=0.04; I2: 0%). Our findings suggest a significantly increased incidence of NMSC in CD patients compared to control data and no significant association between CD and MM incidence. The findings are limited by the quantity and quality of the evidence. Nonetheless, clinicians should emphasize the importance of sun protection, such as sunscreen usage and self-examination for patients with CD.
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Affiliation(s)
- Patrick J Kim
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Rafael Paolo Lansang
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Emma Ko
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mohannad Abu-Hilal
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada, Faculty of Health Sciences, Division of Dermatology, McMaster University, Hamilton, Ontario, Canada
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4
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Mustieles V, Balogh RK, Axelstad M, Montazeri P, Márquez S, Vrijheid M, Draskau MK, Taxvig C, Peinado FM, Berman T, Frederiksen H, Fernández MF, Marie Vinggaard A, Andersson AM. Benzophenone-3: Comprehensive review of the toxicological and human evidence with meta-analysis of human biomonitoring studies. Environ Int 2023; 173:107739. [PMID: 36805158 DOI: 10.1016/j.envint.2023.107739] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Benzophenone-3 (BP-3) and its major metabolite benzophenone-1 (BP-1) are widely used as UV filters in sunscreens and cosmetics to prevent sunburn and skin damage, or as stabilizers to prevent photodegradation in many commercial products. As a result, their presence is ubiquitous in the environment, wildlife and humans. Based on endocrine disruption concerns, international regulatory agencies are performing a closer evaluation. OBJECTIVE AND METHODS This work aimed to comprehensively review the available human relevant evidence for safety issues in MEDLINE/PubMed in order to create a structured database of studies, as well as to conduct an integrative analysis as part of the Human Biomonitoring for Europe (HBM4EU) Initiative. RESULTS A total of 1,635 titles and abstracts were screened and 254 references were evaluated and tabulated in detail, and classified in different categories: i) exposure sources and predictors; ii) human biomonitoring (HBM) exposure levels to perform a meta-analysis; iii) toxicokinetic data in both experimental animals and humans; iv) in vitro and in vivo rodent toxicity studies; and v) human data on effect biomarkers and health outcomes. Our integrative analysis showed that internal peak BP-3 concentrations achieved after a single whole-body application of a commercially available sunscreen (4% w/w) may overlap with concentrations eliciting endocrine disrupting effects in vitro, and with internal concentrations causing in vivo adverse female reproductive effects in rodents that were supported by still limited human data. The adverse effects in rodents included prolonged estrous cycle, altered uterine estrogen receptor gene expression, endometrium hyperplasia and altered proliferation and histology of the mammary gland, while human data indicated menstrual cycle hormonal alterations and increased risk of uterine fibroids and endometriosis. Among the modes of action reported (estrogenic, anti-androgenic, thyroid, etc.), BP-3 and especially BP-1 showed estrogenic activity at human-relevant concentrations, in agreement with the observed alterations in female reproductive endpoints. The meta-analysis of HBM studies identified a higher concern for North Americans, showing urinary BP-3 concentrations on average 10 and 20 times higher than European and Asian populations, respectively. DISCUSSION AND CONCLUSIONS Our work supports that these benzophenones present endocrine disrupting properties, endorsing recent European regulatory efforts to limit human exposure. The reproducible and comprehensive database generated may constitute a point of departure in future risk assessments to support regulatory initiatives. Meanwhile, individuals should not refrain from sunscreen use. Commercially available formulations using inorganic UV filters that are practically not absorbed into systemic circulation may be recommended to susceptible populations.
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Affiliation(s)
- Vicente Mustieles
- University of Granada, Biomedical Research Center (CIBM), Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Ria K Balogh
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Marta Axelstad
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Parisa Montazeri
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Sandra Márquez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Martine Vrijheid
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Monica K Draskau
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Camilla Taxvig
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Francisco M Peinado
- University of Granada, Biomedical Research Center (CIBM), Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
| | - Tamar Berman
- Department of Environmental Health, Ministry of Health, Jerusalem 9101002, Israel
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Mariana F Fernández
- University of Granada, Biomedical Research Center (CIBM), Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
| | | | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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Porriño-Bustamante ML, Montero-Vílchez T, Pinedo-Moraleda FJ, Fernández-Flores Á, Fernández-Pugnaire MA, Arias-Santiago S. Frontal Fibrosing Alopecia and Sunscreen Use: A Cross-sectional Study of Actinic Damage. Acta Derm Venereol 2022; 102:adv00757. [PMID: 35604235 PMCID: PMC9609976 DOI: 10.2340/actadv.v102.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Patients with frontal fibrosing alopecia report higher rates of sunscreen use than control subjects. However, it is not known whether the higher use of sunscreens is a cause or a consequence of the alopecia. A greater use of sunscreens should be associated with a lower incidence of signs of actinic damage. The aim of this study is to assess the presence of actinic damage in patients with frontal fibrosing alopecia. A cross-sectional study was carried out on 101 patients with frontal fibrosing alopecia and 40 control subjects. The presence of actinic damage, in the form of solar lentigines, actinic keratoses, and basal and squamous cell carcinomas, was recorded in both groups, together with sunscreen use. Trichoscopy and skin biopsy were performed on patients. Actinic damage was present more frequently in patients with frontal fibrosing alopecia (69.3%) than in control subjects (50%) (p = 0.031). Patients used sunscreens more frequently than did control subjects (83.2% vs 62.5%, p = 0.008). However, the prevalence of trichoscopic inflammatory signs, peripheral alopecia, and inflammatory infiltrate and sebaceous gland involvement in skin biopsy, were similar in patients who used sunscreens and those who did not use them. In conclusion, patients with frontal fibrosing alopecia had greater actinic damage than did control subjects, and this is hypothesized as a reason for the higher use of sunscreens among patients. Thus, use of sunscreens may not be the trigger for frontal fibrosing alopecia that dermatologists have proposed.
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Affiliation(s)
| | - Trinidad Montero-Vílchez
- Dermatology Department, University Hospital Virgen de las Nieves, Avenida de Madrid, 15, ES-18012, Granada, Spain.
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6
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Wang P, Huang Y, Zhao Y, Zhou Y, Wang H, Zhang L, Shi H, Sze-Yin Leung K, Zhang Y. Organic UV filters mixture exposure and childhood adiposity: A prospective follow-up study in China. Environ Int 2022; 158:106912. [PMID: 34619533 DOI: 10.1016/j.envint.2021.106912] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND UV filters are emerging contaminants with endocrine disrupting effects, but little is known about their health effects, especially for children. OBJECTIVE To assess the association between multiple organic UV filters exposure and adiposity measures and by gender in peripubertal children. METHODS This prospective follow-up study included 327 children aged 7-15 years old. Urinary organic UV filters including benzophenone derivatives (BP-2, BP-3), octyl dimethyl para-aminobenzoic acid (OD-PABA), ethylhexyl methoxycinnamate (EHMC) and its metabolite (4-MCA and 4'-MAP) were quantified. Six adiposity biometrics including height, weight, waist and hip circumferences, and triceps and subscapular skinfold thickness were measured with 1.5-year duration. The Bayesian kernel machine regression method was used to estimate the associations of UV filters mixture with adiposity measurements, and longitudinal analyses were then considered to further evaluate the associations between individual UV filters and trajectories of growth development using linear mixed models or generalized linear mixed models. RESULTS Exposure to mixture of UV filters was negatively associated with most adiposity measurements, with a reduction of 1.399 kg/m2 (95% CI: -2.246 to -0.551 kg/m2) in BMI, 0.674 (95% CI: -1.045 to -0.304) in BMI z-score, 0.033 BF% (95% CI: -0.053 to -0.013), and 2.301 mm (95% CI: -3.823 to -0.78) in subscapular skinfold thickness at baseline, comparing the 75th percentile to the 25th level of UV filters mixture exposure. Consistent associations were found at follow-up. Both baseline and follow-up results suggested that EHMC was identified as the most important contributor to lower adiposity measurements, which was also confirmed by linear mixed models in longitudinal analyses. No significant effects were found in girls. CONCLUSION This study found that childhood organic UV filters exposure was negatively associated with adiposity measures in peripubertal boys, but not girls.
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Affiliation(s)
- Pengpeng Wang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yanran Huang
- Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong Special Administrative Region
| | - Yingya Zhao
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yuhan Zhou
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Hang Wang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Liyi Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Huijing Shi
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Kelvin Sze-Yin Leung
- Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong Special Administrative Region; Institute of Research and Continuing Education, Shenzhen Virtual University Park, Shenzhen, China
| | - Yunhui Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
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Abstract
Sunscreen application to UV-exposed skin is promoted to prevent skin cancer and sun damage, within a comprehensive photoprotection strategy that also includes sun avoidance and wearing UV protective clothing. The benefits of sunscreen are verified in preventing sunburn but appear to be largely presumptive in skin cancer prevention. Contemporary science establishes UVA as a primary driver of melanoma and photoaging. Consequentially, the traditional UVB-skewed protection of sunscreens provides an intellectual and logical explanation for rising skin cancer rates and, in particular, their failure to protect against melanoma. Better protection could be achieved with more balanced UVB/UVA sunscreens, toward spectral homeostasis protection. Greater balanced protection has another advantage of attenuating fewer UVB rays, which aid synthesis of vitamin D and nitric oxide. Percutaneous absorption of Soluble Organic UV Filters leads to systemic exposure, which becomes the relevant safety consideration. It is minimized by selecting Insoluble UV Filters with low absorption potential from a molecular weight above 500 Da. The filters must also be very hydrophilic, very lipophilic, or consist of particles. The risk-benefit ratio is a medical imperative, more so for cosmetics or sunscreens, since in principle there should be no risk from their use. The production of ideal sunscreens that mimic the effective, balanced UVB/UVA attenuation of textiles and shade is now possible, while maintaining an acceptable therapeutic margin of safety in humans and a favorable ecologic profile. Sunscreens with a favorable risk-benefit ratio and good esthetic properties or other consumer-friendly attributes will improve compliance and may achieve substantial clinical benefits.
