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Current Problems in Dermatology 2021Black skin, compared with white skin, is generally assumed to be more resistant to the consequences of sun exposure due to its epidermal melanin content. However, recent... (Review)
Review
Black skin, compared with white skin, is generally assumed to be more resistant to the consequences of sun exposure due to its epidermal melanin content. However, recent scientific evidence shows that black skin is not completely impervious to sunlight. Both clinical and -experimental data have reported sun-induced effects on black skin. Black skin can warm, burn and peel when -exposed to the sun. Exposure to the sun can also cause hyperpigmentation and photoageing manifestations. The current misconceptions expressed by most black individuals about their resistance to sun-induced effects prevent their engagement in sun safe behaviours. Therefore, the demystification of the harmful effects of the sun needs to be supported by more research studies showing the effectiveness of sun protection strategies for the black population.
Topics: Black People; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Skin; Skin Neoplasms; Skin Pigmentation; Sunlight
PubMed: 34698032
DOI: 10.1159/000517594 -
Advances in Experimental Medicine and... 2020Increasing sun exposure is related to lower prevalence of death in cardiovascular disease (CVD), type 2 diabetes, and other noncancer non-CVD. In this chapter we aim to... (Review)
Review
Increasing sun exposure is related to lower prevalence of death in cardiovascular disease (CVD), type 2 diabetes, and other noncancer non-CVD. In this chapter we aim to make a short update on the knowledge regarding sun exposure and all-cause mortality. Data support the hypothesis that low sun exposure habits are a major risk factor for all-cause mortality. Low sun exposure is related to an increased risk of death due to CVD and noncancer/non-CVD, and a minor reduction in risk of cancer. Active sun exposure habits have a dual effect; it increases the incidence of skin cancer, but also improves the prognosis in terms of all-cause mortality. In a low solar intensity region, we should carefully assess both risk and benefits of sun exposure in order to obtain balanced recommendations.
Topics: Cardiovascular Diseases; Cause of Death; Diabetes Mellitus, Type 2; Humans; Risk Factors; Skin Neoplasms; Sunlight
PubMed: 32918215
DOI: 10.1007/978-3-030-46227-7_5 -
Clinical Nutrition ESPEN Feb 2021Vitamin D is a fat-soluble vitamin whose main function in the body is the regulation of bone mineral metabolism. In the last two decades, there has been an intensive... (Review)
Review
BACKGROUND & AIMS
Vitamin D is a fat-soluble vitamin whose main function in the body is the regulation of bone mineral metabolism. In the last two decades, there has been an intensive research for possible vitamin D benefits in non-skeletal health but as today it still remains unclear. The aim of this article is to review vitamin D metabolism and the natural sources to encourage lifestyle changes to avoid deficiency.
REVIEW
Universal screening for vitamin D deficiency is not warranted and it should only be done in cases with risk factors for vitamin deficiency. Vitamin D is measured in the body by determining 25-hydroxycholecalciferol; values below 20 ng/mL (50 nmol/L) are considered inadequate. The three sources of vitamin D are the ultraviolet sun radiation, diet and supplementation. The role of vitamin D supplementation out of the osteoporosis treatment and prevention still remain controversial. Healthy sun exposure and diet should be discussed with all patients with vitamin D deficiency and in general population in promoting health. The skin, through solar radiation, is the main source of vitamin D and provides 90% of the body's needs.
CONCLUSIONS
Changing lifestyle habits, encouraging a controlled sun exposure and proper vitamin D diet is a preventive strategy that should be applied in our daily practice to prevent osteoporosis and other diseases associated with low vitamin D.
Topics: Humans; Sunlight; Ultraviolet Rays; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 33487250
DOI: 10.1016/j.clnesp.2020.12.001 -
The Surgical Clinics of North America Feb 2020The incidence of melanoma continues to increase worldwide. In the United States, melanoma is the fifth most common cancer in men and the sixth most common cancer in... (Review)
Review
The incidence of melanoma continues to increase worldwide. In the United States, melanoma is the fifth most common cancer in men and the sixth most common cancer in women. The risk factors contributing to melanoma have largely remained unchanged, but there is a new focus on modifiable risk factors including sun exposure and ultraviolet light. A large public initiative supported by the Centers for Disease Control focuses on educating the public on the risks of sun exposure and indoor tanning. Early detection and resection of melanoma lesions is necessary to prevent metastasis and reduce medical costs.
