Thought this was the best statement on her site. Would be interesting to see what other trends and misinformation derms would correct if she gave them the platform on her site.
Dr Beibei Du-Harpur, Dermatology Registrar and Clinical Research Fellow
MRCP (Derm) MBBChir MA (Cantab) PGCert ClinEd
Based in London
Instagram:
dermatology_demystified
The burden of skin cancers on NHS dermatology services cannot be underestimated.
Referrals and cases of skin cancer are increasing year-on-year, and this has led to dermatology services pivoting to expand their skin cancer services.
If you have struggled to see an NHS dermatologist for your acne, rosacea, eczema or non skin cancer related concern, this is a big reason why. There are not very many dermatologists in the UK per head, and an enormous amount of our time is now spent dealing with suspected skin cancer. It is true that non-melanoma skin cancers are less dangerous. However, squamous cell carcinoma can be deadly, and treatments of these skin cancers often involve facial surgery, resulting in permanent scars. Most of these skin cancers appear as skin ages, and those who have one skin cancer will usually continue to have more – leading to constant visits to the dermatologist for treatments. This is not how you want to spend your retirement.
Since the 70s, we have come to understand so much more about how dangerous ultraviolet (UV) radiation is, and how important it is to limit our exposure to promote longevity and health of the skin. However, sun seeking behaviours continue to be the norm, despite public health messages. We now know
there is no such thing as a ‘healthy tan’ – it’s an oxymoron from a skin health perspective. Healthy skin is facilitated by sun protective behaviour. This includes: avoiding or limiting exposure to sun at high UV index, seeking shade, wearing sun protective clothing such as a wide-brimmed hat, and using broad-spectrum sunscreens. In the past year I have noticed a worrying trend of hesitancy over sunscreen use due to purported
‘toxic chemicals’.
This is misinformation spread by commercial organisations. UV radiation is so harmful to skin that humans have evolved an entire DNA repair mechanism to address the damage it causes. The risk from sunscreen is unproven and when theoretical concerns have been raised, scientists at regulatory bodies have evaluated the risk and determined it to be irrelevant in real-world use settings.
I have no doubt in safety of the products on our shelves, used according to instructions. On the other hand, the risk from UV is well-established scientifically.
It is a grade I carcinogen.
It is important to be aware that sunscreen work because they contain chemicals (inorganic, or organic) with the ability to absorb dangerous wavelengths of energy. It is a product (in the USA, it is considered a drug) with a dose; 2mg of product for each cm2 skin, to achieve the sun protection factor (SPF) stated on the bottle; this is related to the testing standards. Therefore, there is a relationship between its absorptive power and the amount applied. Inadequate application means significant reduction in protective factor. Furthermore, research has shown that people apply woefully inadequate quantities of sunscreen (even when they know they are being assessed on their application!). Studies have also shown that sun-seeking behaviours are incredibly ingrained; they even persist despite a melanoma diagnosis. There is also data suggesting that high SPF sunscreens are used to facilitate sun-seeking behaviour, which, taking into account that true SPF on skin is nowhere near what it is on the bottle due to inadequate application, extremely dangerous.
Time after time, patients report tanning and burning despite using sunscreen – this is because it is being used incorrectly, or as part of a sun seeking behaviour pattern.
Our public health message is clear: use sunscreen liberally, as part of sun protective behaviour.
We, and patients who see us, could seriously do without large platforms contradicting our message and misleading the public.