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Affiliation(s)
| | - Sharyn A Laughlin
- Division of Dermatology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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8
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Herzog B, Sohn M. The Formula for Best Sunscreen Performance: Beer-Lambert's Law Under the Microscope. Curr Probl Dermatol 2021; 55:133-143. [PMID: 34698036 DOI: 10.1159/000517663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sunscreens used for the protection of human skin work by attenuating the potentially harmful solar UV radiation. In recent years, the quantitative understanding of this attenuating effect has grown tremendously, enabling model calculations of sunscreen performance. Such calculations are based on the simulation of the UV transmission of the sunscreen film applied on human skin. However, there are 2 prerequisites assumed to hold. The first prerequisite is the applicability of the Beer-Lambert law for sunscreen films, and the second is that the thickness variation of the sunscreen film can be described with a gamma distribution of film heights. There is strong evidence from recent experimental work that both assumptions are correct. For several applications, calculations of sunscreen performance have been shown to be useful, for instance, in the design of new sunscreen formulations aiming for a certain sun protection factor or other characteristics, prediction of pre-vitamin D production in the skin in the presence of sunscreen, in vitro measurement of water resistance, and assessment of the ecotoxicological profile of a sunscreen formulation or the influence of oil polarity on UV-filter absorbance and the consequence for sunscreen performance.
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Affiliation(s)
- Bernd Herzog
- BASF Grenzach GmbH, Grenzach-Wyhlen, Germany
- University of Basel, Basel, Switzerland
| | - Myriam Sohn
- BASF Grenzach GmbH, Grenzach-Wyhlen, Germany
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9
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Sunscreens. Med Lett Drugs Ther 2021; 63:115-20. [PMID: 34606203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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10
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Mirmirani P, Vanderweil SG. Frontal fibrosing alopecia with involvement of the central hair part: distribution of hair loss corresponding to areas of sunscreen application. Dermatol Online J 2020; 26:13030/qt8t41g0th. [PMID: 33342178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/14/2020] [Accepted: 07/03/2020] [Indexed: 06/12/2023] Open
Abstract
Frontal fibrosing alopecia (FFA) typically presents with band-like scarring alopecia in the frontal and temporal hairline along with eyebrow loss. Although this type of hair loss is being seen with increased frequency worldwide, the etiology of the condition is unknown. Studies have suggested a potential environmental role with moisturizers and sunscreens being possible triggers. Herein, we present a 42-year-old woman with a biopsy-proven diagnosis of frontal fibrosing alopecia. In addition to the typical pattern, she also had a striking linear patch of hair loss along her central part. This was an area where she regularly applied sunscreen for many years. Although a causative role for sunscreen ingredients in the development of FFA has not been proven, the evidence accumulated thus far, including our suggestive case, substantiates the need for further study. Additionally, increasing awareness of this potential effect leading to appropriate counseling regarding cessation of possible triggers may be critical for the prevention of further hair loss.
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Affiliation(s)
- Paradi Mirmirani
- Department of Dermatology, The Permanente Medical Group, Vallejo, CA Department of Dermatology, University of California, San Francisco, San Francisco, CA Department of Dermatology, Case Western Reserve University, Cleveland, OH.
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11
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Suh S, Pham C, Smith J, Mesinkovska NA. The banned sunscreen ingredients and their impact on human health: a systematic review. Int J Dermatol 2020; 59:1033-1042. [PMID: 32108942 PMCID: PMC7648445 DOI: 10.1111/ijd.14824] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 01/18/2023]
Abstract
Recent evidence of high systemic absorption of sunscreen ingredients has raised concerns regarding the safety of sunscreen products. Oxybenzone (BP-3) and octinoxate (OMC), two common sunscreen ingredients, were recently banned in Key West and Hawaii owing to their toxic effects on marine ecosystems. Their impact on human health requires a careful assessment. To summarize the current evidence on the association between the systemic level of BP-3 or OMC and its health impact, a primary literature search was conducted using PubMed database in February 2019. There are 29 studies that address the impact of these ingredients on human health. Studies show that elevated systemic level of BP-3 has no adverse effect on male and female fertility, female reproductive hormone level, adiposity, fetal growth, child's neurodevelopment, and sexual maturation. However, the association of BP-3 level on thyroid hormone, testosterone level, kidney function, and pubertal timing has been reported and prompts further investigations to validate a true association. The systemic absorption of OMC has no reported effect on thyroid and reproductive hormone levels. In conclusion, current evidence is not sufficient to support the causal relationship between the elevated systemic level of BP-3 or OMC and adverse health outcomes. There are either contradictory findings among different studies or an insufficient number of studies to corroborate the observed association. To accurately evaluate the long-term risk of exposure to BP-3 and OMC from sunscreen, a well-designed longitudinal randomized controlled trial needs to be conducted.
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Affiliation(s)
- Susie Suh
- University of California, Irvine, Department of Dermatology, Irvine, CA
- Case Western Reserve University, Department of Pharmacology, Cleveland, OH
- University of California, Irvine, Department of Ophthalmology, Gavin Herbert Eye Institute, Irvine, CA
| | - Christine Pham
- University of California, Irvine, Department of Dermatology, Irvine, CA
| | - Janellen Smith
- University of California, Irvine, Department of Dermatology, Irvine, CA
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Imhof RL, Larkin SC, Cantwell HM, Torgerson RR, Tolkachjov SN. The association of frontal fibrosing alopecia with skin and hair care products: A survey-based case series of 56 patients seen at the Mayo Clinic. J Am Acad Dermatol 2020; 84:532-534. [PMID: 32437720 DOI: 10.1016/j.jaad.2020.03.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/01/2020] [Accepted: 03/19/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Reese L Imhof
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sydney C Larkin
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota
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13
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Julian AK, Thorburn S, Geldhof GJ. Tanning benefits, seasonal effects, and concerns about sunscreen: Measuring health beliefs about UV among college students. J Am Coll Health 2020; 68:395-402. [PMID: 30849298 DOI: 10.1080/07448481.2019.1574800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 10/23/2018] [Accepted: 01/17/2019] [Indexed: 06/09/2023]
Abstract
Objective: To develop and validate a scale measuring health beliefs about UV in cloudy climates that may impact UV exposure behaviors. Participants: Students at a large university in Oregon completed pilot (N = 115) and final (N = 335) scales online March-July, 2016. Five participants underwent cognitive interviews. Methods: Expert feedback, cognitive interviews, and pilot data guided item development and refinement. We conducted factor analysis and invariance testing. Results: The final four-factor model fit well (χ2 = 37.97, df = 37, RMSEA = 0.000, CFI = 1.000). HBAU subscales are Sunscreen Toxicity, Seasonal Effects, Health Benefits of Tanning, and Tanning Through the Winter. Invariance testing supported strong invariance across sex and tanning status. Conclusion: The HBAU measures beliefs that encourage UV exposure and discourage protection (eg, the belief that sunscreen ingredients are toxic). This scale will enable more comprehensive measurement of cognitive predictors of UV exposure for student health, clinical, and research purposes.