Topics: Humans; Melanoma; Risk Factors; Skin Neoplasms; Sunbathing; Sunlight; Ultraviolet Rays; United States
PubMed: 31753105
DOI: 10.1016/j.suc.2019.09.005 -
Journal of the American Academy of... Mar 2022Terrestrial sunlight is the portion of electromagnetic radiation that is emitted by the sun and reaches Earth's surface. It encompasses 3 major components: UV radiation... (Review)
Review
Terrestrial sunlight is the portion of electromagnetic radiation that is emitted by the sun and reaches Earth's surface. It encompasses 3 major components: UV radiation (290-400 nm), visible light (400-700 nm), and infrared radiation. The deleterious effects of UV radiation have been appreciated for decades, particularly among those with light skin tones (Fitzpatrick skin types I-II) who primarily manifest with burns of varying degrees of severity with sun exposure. In recent years, studies have increasingly shown the negative impact of visible light on skin health, particularly in individuals with skin of color (Fitzpatrick skin types IV-VI), including the exacerbation of hyperpigmentation disorders such as melasma and post-inflammatory hyperpigmentation, as well as induction of the former. Recommendations from medical societies and the US Food and Drug Administration for photoprotection have been evolving along with the knowledge base. Yet, misconceptions about skin damage related to sunlight and the benefits of photoprotection (particularly among those with Fitzpatrick skin types V-VI) are still prevalent among both clinicians and patients. Among patients with skin of color, disorders of hyperpigmentation and other consequences from sun exposure have been associated with impaired skin health and negative burden on quality of life. This review summarizes currently available evidence of the impact of both UV and visible wavelengths and the low utilization of photoprotection measures among people with skin of color, with the goal of providing recommendations to help educate patients.
Topics: Humans; Hyperpigmentation; Infrared Rays; Quality of Life; Skin; Skin Pigmentation; Sunscreening Agents; Ultraviolet Rays; Ethnic and Racial Minorities
PubMed: 34942293
DOI: 10.1016/j.jaad.2021.12.020 -
International Journal of Cosmetic... Oct 2023The adverse effects of solar ultraviolet radiation (UVR) on normal skin are well established, especially in those with poorly melanized skin. Clinically, these effects... (Review)
Review
The adverse effects of solar ultraviolet radiation (UVR) on normal skin are well established, especially in those with poorly melanized skin. Clinically, these effects may be classified as acute, such as erythema or chronic such as keratinocyte and melanocyte skin cancers. Apart from skin type genetics, clinical responses to solar UVR are dependent on geophysical (e.g., solar intensity) and behavioural factors. The latter are especially important because they may result in 'solar overload' with unwanted clinical consequences and ever greater burdens to healthcare systems. Correctly used, sunscreens can mitigate the acute and chronic effects of solar UVR exposure. Laboratory studies also show that sunscreens can inhibit the initial molecular and cellular events that are responsible for clinical outcomes. Despite public health campaigns, global trends continue to show increasing incidence of all types of skin cancer. Large-scale epidemiological studies have shown the benefits of sunscreen use in preventing skin cancer, though it is likely that sunscreen use has not been optimal in such studies. It is evident that without substantial changes in sun-seeking behaviour, sunscreen use is a very important part of the defence against the acute and chronic effects of solar exposure. Ideally, sunscreens should be able to provide the level of protection that reduces the risk of skin cancer in susceptible skin types to that observed in heavily melanized skin.
Topics: Humans; Sunscreening Agents; Ultraviolet Rays; Sunlight; Skin; Skin Neoplasms
PubMed: 37799076
DOI: 10.1111/ics.12897 -
Journal of Cancer Education : the... Jun 2022Kitesurfing is one of many water sports that are growing in popularity throughout the world. In such sports, practitioners are exposed not only to direct sunlight but...
