Separating Fact From Fiction

I walked into an exam room in my office last week to see a patient, who had come in for her yearly skin check. I recommend these checks for people with a history of excessive sun exposure, a family history of skin cancer in a first degree relative or people with atypical appearing moles. I was glad to see she had followed my recommendation to come in. I was not happy, however, to see how tan she looked, and this must have shown in my expression, because she immediately launched into an explanation.

"I wore SPF 30 sunscreen every day, and I even went tanning a few times before we left for Aruba so that I wouldn't burn when I was there," she said. I was glad to hear that she had used her sunscreen but dismayed to learn about her trips to a tanning salon. Despite the amount of time I spend talking with patients about their skin and answering questions about advice they have heard from friends or found on the Web, it is impossible for me to correct all of the inaccurate recommendations that they find. It is very difficult to separate fact from fiction in all of the information that is available from media and other sources about skin care. But as part of my continuing effort to set the record straight on some issues I am asked about on a regular basis, I would like you to consider this question: Would you recognize the following statements as myths if you came across them in an article about skin care?

Myth: Preservatives in skin care products are harmful
Most skin care products, including moisturizers, cleansers, makeup and sunscreens contain preservatives. Preservatives help to prevent the growth of bacteria and fungi which would otherwise contaminate and spoil these items. One of the most common classes of preservatives is the parabens, which include methylparaben, propylparaben and butylparaben. In 2002 a study that found parabens in breast cancer tissue and also identified a weak estrogenic effect of these compounds ignited concerns that parabens might cause breast cancer. However, the study did not show that parabens are harmful or that they cause breast cancer. It is not even known whether topical application of parabens leads to their accumulation in our bodies. Parabens can cause reactions in patients with active eczema, or in people who are allergic to these compounds, so it is reasonable for these people to avoid them. The rest of us can be guided by the conclusion published in 2006 by the FDA that cosmetics containing parabens are safe.

Myth: Stress causes acne
Acne is caused by a complex interaction between skin cells, skin oils, bacteria and hormonal factors. However, in patients with acne, there are factors which sometimes influence the severity of acne flares and for some people these include stress and anxiety. For people who develop acne flares with stress, therapy to learn how to cope with stress cannot replace more traditional treatments such as RetinA, benzoyl peroxide and antibiotics, but it may allow acne to be more easily controlled by these traditional treatments.

Myth: It is good to get a base tan at a salon before going on vacation
There is no such thing as a safe tan. Although tanning salons may advertise to the contrary, all tanning booths emit harmful UVB or UVA rays, both of which produce aging changes in the skin and increase the risk of skin cancer. Of course, they also produce a tan, which is why so many people continue to frequent these establishments despite mounting evidence of their danger. In addition to skin damage, UV light in tanning beds can harm the eyes unless proper protective glasses are worn. It makes much more sense to use a topical self-tanner if you want some color. Just remember, the self-tanner does not provide significant protection against sunburn, so you have to use sunscreen and minimize UV exposure to prevent burns while you are on vacation.

Myth: It is not safe to use RetinA in the summer
RetinA is a very effective treatment for acne, as well as for sun damage and skin aging changes. It works to unclog pores, stimulate collagen formation and also to thin the topmost layer of the skin. This latter effect renders the skin slightly more sensitive to UV exposure. So, when using RetinA , it is important to use sunscreen and avoid excessive UV exposure. If these precautions are followed, RetinA can be safely used year-round.

Myth: Blackheads are a result of inadequate cleansing
Blackheads, or comedones, as we dermatologists call them, are made up of skin cells and skin oils that accumulate inside pores. They are not made up of dirt, and cannot be washed or scrubbed off. Excessive scrubbing will simply irritate the skin. Cleansing with a product containing salicylic acid, which can help dissolve the material clogging the pores, can help remove then. Gentle extraction by a dermatologist or esthetician can also remove them, but they tend to re-accumulate in people who are susceptible. Regular use of a retinoid, such as RetinA or Differin can help to prevent this.

Fashion & Beauty: More articles and features on beauty