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Affiliation(s)
- Anne K Julian
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Sheryl Thorburn
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - G John Geldhof
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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14
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Matta MK, Florian J, Zusterzeel R, Pilli NR, Patel V, Volpe DA, Yang Y, Oh L, Bashaw E, Zineh I, Sanabria C, Kemp S, Godfrey A, Adah S, Coelho S, Wang J, Furlong LA, Ganley C, Michele T, Strauss DG. Effect of Sunscreen Application on Plasma Concentration of Sunscreen Active Ingredients: A Randomized Clinical Trial. JAMA 2020; 323:256-267. [PMID: 31961417 PMCID: PMC6990686 DOI: 10.1001/jama.2019.20747] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE A prior pilot study demonstrated the systemic absorption of 4 sunscreen active ingredients; additional studies are needed to determine the systemic absorption of additional active ingredients and how quickly systemic exposure exceeds 0.5 ng/mL as recommended by the US Food and Drug Administration (FDA). OBJECTIVE To assess the systemic absorption and pharmacokinetics of the 6 active ingredients (avobenzone, oxybenzone, octocrylene, homosalate, octisalate, and octinoxate) in 4 sunscreen products under single- and maximal-use conditions. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial at a clinical pharmacology unit (West Bend, Wisconsin) was conducted in 48 healthy participants. The study was conducted between January and February 2019. INTERVENTIONS Participants were randomized to 1 of 4 sunscreen products, formulated as lotion (n = 12), aerosol spray (n = 12), nonaerosol spray (n = 12), and pump spray (n = 12). Sunscreen product was applied at 2 mg/cm2 to 75% of body surface area at 0 hours on day 1 and 4 times on day 2 through day 4 at 2-hour intervals, and 34 blood samples were collected over 21 days from each participant. MAIN OUTCOMES AND MEASURES The primary outcome was the maximum plasma concentration of avobenzone over days 1 through 21. Secondary outcomes were the maximum plasma concentrations of oxybenzone, octocrylene, homosalate, octisalate, and octinoxate over days 1 through 21. RESULTS Among 48 randomized participants (mean [SD] age, 38.7 [13.2] years; 24 women [50%]; 23 white [48%], 23 African American [48%], 1 Asian [2%], and 1 of unknown race/ethnicity [2%]), 44 (92%) completed the trial. Geometric mean maximum plasma concentrations of all 6 active ingredients were greater than 0.5 ng/mL, and this threshold was surpassed on day 1 after a single application for all active ingredients. For avobenzone, the overall maximum plasma concentrations were 7.1 ng/mL (coefficient of variation [CV], 73.9%) for lotion, 3.5 ng/mL (CV, 70.9%) for aerosol spray, 3.5 ng/mL (CV, 73.0%) for nonaerosol spray, and 3.3 ng/mL (CV, 47.8%) for pump spray. For oxybenzone, the concentrations were 258.1 ng/mL (CV, 53.0%) for lotion and 180.1 ng/mL (CV, 57.3%) for aerosol spray. For octocrylene, the concentrations were 7.8 ng/mL (CV, 87.1%) for lotion, 6.6 ng/mL (CV, 78.1%) for aerosol spray, and 6.6 ng/mL (CV, 103.9%) for nonaerosol spray. For homosalate, concentrations were 23.1 ng/mL (CV, 68.0%) for aerosol spray, 17.9 ng/mL (CV, 61.7%) for nonaerosol spray, and 13.9 ng/mL (CV, 70.2%) for pump spray. For octisalate, concentrations were 5.1 ng/mL (CV, 81.6%) for aerosol spray, 5.8 ng/mL (CV, 77.4%) for nonaerosol spray, and 4.6 ng/mL (CV, 97.6%) for pump spray. For octinoxate, concentrations were 7.9 ng/mL (CV, 86.5%) for nonaerosol spray and 5.2 ng/mL (CV, 68.2%) for pump spray. The most common adverse event was rash, which developed in 14 participants. CONCLUSIONS AND RELEVANCE In this study conducted in a clinical pharmacology unit and examining sunscreen application among healthy participants, all 6 of the tested active ingredients administered in 4 different sunscreen formulations were systemically absorbed and had plasma concentrations that surpassed the FDA threshold for potentially waiving some of the additional safety studies for sunscreens. These findings do not indicate that individuals should refrain from the use of sunscreen. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03582215.
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Affiliation(s)
- Murali K. Matta
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Jeffry Florian
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Robbert Zusterzeel
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Nageswara R. Pilli
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Vikram Patel
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Donna A. Volpe
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Yang Yang
- Division of Pharmaceutical Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Luke Oh
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Edward Bashaw
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Issam Zineh
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | | | - Sarah Kemp
- Spaulding Clinical Research, West Bend, Wisconsin
| | | | - Steven Adah
- Division of Nonprescription Drug Products, Office of Drug Evaluation IV, Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Sergio Coelho
- Division of Nonprescription Drug Products, Office of Drug Evaluation IV, Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Jian Wang
- Office of Drug Evaluation IV, Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Lesley-Anne Furlong
- Office of Drug Evaluation IV, Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Charles Ganley
- Office of Drug Evaluation IV, Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Theresa Michele
- Division of Nonprescription Drug Products, Office of Drug Evaluation IV, Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - David G. Strauss
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
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15
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Mazori DR. Annual skin check: examining the dermatology headlines of 2019. Cutis 2019; 104:E28-E30. [PMID: 31939942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
As the calendar year comes to an end, this article reviews unique issues in dermatology that made the news in 2019: chemical sunscreen, the measles outbreak, drug approvals for pediatric dermatology and orphan diseases, and recalls of popular skin care products.
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Affiliation(s)
- Daniel R Mazori
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn, USA
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16
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Mínguez-Alarcón L, Chiu YH, Nassan FL, Williams PL, Petrozza J, Ford JB, Calafat AM, Hauser R, Chavarro JE. Urinary concentrations of benzophenone-3 and reproductive outcomes among women undergoing infertility treatment with assisted reproductive technologies. Sci Total Environ 2019; 678:390-398. [PMID: 31077917 PMCID: PMC6550292 DOI: 10.1016/j.scitotenv.2019.04.452] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 05/20/2023]
Abstract
Benzophenone-3 is used in a variety of cosmetic products as a sunscreen, and has shown weak estrogenic and antiandrogenic activity in animal and in vitro studies. Few studies have evaluated whether benzophenone-3 is associated with reproductive outcomes among women. We studied 304 women undergoing infertility treatment (2007-2017) in the prospective Environment and Reproductive Health cohort study and who underwent 449 treatment cycles (n = 788 urines). Generalized linear mixed models were used with random intercepts to account for multiple cycles, and adjusting for confounders including physical activity. Analyses were also stratified by self-reported moderate/heavy outdoor work. The cycle-specific median (IQR) urinary benzophenone-3 concentration was 147 (58, 462) μg/L, and 98% samples had detectable concentrations. Self-reported sunscreen use, physical activity, and time spent on moderate/heavy outdoor work were positively associated with urinary benzophenone-3. Adjusted probabilities of implantation, clinical pregnancy and live birth were higher in increasing quartiles of benzophenone-3, but these associations were restricted to women who reported spending time outdoors performing moderate/heavy work. Specifically, among these women, those in the highest quartile of benzophenone-3 concentrations had 51% higher implantation (p,trend = 0.02), 68% higher clinical pregnancy (p,trend = 0.01) and 75% higher live birth (p,trend = 0.02) adjusted probabilities than women in the lowest quartile. Benzophenone-3 was unrelated to these outcomes among women who did not report doing moderate/heavy work outdoors. These results confirm that sunscreen use is a source of benzophenone-3 exposure, and show positive associations between benzophenone-3 and pregnancy outcomes, especially among women who reported engaging in outdoor work. Since these associations may be subject to important residual confounding by lifestyle factors, further research is needed to confirm these novel results in other populations, and to investigate whether other factors may be affecting the relation of benzophenone-3 with fertility and other health outcomes.
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Affiliation(s)
- Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, United States of America.
| | - Yu-Han Chiu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America
| | - Feiby L Nassan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, United States of America; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, United States of America
| | - Paige L Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, United States of America
| | - John Petrozza
- Division of Reproductive Medicine and IVF, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, United States of America
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, United States of America
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America; Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America
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17
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Lindstrom AR, von Schuckmann LA, Hughes MCB, Williams GM, Green AC, van der Pols JC. Regular Sunscreen Use and Risk of Mortality: Long-Term Follow-up of a Skin Cancer Prevention Trial. Am J Prev Med 2019; 56:742-746. [PMID: 30885518 DOI: 10.1016/j.amepre.2018.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Sunscreen is widely used to protect the skin from harmful effects of sun exposure. However, there are concerns that sunscreens may negatively affect overall health. Evidence of the general safety of long-term regular sunscreen use is therefore needed. METHODS The effect of long-term sunscreen use on mortality was assessed over a 21-year period (1993-2014) among 1,621 Australian adults who had participated in a randomized skin cancer prevention trial of regular versus discretionary sunscreen use (1992-1996). In 2018, an intention-to-treat analysis was conducted using Cox proportional hazards regression to compare death rates in people who were randomized to apply sunscreen daily for 4.5years, versus randomized to use sunscreen at their usual, discretionary level. All-cause mortality and deaths resulting from cardiovascular disease, cancer, and other causes were considered. RESULTS In total, 160 deaths occurred in the daily sunscreen group compared with 170 deaths in the discretionary sunscreen group (hazard ratio=0.94, 95% CI=0.76, 1.17); 59vs 76 cardiovascular disease deaths (hazard ratio=0.77, 95% CI=0.55, 1.08), 63vs 58 cancer deaths (hazard ratio=1.09, 95% CI=0.76, 1.57), and 45vs 44 deaths resulting from other causes (hazard ratio=1.02, 95% CI=0.67, 1.54) occurred respectively. CONCLUSIONS Regular use of a sun protection factor 16 sunscreen on head, neck, arms, and hands for 4.5years did not increase mortality.
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Affiliation(s)
- Akiaja R Lindstrom
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Lena A von Schuckmann
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Maria Celia B Hughes
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Gail M Williams
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Adele C Green
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia; CRUK Manchester Institute and Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Jolieke C van der Pols
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia.
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18
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Affiliation(s)
- Jayden Galamgam
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Natalia Linou
- United Nations Development Program, New York, NY, USA
| | - Eleni Linos
- Program for Clinical Research, Department of Dermatology, University of California, San Francisco, CA 94115, USA.
