Over the years, medical science has made its share of claims.  Many have led to improved lives and others were outright laughable.  Old magazines carry ads with physicians touting the health benefits of smoking.  The 50’s gushed that margarine was ‘safer than butter’, and as breast cancer rates in post-war America increased, many suspected the cause was bras.  After all, didn’t all women who developed breast cancer previously wear a bra?  And anyone remember when lobotomies were an option for depression?

The conversation has never been more heated than today, with skin care seemingly at the center of the maelstrom.  With so many voices striving to be heard, the most outlandish declarations usually make headlines and accepted as gospel.  Conversely, well-established facts such as increased sunshine responsible for skin cancer are universally ignored; now, melanoma is the number one killer of women aged 20 to 29.  It’s quite a paradox to march against breast cancer, which continues to decline, while refusing to use sunscreen.

In addition, the internet clogs mailboxes with breathless accounts of incredible secrets and scams, which range from “your shampoo causes cancer!” to “toothpaste creates acne!”  My favorite remains the “I woke up in a bathtub of ice and learned I was missing my kidneys” claim.  Knowing the time it takes to  close a wound, I am impressed the culprits always do an excellent suturing job.

Forgotten in all the health-scam hullabaloo and claims of danger is that all rates of cancer continue to drop the last few years.  This comes as bad news to those peddling their own brands of cure, but a bright spot remains as two cancers continue to climb:  lung and skin, each highly preventable by lifestyle decisions.  But as a nation that trips from one media-generated scare to another (remember apples and Alar? Nightlights and leukemia? Teflon-coated pans?), it’s best to take a breath and talk sensibly.  Good people have reasonable concerns, so let’s take a look at a few of the claims:

“Sunscreens Cause Skin Cancer”.  The few studies in question have all included mice, whose skin is quite different from humans.  And it was never determined whether certain chemicals in the sunscreen caused the skin cancer or the enormous amounts of ultra-violet light.  Finally, to reach a tumor-induced state the levels of the chemicals in question were enormous.  Apples are good for you, but eating 5,000 a day isn’t sensible.

Undisputed is that all tanning causes DNA damage, whether by natural sun exposure or privacy of the tanning bed, and can lead to skin cancer formation.  As for sunscreens causing cancer, questions have been raised about chemical sunscreens, because while they disperse UV rays, they can also be absorbed by the skin.   While approved by the FDA and the American Academy of Dermatology, independent research continues into possible systemic side effects of oxy- and avobenzone, key ingredients in many formulations.  (Zinc oxide and titanium dioxide are referred to as physical sunscreens, since they reflect and scatter UV rays.  Because they are not absorbed, are considered very safe).  The bottom line is that no evidence-based research has ever shown that these chemicals widely used in sunscreens cause skin cancer. 

My advice is to not avoid sunscreens entirely. If concerns exist, use SPF broad spectrum zinc oxide or titanium dioxide formulations.  In addition, consider light-weight sun-protective clothing and hats, UV-protective sunglasses and shade during the hotter times of day.  Of course, if one wants a truly organic option, hippo sweat has recently been shown to have superior sun protection and as a bonus, repel biting flies.  And unwelcome neighbors.

“Americans are Vitamin D Deficient and Need More Sunshine”.  Yes and no.  Americans really do need more Vitamin D than they are receiving, and sunlight is efficient in producing it.  Vitamin D, necessary for developing healthy bones and promoting muscle performance, is produced in the skin under ultraviolet radiation effects, but more sunshine is not the answer.  The incredible missing point of this argument is that the average Caucasian living in Chattanooga, Tennessee can get all the sunshine they need for Vitamin D production in five minutes on a July afternoon.  Anymore time after that reverses the benefit, breaking Vitamin D down and increasing DNA damage.  Sorry, indoor tanning industry.  For the rest of us, fortified orange juice, Total cereal, salmon, yogurt, oral supplements and multivitamins will do just fine, and are not carcinogenic.

“My Basetan Protects Me From Sunburn”.  Yes. As long as you also believe smoking cigarettes is a healthy alternative to smoking crack.  The browning of the skin, while still somewhat aesthetically pleasing in our society, is the result of the body shooting melanocytes to the surface to absorb ultraviolet light.  Around 35 to 40 years of age, some sun-worshiping women will develop permanent dark patches on the face called melasma, and round ‘liver’ spots on chest, shoulders, arms and backs of hands.  Basically, the body says “Hey, you haven’t been protecting me very well from the sun, so I am sending my own sunscreen out.  Sorry it’s not very even, and quite dark, but I need to survive”.  This action of the skin is a dangerous time, for if during this cascade only one, tiny melanocytic cell ‘switches on’ and begins to replicate, we have melanoma.

“Some Moisturizers and Face Products Cause Breakouts”.  It’s true.  On the simple basis that some of these products may contain certain oils and clog pores, causing ‘comodomes’, or blocked follicles that are wonderful places for bacteria to breed.  That action results in “breakouts”.  Look for products that are advertised as “non-comodogenic”.  These cleansers are generally mild, soap-free and hypo-allergenic.

“Deodorants and Antiperspirants are Dangerous”.  The National Cancer Institute categorically states that deodorants, which mask unpleasant odors created by skin bacteria, have never shown any danger to humans, outside of the occasional contact dermatitis reaction that can occur from using the same product too long.  They are in the same category as perfumes and colognes, which hold a pleasing fragrance in a safe alcohol-based vehicle.  