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19
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Abstract
The solar radiation range has harmful and beneficial effects. Sunscreens, which selectively block specific spectral regions, may potentially interfere with skin homeostasis. For instance, the ultraviolet (UV) B waveband produces erythema and DNA damage; simultaneously, it induces pre-vitamin D3 synthesis. UVA1 and visible light can both induce pigmentation in skin phototypes IV–VI, and act in synergy to induce erythema and persistent pigment darkening. In contrast, UVA may contribute to blood pressure control and cardioprotection by inducing release of nitric oxide from intracutaneous photolabile nitric oxide derivatives. Finally, infrared A radiation alters the collagen equilibrium of the dermal extracellular matrix but is involved in the regulation of body temperature and in nitric oxide release, with a potential beneficial impact on blood pressure regulation. Ideally, photoprotection should thus be performed with a neutral density filter, mitigating all radiation ranges homogeneously, to maintain solar spectrum homeostasis. Natural compounds such as mycosporine-like amino acids are promising natural UV radiation-filtering compounds for an improved homeostasis with our environment. Lastly, we should not forget individual characteristics and behavior, as homeostasis differs according to individual phototypes and skin exposure behaviors.
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Affiliation(s)
- Fernando Stengel
- Buenos Aires Skin, Avenida Cordoba 1184, 10 Piso. (1055), Ciudad Autónoma de Buenos Aires, Argentina.
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20
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Abstract
Photodermatoses occur in males and females of all races and ages. Onset can be variable in timing and influenced by genetic and environmental factors. Photodermatoses are broadly classified as immunologically mediated, chemical- and drug-induced, photoaggravated, and genetic (defective DNA repair or chromosomal instability) diseases. Advances in the field have led to improved recognition and treatment of many photodermatoses. The purpose of this focused review is to provide an update on the diagnosis and management of a variety of photodermatoses, both common and less common, with review of recent updates in the literature pertaining to their diagnosis and management.
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Affiliation(s)
- Amanda F Nahhas
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA
| | - David M Oberlin
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA
| | - Taylor L Braunberger
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA
| | - Henry W Lim
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA.
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21
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Sunscreens. Med Lett Drugs Ther 2018; 60:129-32. [PMID: 30133423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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22
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Grossman DC, Curry SJ, Owens DK, Barry MJ, Caughey AB, Davidson KW, Doubeni CA, Epling JW, Kemper AR, Krist AH, Kubik M, Landefeld S, Mangione CM, Silverstein M, Simon MA, Tseng CW. Behavioral Counseling to Prevent Skin Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2018; 319:1134-1142. [PMID: 29558558 DOI: 10.1001/jama.2018.1623] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Skin cancer is the most common type of cancer in the United States. Although invasive melanoma accounts for only 2% of all skin cancer cases, it is responsible for 80% of skin cancer deaths. Basal and squamous cell carcinoma, the 2 predominant types of nonmelanoma skin cancer, represent the vast majority of skin cancer cases. OBJECTIVE To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on behavioral counseling for the primary prevention of skin cancer and the 2009 recommendation on screening for skin cancer with skin self-examination. EVIDENCE REVIEW The USPSTF reviewed the evidence on whether counseling patients about sun protection reduces intermediate outcomes (eg, sunburn or precursor skin lesions) or skin cancer; the link between counseling and behavior change, the link between behavior change and skin cancer incidence, and the harms of counseling or changes in sun protection behavior; and the link between counseling patients to perform skin self-examination and skin cancer outcomes, as well as the harms of skin self-examination. FINDINGS The USPSTF determined that behavioral counseling interventions are of moderate benefit in increasing sun protection behaviors in children, adolescents, and young adults with fair skin types. The USPSTF found adequate evidence that behavioral counseling interventions result in a small increase in sun protection behaviors in adults older than 24 years with fair skin types. The USPSTF found inadequate evidence on the benefits and harms of counseling adults about skin self-examination to prevent skin cancer. CONCLUSIONS AND RECOMMENDATION The USPSTF recommends counseling young adults, adolescents, children, and parents of young children about minimizing exposure to UV radiation for persons aged 6 months to 24 years with fair skin types to reduce their risk of skin cancer. (B recommendation) The USPSTF recommends that clinicians selectively offer counseling to adults older than 24 years with fair skin types about minimizing their exposure to UV radiation to reduce risk of skin cancer. Existing evidence indicates that the net benefit of counseling all adults older than 24 years is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the presence of risk factors for skin cancer. (C recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of counseling adults about skin self-examination to prevent skin cancer. (I statement).
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Affiliation(s)
| | | | | | - Douglas K Owens
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California
- Stanford University, Stanford, California
| | | | | | | | | | | | | | - Alex H Krist
- Fairfax Family Practice Residency, Fairfax, Virginia
- Virginia Commonwealth University, Richmond
| | | | | | | | | | | | - Chien-Wen Tseng
- University of Hawaii, Honolulu
- Pacific Health Research and Education Institute, Honolulu, Hawaii
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23
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Wang JV, Korta DZ, Zachary CB. Gel manicures and ultraviolet A light: A call for patient education. Dermatol Online J 2018; 24:13030/qt5hx4g5v4. [PMID: 29634895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 06/08/2023] Open
Abstract
Gel manicures have become a popular beauty trend in recent years. The specially formulated nail polish must undergo curing under light-based units. The majority of these curing lamps emit high-intensity ultraviolet A, which can cause skin damage and increase the risk for skin cancers. Incorporating relevant information in patient education endeavors can help them practice avoidance, apply broad-spectrum sunscreen prior, or use nitrile exam gloves in order to prevent photoaging and skin cancer resulting from these procedures.
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Affiliation(s)
- Jordan V Wang
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania.
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24
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Bosanac SS, Clark AK, Sivamani RK. Phytophotodermatitis related to carrot extract-containing sunscreen. Dermatol Online J 2018; 24:13030/qt2nv2d1n0. [PMID: 29469776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 06/08/2023] Open
Abstract
Phytophotodermatitis is a clinical diagnosis from phototoxicity of the skin induced by contact with plants or their extracts. Phytophotodermatitis maypresent with burning, erythema, patches, plaques, vesicles, bullae, or hyperpigmented patches in welldemarcated and unusual shapes. Inquiring about occupation, hobbies, and plant or plant extract contact is essential to establishing the diagnosis. Herein we present a case of phytophotodermatitisafter use of carrot extract-containing sunscreen presenting as a hyperpigmented patch in a geometric distribution with accentuation of pigment within the dynamic rhytides.
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Affiliation(s)
| | | | - R K Sivamani
- Department of Dermatology, University of California Davis, Sacramento, California, Department of Biological Sciences, California State University Sacramento, Sacramento, California.
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25
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Siller A, Blaszak SC, Lazar M, Olasz Harken E. Update About the Effects of the Sunscreen Ingredients Oxybenzone and Octinoxate on Humans and the Environment. Plast Surg Nurs 2018; 38:158-161. [PMID: 30507815 DOI: 10.1097/psn.0000000000000244] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
As skin cancer prevalence continues to rise, the importance of sun protection, including sunscreen use, has become accepted in the public. Sunscreens are divided into two main categories based on the type of their active ingredient, organic and inorganic ultraviolet (UV) filters. It has been shown that inorganic filters are more effective at blocking forms of UV light, both UVA and UVB, as compared with organic filters because organic sunscreens absorb and convert radiation whereas inorganic sunscreens reflect radiation. The use of the two most common organic filters, oxybenzone and octinoxate, has recently been restricted in Hawaii due to their harmful effect on the coral reefs. Here, we discuss recent studies about these specific filters related to the adverse health risks they pose for humans and other organisms, as well as environmental repercussions.
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Affiliation(s)
- Alfredo Siller
- Alfredo Siller, BS, is medical student, Medical College of Wisconsin, Milwaukee. Scott C. Blaszak, BS, is medical student, Medical College of Wisconsin, Milwaukee. Michelle Lazar, is college student, University of Wisconsin, Madison. Edit B. Olasz Harken, MD, PhD, is Associate Professor, Medical College of Wisconsin, Milwaukee. She is co-founder of Harken Derm LLC
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26
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Gomes-Neto A, Aguilera P, Prieto L, Seité S, Moyal D, Carrera C, Malvehy J, Puig S. Efficacy of a Daily Protective Moisturizer with High UVB and UVA Photoprotection in Decreasing Ultraviolet Damage: Evaluation by Reflectance Confocal Microscopy. Acta Derm Venereol 2017; 97:1196-1201. [PMID: 28661544 DOI: 10.2340/00015555-2736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with photodermatoses or actinic keratosis benefit from very high ultraviolet B-ultraviolet A (UVB-UVA) photoprotection. However, poor compliance is an issue that jeopardizes adequate protection, leading to disease recurrence. This study evaluated the efficacy of a daily protective moisturizer with high UVB and UVA photoprotection applied 8 h before irradiation. A monocentric, open-label, prospective, control pilot study was performed including 10 patients. Patients were irradiated with UVB and UVA before and 8 h after topical application of the product. Reflectance confocal microscopy (RCM) assessment was performed 24 h later. Clinical assessment showed a statistically significant increase in minimal erythema dose (MED) after application of the product (p <0.001). Signs of UV damage according to RCM were not observed on photoprotected skin (p <0.05). Skin irradiated 8 h after applying a daily protective moisturizer presented an increase in MED and RCM findings that equal the findings for non-irradiated skin.
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Affiliation(s)
- Antonio Gomes-Neto
- Melanoma Unit, Dermatology Department, Hospital Clínic and IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain
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27
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Abstract
Sunscreens have been widely used by the general public for their photoprotective properties, including prevention of photocarcinogenesis and photoaging and management of photodermatoses. It is important to emphasize to consumers the necessity of broad-spectrum protection, with coverage of both ultraviolet A (320-400 nm) and ultraviolet B (290-320 nm) radiation. This review discusses the benefits of sunscreen, different ultraviolet filters, sunscreen regulations and controversies, the importance of broad-spectrum protection, issues of photostability and formulation, and patient education and compliance.
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Affiliation(s)
| | - Rohit Maruthi
- Boston University School of Medicine, Boston, MA, USA
| | - Steve Q Wang
- Department of Dermatology, Memorial Sloane Kettering, New York, NY, USA
| | - Henry W Lim
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA.
- Department of Dermatology, Henry Ford Medical Center-New Center One, 3031 W. Grand Boulevard, Suite 800, Detroit, MI, 48202, USA.
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28
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Sharma A, Bányiová K, Babica P, El Yamani N, Collins AR, Čupr P. Different DNA damage response of cis and trans isomers of commonly used UV filter after the exposure on adult human liver stem cells and human lymphoblastoid cells. Sci Total Environ 2017; 593-594:18-26. [PMID: 28340478 DOI: 10.1016/j.scitotenv.2017.03.043] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 02/25/2017] [Accepted: 03/05/2017] [Indexed: 06/06/2023]
Abstract
2-ethylhexyl 4-methoxycinnamate (EHMC), used in many categories of personal care products (PCPs), is one of the most discussed ultraviolet filters because of its endocrine-disrupting effects. EHMC is unstable in sunlight and can be transformed from trans-EHMC to emergent cis-EHMC. Toxicological studies are focusing only on trans-EHMC; thus the toxicological data for cis-EHMC are missing. In this study, the in vitro genotoxic effects of trans- and cis-EHMC on adult human liver stem cells HL1-hT1 and human-derived lymphoblastoid cells TK-6 using a high-throughput comet assay were studied. TK-6 cells treated with cis-EHMC showed a high level of DNA damage when compared to untreated cells in concentrations 1.56 to 25μgmL-1. trans-EHMC showed genotoxicity after exposure to the two highest concentrations 12.5 and 25μgmL-1. The increase in DNA damage on HL1-hT1 cells induced by cis-EHMC and trans-EHMC was detected at the concentration 25μgmL-1. The No observed adverse effect level (NOAEL, mg kg-1bwday-1) was determined using a Quantitative in vitro to in vivo extrapolation (QIVIVE) approach: NOAELtrans-EHMC=3.07, NOAELcis-EHMC=0.30 for TK-6 and NOAELtrans-EHMC=26.46, NOAELcis-EHMC=20.36 for HL1-hT1. The hazard index (HI) was evaluated by comparing the reference dose (RfD, mgkg-1bwday-1) obtained from our experimental data with the chronic daily intake (CDI) of the female population. Using comet assay experimental data with the more sensitive TK-6 cells, HIcis-EHMC was 7 times higher than HItrans-EHMC. In terms of CDI, relative contributions were; dermal exposure route>oral>inhalation. According to our results we recommend the RfDtrans-EHMC=0.20 and RfDcis-EHMC=0.02 for trans-EHMC and cis-EHMC, respectively, to use for human health risk assessment. The significant difference in trans-EHMC and cis-EHMC response points to the need for toxicological reevaluation and application reassessment of both isomers in PCPs.
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Affiliation(s)
- Anežka Sharma
- Masaryk University, Faculty of Science, RECETOX, Research Centre for Toxic Compounds in the Environment, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Katarína Bányiová
- Masaryk University, Faculty of Science, RECETOX, Research Centre for Toxic Compounds in the Environment, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Pavel Babica
- Masaryk University, Faculty of Science, RECETOX, Research Centre for Toxic Compounds in the Environment, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Naouale El Yamani
- Department of Nutrition, University of Oslo, PO Box 1046, Blindern, N-0316 Oslo, Norway; Department of Environmental Chemistry, Health Effect Laboratory, NILU-Norwegian Institute for Air Research, Instituttveien 18, 2007 Kjeller, Norway
| | | | - Pavel Čupr
- Masaryk University, Faculty of Science, RECETOX, Research Centre for Toxic Compounds in the Environment, Kamenice 753/5, 625 00 Brno, Czech Republic.
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Corinaldesi C, Damiani E, Marcellini F, Falugi C, Tiano L, Brugè F, Danovaro R. Sunscreen products impair the early developmental stages of the sea urchin Paracentrotus lividus. Sci Rep 2017; 7:7815. [PMID: 28798318 PMCID: PMC5552690 DOI: 10.1038/s41598-017-08013-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/06/2017] [Indexed: 12/03/2022] Open
Abstract
Marine ecosystems are increasingly threatened by the release of personal care products. Among them, sunscreens are causing concern either for the effects on skin protection from UV radiation and for the potential impacts on marine life. Here, we assessed the UVA protective efficacy of three sunscreens on human dermal fibroblasts, including two common products in Europe and USA, and an eco-friendly product. The sunscreens' effects were also tested on Paracentrotus lividus, a marine species possibly threatened by these contaminants. We found that all tested sunscreens had similar efficacy in protecting human fibroblasts from UVA radiation. Conversely, the sunscreens' effects on embryo-larval development of P. lividus were dependent on the product tested. In particular, the USA sunscreen, containing benzophenone-3, homosalate and preservatives, caused the strongest impact on the sea urchin development, whereas the eco-friendly sunscreen determined the weakest effects. These results suggest that although the tested products protected human skin cells from UVA-induced damage, they might severely affect the success of recruitment and survival of the sea urchin. Our findings underline the importance of developing eco-friendly sunscreens for minimising or avoiding the impact on marine life while protecting human skin from UV damage.
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Affiliation(s)
- Cinzia Corinaldesi
- Department of Sciences and Engineering of Materials, Environment and Urbanistics, Polytechnic University of Marche, Via Brecce Bianche, Ancona, Italy.
| | - Elisabetta Damiani
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, Ancona, Italy
| | - Francesca Marcellini
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, Ancona, Italy
- Ecoreach Ltd., Corso Stamira 61, 60121, Ancona, Italy
| | - Carla Falugi
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, Ancona, Italy
| | - Luca Tiano
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, Ancona, Italy
| | - Francesca Brugè
- Department of Clinical, Specialistic and Odontostomatological Sciences, Polytechnic University of Marche, Via Brecce Bianche, Ancona, Italy
| | - Roberto Danovaro
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, Ancona, Italy
- Stazione Zoologica Anton Dohrn, Naples, Italy
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Abstract
Electromagnetic radiation in the ultraviolet, visible, and infrared ranges all produce biologic effects. Ultraviolet filters are the most well-studied photoprotective measure for the adverse effects of ultraviolet radiation. Because of the reported endocrinologic effects of oxybenzone in animal studies, its effects on coral reefs, and its photocontact allergy potential, its use has been minimized in many countries worldwide. New developments in topical antioxidants and oral and subcutaneous agents (eg, Polypodium leucotomos extract, afamelanotide, nicotinamide) with photoprotective and antiphotocarcinogenic properties could potentially provide addition modalities for protection against the effects of visible light and infrared radiation.
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Affiliation(s)
- Henry W Lim
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
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Babino G, Diluvio L, Bianchi L, Orlandi A, Di Prete M, Chimenti S, Milani M, Campione E. Long-term use of a new topical formulation containing piroxicam 0.8% and sunscreen: efficacy and tolerability on actinic keratosis. A proof of concept study. Curr Med Res Opin 2016; 32:1345-9. [PMID: 27046744 DOI: 10.1080/03007995.2016.1174678] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Cyclooxygenase (COX) 1 and 2 enzyme up-regulation is involved in the pathogenetic process of actinic keratosis (A.K.) and non-melanoma skin cancers. Diclofenac, a non-steroidal anti-inflammatory (N.S.A.I.D.) drug, is used as topical treatment of A.K. Piroxicam is a N.S.A.I.D. characterized by a high COX-1 inhibition activity. STUDY AIM We conducted an 18 month exploratory open-label study on A.K., to assess the efficacy and tolerability of a new topical formulation of piroxicam and sunscreen in A.K. PATIENTS Enrolled subjects applied a galenic formulation of piroxicam 0.8%, vehiculated in a topical product containing sun filters with high (50+) and broad spectrum (UVA) actions, twice a day for 6 months. Subjects were then followed up for additional 12 months. Thirty-eight subjects with a total of 69 A.K. lesions participated in the trial. The primary outcome was the evolution of the Actinic Keratosis Erythema Scale Atrophy (A.K.E.S.A) score assessing erythema, scale, and atrophy of a target A.K. lesion. Secondary outcomes were the percentage of treated lesions with complete (100%) or partial (≥75%) clearance and the evaluation skin tolerability. RESULTS A.K.E.S.A. mean (S.D.) score at baseline was 7.5 (1.2). After 6 months of treatment, A.K.E.S.A. score decreased to 0.9 (1.1), a -88% reduction versus baseline. At the end of follow-up, A.K.E.S.A. score was 0.8 (1.2). A complete response was achieved in 38 of the 69 lesions (55%, 95% C.I.: 43% to 66%) and clearance was maintained 1 year post-treatment. A partial clearance was observed in 57 of 69 treated lesions (83%, 95% C.I.: 73% to 91%). Adverse events were limited to mild local irritation. CONCLUSION Our experience suggests that 6 month topical piroxicam 0.8% is efficacious and well tolerated in A.K. Clinical efficacy is maintained 1 year post-treatment. The main limitation of our study is that it was an open label non-controlled trial. Future controlled trials are warranted in order to compare the efficacy and tolerability of this topical piroxicam preparation with standard treatments in the management of A.K.