As for the antiperspirants, the American Cancer Society, a paragon of respectability, flatly denies any danger.  That said, a careful examination of the recent research cautiously adds “As far as we know…” or “Current thought ...”.  Scientists want to determine what connection – if any – exists between breast cancer and women who shave their armpits, and then apply a product containing an aluminum compound.  The aluminum may have a change in the body when absorbed and have an estrogen-like effect, which is found in increased levels of women with breast cancer. 

There is also worry of aluminum products increasing chances of developing Alzheimer’s.  This allegation appears to have originally been made by manufacturers’ of aluminum-free products, and remains completely unproven.  Personally, I use an antiperspirant only for long public events in the summer, otherwise a deodorant is my first choice.  For the ladies, don't use deodorants after freshly shaving, making it best to shave in the evening, and never use a product on broken or irritated skin.

“Sodium laureth sulfate in shampoos causes _________ (fill in the blank)”.  According to one breathless, bogus e-mail, and multiple ‘healthy’ or ‘organic’ websites which look to justify some very expensive products, this ingredient makes cyanide appear like candy. It is often promoted in the media, and by companies who don't use sodium laureth sulfate (SLS), that SLS can cause multiple irritations and reactions including blindness, hair loss, and may even cause cancer. If something so prevalent were that dangerous, I would expect a large body count.  But it doesn’t exist.

Sodium laureth sulfate is a very effective and inexpensive surfactant, which means it makes things foam.   And if you want natural, it is derived from coconut oil.  The two key arguments against SLS are that in its manufacture it may become contaminated by known carcinogens.  However, pumping gas every week is a far more dangerous activity with exposure to another known carcinogen -- gasoline.  The other objection is that SLS is found both in personal and industrial applications.  But this is true of many products, including gum, water and shortening.   Beeswax—the quintessential organic darling-- has over 300 industrial uses other than candles and lip balm. 

And of course SLS is an irritant to the eyes!  I enjoy hot sauce, but I wouldn’t use it for cleaning ear wax.

“Anti-aging just sounds like a rip-off”.    And if you don’t understand how the ingredients work, it makes it all the more difficult.  In the United States, manufacturers do not have to demonstrate either safety or the promised action of their products prior to selling them.  Many try very hard to meet these standards, but legally, they don’t have to.  So it is up to the consumer to understand what’s in that lotion or cream.

In addition, the current anti-aging landscape is filled with products advertised with green tea extracts (a documented photo-protective agent orally and topically), lavender, chamomile, aloe and flaxseed, just to name a few organic compounds.  Does one drink it or put it on the face?  What’s the research and science?  Because the topic is so enormous, it’s safe to say that if you like it, think it works and can afford it, by all means, be my guest.  At least you’re doing your part to keep the economy going.

But some basics remain.  Retinoid (tretinoin cream .1%), a derivative of vitamin A, really does prove in study after study that it is useful in the treatment of early stage, active stretch mark and wrinkle formation.  Kinerase is available without a prescription, and can knock down fine wrinkles, make skin smoother and lighten darker spots.  Any product with copper peptide really can induce some collagen synthesis, and over time, lactic acid bases create an illusion of lessening the effects of cellulite.  Glycerin and beeswax are used to moisturize skin and smooth the normally rough surface keratin.

Among long-time professional colleagues in dermatology, it is understood that the first three ingredients in any formulation are the ‘give-away’ to what it really is:  everything else is window dressing and American marketing.

So what’s the bottom line for well-researched predictable skin care health? 

First, the bad news can be pretty bad.  The two worst activities to prematurely age skin are unprotected ultraviolet light exposure and smoking.    Studies have documented an affiliation between smoking and skin wrinkles since 1856. Smokers have five times more wrinkling than non-smokers, and have thinner skin, greyer hair, deeper wrinkles, and increased skin cancers. 

There’s more.  Overall, skin aging signs begin at about age 30.  Surface texture changes occur due to slower cellular turnover in the epidermis.  The results are fine lines, wrinkles, and dryer skin.  And cushiony collagen in the dermis – the second layer from the top -- decreases by 1% yearly after age 30.  This results in decreased elasticity, deeper wrinkles and thinner skin.  Melanocytes decrease up to 20% by decade resulting in more easily obtained burns.   Hair follicles stop producing hair, or because of estrogen loss and testosterone increases, result in hair growth on the face in women. 

But if lifestyle got you in trouble, the same could help you out.  A nutritious, balanced diet with adequate hydration, and an effective skin care regimen can improve your skin health. 

First, habits of prevention are necessary as mentioned previously with sun protection and not smoking.  Next, get a good night’s sleep.  Those dark eye rings will respond and fade.  Cold cucumber or potato slices for fifteen minutes constrict blood vessels, and are an added boost for special outings or photos.

Third, use mild soaps or soap-free cleansers daily and pat dry.  Strong soaps encourage extra drying which the body compensates with more oil output, a vicious cycle.  When finished, apply a water-based moisturizer with 30 SPF UVA/UVB sunscreen.  You can apply make-up afterwards.

Fourth, diet is much bigger than given credit.  Avoid excess salt which promotes a bloated look.  Whole grains, fish, red and green vegetables, citrus, and nuts are filled with the right vitamins which improve skin health.  And if your body is two-thirds water, don’t substitute Diet Coke.

 Finally, consider a weekly exfoliation with either glycolic foam or wash.  This routine promotes healthy hydration, a smoother texture, helps controls annoying adult acne, allows for even moisturizing and even stimulates collagen production.  Follow with an anti-oxidant serum containing Vitamin C E.     

Your skin is the largest organ of the body.  It is assaulted by more diseases and disorders than any other system, but it was designed to be one of the most easily influenced.  While we debate the merits of the many claims and concerns, at least there’s one thing we can agree on:  asking questions and finding answers will make for great skin for now, and for many years to come.