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Affiliation(s)
- Graziella Babino
- a Department of Dermatology , University of Rome Tor Vergata , Rome , Italy
| | - Laura Diluvio
- a Department of Dermatology , University of Rome Tor Vergata , Rome , Italy
| | - Luca Bianchi
- a Department of Dermatology , University of Rome Tor Vergata , Rome , Italy
| | - Augusto Orlandi
- b Department of Anatomic Pathology , University of Rome Tor Vergata , Rome , Italy
| | - Monia Di Prete
- a Department of Dermatology , University of Rome Tor Vergata , Rome , Italy
| | - Sergio Chimenti
- a Department of Dermatology , University of Rome Tor Vergata , Rome , Italy
| | | | - Elena Campione
- a Department of Dermatology , University of Rome Tor Vergata , Rome , Italy
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Sánchez G, Nova J, Rodriguez‐Hernandez AE, Medina RD, Solorzano‐Restrepo C, Gonzalez J, Olmos M, Godfrey K, Arevalo‐Rodriguez I. Sun protection for preventing basal cell and squamous cell skin cancers. Cochrane Database Syst Rev 2016; 7:CD011161. [PMID: 27455163 PMCID: PMC6457780 DOI: 10.1002/14651858.cd011161.pub2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND 'Keratinocyte cancer' is now the preferred term for the most commonly identified skin cancers basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), which were previously commonly categorised as non-melanoma skin cancers (NMSC). Keratinocyte cancer (KC) represents about 95% of malignant skin tumours. Lifestyle changes have led to increased exposure to the sun, which has, in turn, led to a significant increase of new cases of KC, with a worldwide annual incidence of between 3% and 8%. The successful use of preventive measures could mean a significant reduction in the resources used by health systems, compared with the high cost of the treatment of these conditions. At present, there is no information about the quality of the evidence for the use of these sun protection strategies with an assessment of their benefits and risks. OBJECTIVES To assess the effects of sun protection strategies (i.e. sunscreen and barrier methods) for preventing keratinocyte cancer (that is, basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) of the skin) in the general population. SEARCH METHODS We searched the following databases up to May 2016: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trial registries and the bibliographies of included studies for further references to relevant trials. SELECTION CRITERIA We included randomised controlled clinical trials (RCTs) of preventive strategies for keratinocyte cancer, such as physical barriers and sunscreens, in the general population (children and adults), which may provide information about benefits and adverse events related to the use of solar protection measures. We did not include trials focused on educational strategies to prevent KC or preventive strategies in high-risk groups. Our prespecified primary outcomes were BCC or cSCC confirmed clinically or by histopathology at any follow-up and adverse events. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies for eligibility using Early Review Organizing Software (EROS). Similarly, two review authors independently used predesigned data collection forms to extract information from the original study reports about the participants, methods of randomisation, blinding, comparisons of interest, number of participants originally randomised by arm, follow-up losses, and outcomes, and they assessed the risk of bias. We resolved any disagreement by consulting a third author and contacted trial investigators of identified trials to obtain additional information. We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included one RCT (factorial design) that randomised 1621 participants.This study compared the daily application of sunscreen compared with discretionary use of sunscreen, with or without beta-carotene administration, in the general population. The study was undertaken in Australia; 55.2% of participants had fair skin, and they were monitored for 4.5 years for new cases of BCC or cSCC assessed by histopathology. We found this study to be at low risk of bias for domains such as allocation, blinding, and incomplete outcome data. However, we found multiple unclear risks related to other biases, including an unclear assessment of possible interactions between the effects of the different interventions evaluated (that is, sunscreen and beta-carotene). We found no difference in terms of the number of participants developing BCC (n = 1621; risk ratio (RR) 1.03, 95% confidence interval (CI) 0.74 to 1.43) or cSCC (n = 1621; RR 0.88, 95% CI 0.50 to 1.54) when comparing daily application of sunscreen with discretionary use, even when analyses were restricted to groups without beta-carotene supplementation. This evidence was of low quality, which means that there is some certainty that future studies may alter our confidence in this evidence.We reported adverse events in a narrative way and included skin irritation or contact allergy.We identified no studies that evaluated other sun protection measures, such as the use of sun-protective clothing, sunglasses, or hats, or seeking the shade when outdoors. AUTHORS' CONCLUSIONS In this review, we assessed the effect of solar protection in preventing the occurrence of new cases of keratinocyte cancer. We only found one study that was suitable for inclusion. This was a study of sunscreens, so we were unable to assess any other forms of sun protection. The study addressed our prespecified primary outcomes, but not most of our secondary outcomes. We were unable to demonstrate from the available evidence whether sunscreen was effective for the prevention of basal cell carcinoma (BCC) or cutaneous squamous cell carcinoma (cSCC).Our certainty in the evidence was low because there was a lack of histopathological confirmation of BCC or cSCC in a significant percentage of cases. Amongst other sources of bias, it was not clear whether the study authors had assessed any interaction effects between the sunscreen and beta-carotene interventions. We think that further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
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Affiliation(s)
- Guillermo Sánchez
- Instituto de Evaluación Tecnológica en SaludBogotá D.C.Colombia
- Fundación Universitaria de Ciencias de la SaludDivision of ResearchBogotá D.C.Colombia
| | - John Nova
- Instituto Nacional de Dermatología, Centro Dermatológico Federico Lleras AcostaAvenida 1a N°. 13 A 61Bogotá D.C.Colombia11001000
| | | | - Roger David Medina
- Fundación Universitaria de Ciencias de la SaludDivision of ResearchBogotá D.C.Colombia
| | - Carolina Solorzano‐Restrepo
- Fundación Universitaria de Ciencias de la SaludDepartment of DermatologyCarrera 18 # 8‐95Bogotá D.C.Colombia11001000
| | - Jenny Gonzalez
- Fundación Universitaria de Ciencias de la SaludDepartment of DermatologyCarrera 18 # 8‐95Bogotá D.C.Colombia11001000
| | - Miguel Olmos
- Fundación Universitaria de Ciencias de la SaludDepartment of DermatologyCarrera 18 # 8‐95Bogotá D.C.Colombia11001000
| | - Kathie Godfrey
- The University of Nottinghamc/o Cochrane Skin GroupNottinghamUK
| | - Ingrid Arevalo‐Rodriguez
- Instituto de Evaluación Tecnológica en SaludBogotá D.C.Colombia
- Fundación Universitaria de Ciencias de la SaludDivision of ResearchBogotá D.C.Colombia
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McSweeney PC. The safety of nanoparticles in sunscreens: An update for general practice. Aust Fam Physician 2016; 45:397-399. [PMID: 27622230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Recent media coverage has raised public awareness regarding the safety of sunscreens containing zinc (ZnO) and titanium (TiO2) nanoparticles. In Australia, the rates of skin cancer are among the highest in the world, and sunscreen is a commonly used protective agent against harmful ultraviolet (UV) radiation. General practitioners (GPs) commonly manage skin cancer and may be faced with questions from patients regarding the safety of sunscreens. OBJECTIVE The aim of this article is to explain the role of nanoparticles in sunscreen, clarify the results of the literature regarding safety, and provide GPs with knowledge to assist in sun-safety discussion with patients. DISCUSSION Current evidence suggests that the likelihood of harm from the use of sunscreens containing nanoparticles is low; however, further research into this area is required. Sunscreens have been proven to reduce rates of non-melanoma and melanoma skin cancers; hence, their use in prevention should be encouraged.
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Zastrow L, Lademann J. Light - Instead of UV Protection: New Requirements for Skin Cancer Prevention. Anticancer Res 2016; 36:1389-1393. [PMID: 26977040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The requirements on sunscreens have essentially changed, since some years ago it was demonstrated that approximately 50% of free radicals, that are formed in the skin by solar radiation, originate from the visible and infrared regions of the solar spectrum. In addition, a critical radical concentration threshold could be found. If this concentration, the free radical threshold value (FRTV), is exceeded, sunburn, immunosuppression and skin cancer may develop. Application of sunscreens and lotions protects against sunburn in the UV region of the solar spectrum and therefore is frequently used to extend people's stay in the sun. However, this behaviour can enhance the concentration of free radicals formed in the visible and infrared regions of the solar spectrum, so that the critical radical threshold is exceeded and the skin may be damaged.
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Affiliation(s)
- Leonhard Zastrow
- Charité - Universitätsmedizin Berlin, Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany
| | - Jürgen Lademann
- Charité - Universitätsmedizin Berlin, Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany
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35
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Reiter C, Groleau-Poiré MP. [The other side of the tube]. Krankenpfl Soins Infirm 2015; 108:78-79. [PMID: 26685545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Miralles JC, Escudero AI, Carbonell A, Martínez A, Fernández E, Cardona P. Allergic contact dermatitis from ethylhexyl salicylate. J Investig Allergol Clin Immunol 2015; 25:66-67. [PMID: 25898701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
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Jalalat S. Sunscreens causing cancer? The facts. Cutis 2015; 95:E30-E33. [PMID: 25671455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Recent reports about sunscreen safety have received widespread media attention with headlines on many news broadcasts and Web sites claiming, "Your sunscreen may be giving you cancer." Are claims that deem sunscreens unsafe true? Do the potential risks of sunscreen use outweigh the benefits? As dermatology residents, what do you tell your patients? This article addresses 2 major concerns by providing a critical analysis of the available evidence-based data as well as additional resources for further exploration.
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Buck Louis GM, Kannan K, Sapra KJ, Maisog J, Sundaram R. Urinary concentrations of benzophenone-type ultraviolet radiation filters and couples' fecundity. Am J Epidemiol 2014; 180:1168-75. [PMID: 25395025 DOI: 10.1093/aje/kwu285] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Concern has arisen about benzophenone (BP) ultraviolet (UV) radiation filters, given their use in sunscreen and personal-care products and their reported estrogenic and antiandrogenic activity. We recruited 501 couples who were discontinuing use of contraceptives in order to become pregnant for the Longitudinal Investigation of Fertility and the Environment (LIFE) Study (Michigan and Texas, 2005-2009). Couples provided urine specimens and completed daily journals until they either achieved pregnancy or had tried for 12 months. Women used fertility monitors to time sexual intercourse and digital pregnancy tests. Urinary concentrations of 5 UV filters (ng/mL) were determined using triple-quadrupole mass spectrometry: 2,4-dihydroxybenzophenone (also called BP-1); 2,2',4,4'-tetrahydroxybenzophenone (BP-2); 2-hydroxy-4-methoxybenzophenone (BP-3); 2,2'-dihydroxy-4-methoxybenzophenone (BP-8); and 4-hydroxybenzophenone. Fecundability odds ratios were estimated for each UV filter (dichotomized at the 75th percentile) and adjusted for age, creatinine concentration, body mass index (weight (kg)/height (m)(2)), cotinine concentration, season, and site, while accounting for time off contraception. Separate models were fitted for each UV filter and partner; final models included partners' concentrations. Male partners' concentrations of BP-2 and 4-hydroxybenzophenone were associated with reduced fecundity in adjusted models (fecundability odds ratio (FOR) = 0.69 (95% confidence interval (CI): 0.50, 0.95) and FOR = 0.74 (95% CI: 0.54, 1.00), respectively). In models adjusting for both partners' concentrations, male BP-2 concentration remained associated with reduced fecundity (FOR = 0.69, 95% CI: 0.49, 0.97). These data suggest that male exposure to select UV filters may diminish couples' fecundity, resulting in a longer time to pregnancy.
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Tsui MMP, Leung HW, Wai TC, Yamashita N, Taniyasu S, Liu W, Lam PKS, Murphy MB. Occurrence, distribution and ecological risk assessment of multiple classes of UV filters in surface waters from different countries. Water Res 2014; 67:55-65. [PMID: 25261628 DOI: 10.1016/j.watres.2014.09.013] [Citation(s) in RCA: 219] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 09/01/2014] [Accepted: 09/06/2014] [Indexed: 05/14/2023]
Abstract
Organic UV filters are common ingredients of personal care products (PCPs), but little is known about their distribution in and potential impacts to the marine environment. This study reports the occurrence and risk assessment of twelve widely used organic UV filters in surface water collected in eight cities in four countries (China, the United States, Japan, and Thailand) and the North American Arctic. The number of compounds detected, Hong Kong (12), Tokyo (9), Bangkok (9), New York (8), Los Angeles (8), Arctic (6), Shantou (5) and Chaozhou (5), generally increased with population density. Median concentrations of all detectable UV filters were <250 ng/L. The presence of these compounds in the Arctic is likely due to a combination of inadequate wastewater treatment and long-range oceanic transport. Principal component analysis (PCA) and two-way analysis of variance (ANOVA) were conducted to explore spatiotemporal patterns and difference in organic UV filter levels in Hong Kong. In general, spatial patterns varied with sampling month and all compounds showed higher concentrations in the wet season except benzophenone-4 (BP-4). Probabilistic risk assessment showed that 4-methylbenzylidene camphor (4-MBC) posed greater risk to algae, while benzophenone-3 (BP-3) and ethylhexyl methoxycinnamate (EHMC) were more likely to pose a risk to fishes and also posed high risk of bleaching in hard corals in aquatic recreational areas in Hong Kong. This study is the first to report the occurrence of organic UV filters in the Arctic and provides a wider assessment of their potential negative impacts in the marine environment.
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Affiliation(s)
- Mirabelle M P Tsui
- Department of Biology and Chemistry, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China; State Key Laboratory in Marine Pollution, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China
| | - H W Leung
- Department of Biology and Chemistry, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China; State Key Laboratory in Marine Pollution, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China; Department of Applied Science, Hong Kong Institute of Vocational Education, Chai Wan, Hong Kong, China
| | - Tak-Cheung Wai
- State Key Laboratory in Marine Pollution, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China
| | - Nobuyoshi Yamashita
- National Institute of Advanced Industrial Science and Technology (AIST), 16-1 Onogawa, Tsukuba, Ibaraki 305-8569, Japan
| | - Sachi Taniyasu
- National Institute of Advanced Industrial Science and Technology (AIST), 16-1 Onogawa, Tsukuba, Ibaraki 305-8569, Japan
| | - Wenhua Liu
- Marine Biology Institute, Science Center, Shantou University, 243 Daxue Road, Shantou, Guangdong, 515063, PR China
| | - Paul K S Lam
- Department of Biology and Chemistry, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China; State Key Laboratory in Marine Pollution, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China
| | - Margaret B Murphy
- Department of Biology and Chemistry, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China; State Key Laboratory in Marine Pollution, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China.
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Gentzsch S, Kern JS, Loeckermann S, Geissler E, Seufert J, Bernard C, Kohlhase J, Bruckner-Tuderman L, Meiss F. Iatrogenic vitamin D deficiency in a patient with Gorlin syndrome: the conundrum of photoprotection. Acta Derm Venereol 2014; 94:459-60. [PMID: 24202285 DOI: 10.2340/00015555-1714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sabrina Gentzsch
- Department of Dermatology, University Freiburg - Medical Center, Freiburg, Germany
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Holick MF. Sunlight, ultraviolet radiation, vitamin D and skin cancer: how much sunlight do we need? Adv Exp Med Biol 2014; 810:1-16. [PMID: 25207357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Vitamin D is the sunshine vitamin for good reason. During exposure to sunlight, the UV B photons enter the skin and photolyze 7-dehydrocholesterol to previtamin D3 which in turn is isomerized by the body's temperature to vitamin D3. Most humans have depended on sun for their vitamin D requirement. Skin pigment, sunscreen use, aging, time of day, season and latitude dramatically affect previtamin 13 synthesis. Vitamin D deficiency was thought to have been conquered, but it is now recognized that more than 50% of the world's population is at risk for vitamin D deficiency. This deficiency is in part due to the inadequate fortification of foods with vitamin D and the misconception that a healthy diet contains an adequate amount of vitamin D. Vitamin D deficiency causes growth retardation and rickets in children and will precipitate and exacerbate osteopenia, osteoporosis and increase risk of fracture in adults. The vitamin D deficiency has been associated pandemic with other serious consequences including increased risk of common cancers, autoimmune diseases, infectious diseases and cardiovascular disease. There needs to be a renewed appreciation of the beneficial effect of moderate sunlight for providing all humans with their vitamin D requirement for health.
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Zhang F, Zhang J, Tong C, Chen Y, Zhuang S, Liu W. Molecular interactions of benzophenone UV filters with human serum albumin revealed by spectroscopic techniques and molecular modeling. J Hazard Mater 2013; 263 Pt 2:618-26. [PMID: 24231334 DOI: 10.1016/j.jhazmat.2013.10.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 09/18/2013] [Accepted: 10/10/2013] [Indexed: 05/08/2023]
Abstract
Benzophenone (BP)-type UV filters have been widely used in many personal care products to protect human from UV exposure. Their dermal applications can cause direct human health risk following accumulation in bloodstream. Few studies have addressed whether BP-type UV filters could bind and alter the structure and function of human serum albumin (HSA), the major carrier protein in plasma. Four benzophenones, BP-1, BP-2, BP-3 and BP-8 were selected to investigate their potentially toxic interactions with HSA and the intrinsic binding mechanism using combined spectroscopies and molecular docking techniques. Four benzophenones significantly quench the intrinsic fluorescence of HSA via static mode. The competitive binding fluorescence assay and molecular docking both revealed that the benzophenones bind at site II of HSA. Their binding constants range from 1.91 × 10(4)M(-1) to 12.96 × 10(4)M(-1) at 296 K. BP-8 interacts with HSA mainly through hydrogen bonding interactions and van der Waals interactions, while hydrophobic interactions and electrostatic interactions are dominant for interactions between BP-1, BP-2, BP-3 and HSA. Molecular docking revealed that the changes in structural moiety and hydrophobicity of four benzophenones account for their different binding affinities. As further revealed by circular dichroism and time-resolved fluorescence decay, these benzophenones cause global and local structural changes of HSA, which illustrates their potential toxicity to cause structural damage of HSA. Two degradation products of BP-3 have higher binding affinities to HSA, suggesting higher potencies in causing adverse effects on human health.
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Affiliation(s)
- Feng Zhang
- College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, People's Republic of China
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Debska O, Kamińska-Winciorek G, Spiewak R. [Does sunscreen use influence the level of vitamin D in the body?]. Pol Merkur Lekarski 2013; 34:368-370. [PMID: 23882939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Solar radiation is necessary for the normal functioning of the body. It enables the synthesis of vitamin D that supports the physiological status of the skeleton, it also improves the frame of mind. Nevertheless, UV irradiation also induces adverse effects in the skin, including sunburn and skin cancer. The use of sunscreens is highly recommended during periods of intensive insolation. There are, however, concerns about possible interference with synthesis of vitamin D in the skin by sunscreens, which might lead to hypovitaminosis. The present article summarises published studies on the possible inhibition of vitamin D synthesis as a result from using sunscreens.
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Affiliation(s)
- Olga Debska
- Uniwersytet Jagiellorński Collegium Medicum, Zakład Dermatologii Doświadczalnej i Kosmetologii, Wydział Farmaceutyczny, Kraków
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Duirk SE, Bridenstine DR, Leslie DC. Reaction of benzophenone UV filters in the presence of aqueous chlorine: kinetics and chloroform formation. Water Res 2013; 47:579-587. [PMID: 23168312 DOI: 10.1016/j.watres.2012.10.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 09/20/2012] [Accepted: 10/10/2012] [Indexed: 06/01/2023]
Abstract
The transformation of two benzophenone UV filters (Oxybenzone and Dioxybenzone) was examined over the pH range 6-11 in the presence of excess aqueous chlorine. Under these conditions, both UV filters were rapidly transformed by aqueous chlorine just above circumneutral pH while transformation rates were significantly lower near the extremes of the pH range investigated. Observed first-order rate coefficients (k(obs)) were obtained at each pH for aqueous chlorine concentrations ranging from 10 to 75 μM. The k(obs) were used to determine the apparent second-order rate coefficient (k(app)) at each pH investigated as well as determine the reaction order of aqueous chlorine with each UV filter. The reaction of aqueous chlorine with either UV filter was found to be an overall second-order reaction, first-order with respect to each reactant. Assuming elemental stoichiometry described the reaction between aqueous chlorine and each UV filter, models were developed to determine intrinsic rate coefficients (k(int)) from the k(app) as a function of pH for both UV filters. The rate coefficients for the reaction of HOCl with 3-methoxyphenol moieties of oxybenzone (OXY) and dioxybenzone (DiOXY) were k(1,OxY) = 306 ± 81 M⁻¹s⁻¹ and k(1,DiOxY) = 154 ± 76 M⁻¹s⁻¹, respectively. The k(int) for the reaction of aqueous chlorine with the 3-methoxyphenolate forms were orders of magnitude greater than the un-ionized species, k(2,OxY) = 1.03(±0.52) × 10⁶ M⁻¹s⁻¹ and k(2_1,DiOxY) = 4.14(±0.68) × 10⁵ M⁻¹s⁻¹. Also, k(int) for the reaction of aqueous chlorine with the DiOXY ortho-substituted phenolate moiety was k(2_2,DiOxY) = 2.17(±0.30) × 10³ M⁻¹s⁻¹. Finally, chloroform formation potential for OXY and DiOXY was assessed over the pH range 6-10. While chloroform formation decreased as pH increased for OXY, chloroform formation increased as pH increased from 6 to 10 for DiOXY. Ultimate molar yields of chloroform per mole of UV filter were pH dependent; however, chloroform to UV filter molar yields at pH 8 were 0.221 CHCl₃/OXY and 0.212 CHCl₃/DiOXY.
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Affiliation(s)
- Stephen E Duirk
- University of Akron, Department of Civil Engineering, 210 Auburn Science and Engineering Center, Akron, OH 44325, USA.
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Montenegro L, Puglisi G. Evaluation of sunscreen safety by in vitro skin permeation studies: effects of vehicle composition. Pharmazie 2013; 68:34-40. [PMID: 23444778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
For sunscreens to be safe and effective, the lowest possible UV-filter percutaneous absorption should be achieved. In this paper, we evaluated in vitro release and permeation through human skin of two UV-filters, octyl methoxycinnammate (OMC) and butyl methoxydibenzoyl methane (BMBM) from six commercial O/W emulsions and we estimated their margin of safety (MoS). OMC and BMBM in vitro release and skin permeation were investigated in Franz-type diffusion cells and permeation data were used to calculate MoS. OMC in vitro skin permeation depended on both its concentration and vehicle composition while BMBM skin permeation depended on its release from the vehicle. MoS values were well beyond the lowest limit accepted for safe products. Although sunscreen skin permeation may depend on many factors, the commercial products investigated are safe under normal "in use" conditions.
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Affiliation(s)
- L Montenegro
- Department of Drug Sciences, University of Catania, V.le A .Doria 6, 95125 Catania, Italy.
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Ma NS, Gordon CM. The truth about vitamin D and adolescent skeletal health. Adolesc Med State Art Rev 2012; 23:457-470. [PMID: 23437682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Nina S Ma
- Division of Endocrinology, Boston Children's Hospital, Harvard Medical School, USA.
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Kircik LH, Dahl A, Yatskayer M, Raab S, Oresajo C. Safety and efficacy of two anti-acne/anti-aging treatments in subjects with photodamaged skin and mild to moderate acne vulgaris. J Drugs Dermatol 2012; 11:737-740. [PMID: 22648221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Although reliable prevalence data are not available, adult acne is thought to be somewhat common, and it is not unusual for patients to have acne as well as early signs of skin aging. A novel anti-acne/anti-aging formulation (Treatment A) has been developed for daily use by patients to address both signs of skin aging and facial acne vulgaris. The novel, non-prescription formulation includes several ingredients shown to target factors underlying the pathogenesis of acne vulgaris while also addressing multiple components in the pathophysiology of skin aging. METHODS A blinded, randomized, split-face study was conducted to evaluate and compare the tolerability and efficacy of the novel anti-acne/ anti-aging product in subjects with photodamaged skin and acne vulgaris relative to tretinoin cream 0.025% (Treatment B). All subjects also were given supportive skincare, consisting of a cleanser, moisturizer, and sunscreen. Each treatment was assessed for its effects on subjects' appearance, lesion count reductions, and tolerability. RESULTS Treatment A produced statistically significantly greater improvements in skin tone evenness, skin tone clarity, and blemishes and blotchiness. There were also statistically greater reductions in total lesion count for acne patients on the side of the face treated with Treatment A compared to Treatment B; Treatment A was also associated with early (day 2) improvement in skin tone evenness and clarity, tactile skin smoothness, and blemishes and blotchiness. Both treatments demonstrated favorable tolerability. CONCLUSION The novel topical anti-aging/anti-acne therapy (Treatment A) within a comprehensive skin care regimen of cleanser, moisturizer, and sunscreen may maximize efficacy and tolerability and contribute to our armamentarium for treating both photodamage and acne at the same time.
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Affiliation(s)
- Leon H Kircik
- Physicians Skin Care, PLLC, Louiseville, KY 40217, USA.
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Bogle M, Hodgden J. Question: Does sunscreen use cause vitamin D deficiency? J Okla State Med Assoc 2012; 105:9-10. [PMID: 22458041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Abstract
Today engineered nano-materials have attracted a great deal of attention due to their important properties which have given birth to vast technological and economic growth in a number of industrial sectors. Nano-materials are indeed expected to become the cornerstone of a number of sectors such as microelectronics, materials, textiles, energy, healthcare and cosmetic goods. Nanotechnology applications will give rise to cleaner energy production, lighter and more durable materials, inexpensive clean water production and will benefit medical applications such as smart drugs and diagnostics. However, one has to be mindful of the risks involved concerning potential toxicity and exposure route and the verdict is still out on a number of nano-materials as to the relative dangers to humans and the environment. This brief review hopes to describe some of the main contenders and their real world applications but it should only be considered a snapshot of the industry and its relative potential.
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Leyden JJ. Efficacy of a novel rosacea treatment system: an investigator-blind, randomized, parallel-group study. J Drugs Dermatol 2011; 10:1179-1185. [PMID: 21968669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION A rosacea treatment system (cleanser, metronidazole 0.75% gel, hydrating complexion corrector, and sunscreen SPF30) has been developed to treat rosacea. METHODS Thirty women with mild or moderate erythema of rosacea on their facial cheeks were randomly assigned to use one of the following for 28 days: the rosacea treatment system (RTS); RTS minus metronidazole (RTS-M); or metronidazole 0.75% gel plus standard skin care (standard cleanser and standard moisturizer/sunscreen) (M+SSC). RESULTS At day 28, global improvement was evident in 90 percent of patients using RTS, 60 percent using RTS-M, and 67 percent using M+SSC. Erythema was significantly lower with RTS from day 14 onward, and unchanged with M+SSC. The proportion of patients reporting their skin was easily irritated at least sometimes was 40 percent with RTS, 70 percent with RTS-M, and 89 percent with M+SSC. CONCLUSION The rosacea treatment system may offer superior efficacy and tolerability to metronidazole plus the standard skin care used in this study.
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