Kitesurfing is one of many water sports that are growing in popularity throughout the world. In such sports, practitioners are exposed not only to direct sunlight but also to reflection from the water surface, which aggravates the impact of solar radiation on the skin. This study sought to analyse the photoprotection and photoexposure habits and knowledge of elite kitesurfers and their beliefs and attitudes in this respect. A sample of convenience of 72 male kitesurfers completed a validated questionnaire in full. By Fitzpatrick phototype, the most common classes were types I and II (69.4%). On average, kitesurfers had been practising their sport for 10.93 years, at a rate of 13.93 h per week. During the last sports season, 84.7% of respondents had suffered at least one sunburn, while 43.1% had been sunburned at least three times. The sun protection practice most commonly adopted was the use of sunscreen cream, which was used by 79.2% of respondents. Although 43.2% of respondents recognized to be worried about they might get skin cancer from the sun, 31.9% does not like using sunscreen and 44.4% like sunbathing. Regarding the respondents' knowledge of facts about sun exposure, the average rate of correct answers for the items evaluated was 66.9%. In conclusion, elite kitesurfers are potentially exposed to dangerous levels of UV radiation, which caused numerous sunburn episodes during the last sports season. It is necessary to raise these athletes' awareness of their risk of developing skin cancer and of the need to improve their sun protection and skin surveillance practices.
Topics: Habits; Health Knowledge, Attitudes, Practice; Humans; Male; Skin Neoplasms; Sunburn; Sunlight; Sunscreening Agents
PubMed: 32720132
DOI: 10.1007/s13187-020-01838-7 -
Public Health Research & Practice Mar 2022Exposure to ultraviolet (UV) radiation from the sun has both risks, including skin cancer and premalignant lesions, skin aging and cataracts, and benefits, including the... (Review)
Review
IMPORTANCE
Exposure to ultraviolet (UV) radiation from the sun has both risks, including skin cancer and premalignant lesions, skin aging and cataracts, and benefits, including the production of vitamin D. Health policies guide informed decision making about balancing these risks and benefits. However variability in advice given by different agencies (e.g. government, health organisations, consumer organisations) may lead to confusion among the general public, resulting in suboptimal health-related behaviours by consumers.
OBJECTIVE
To review and assess the consistency of recommendations in relevant guidance documents in Australia and New Zealand regarding the risks and benefits of sun exposure. Study type and methods: A rapid desktop review of publicly available sun exposure guidance documents from government and nongovernment websites was undertaken between February and April 2021. Four major themes and their subthemes were extracted from documents: sun protection; balance between risks and benefits of sun exposure; non-vitamin D benefits of sun exposure; and sun exposure and vitamin D production. We then undertook a more detailed analysis of recommendations regarding sun exposure to maintain sufficient vitamin D status.
RESULTS
Nineteen documents met the inclusion criteria (13 Australian, five New Zealand, and one joint Australian and New Zealand document). Most documents provided extensive advice about sun protection and sun exposure and vitamin D production and their respective subthemes, while only 2/19 documents provided advice regarding the non-vitamin D benefits of sun exposure (benefits for melatonin production and reduction of sleep disorders). Documents varied widely in their recommendations in relation to sun exposure required for vitamin D production. For example, while three documents stated that sun exposure is required on most days of the week for adequate vitamin D production, two stated that sun exposure is required daily. One document advised that people with darker skin require three to six times more sun exposure than those with lighter skin, while another advised two to three times more sun exposure is required.
CONCLUSION
Current guidance documents show great variation in the advice for sun exposure and vitamin D production, and little advice is being provided on non-vitamin D health benefits. Extensive variations in the advice provided could be confusing for consumers and result in unhealthy behavioural action. Based on this evidence, better and more consistent guidance and advice about the risk and benefits of sun exposure is required.
Topics: Australia; Humans; New Zealand; Sunlight; Ultraviolet Rays; Vitamin D
PubMed: 35290996
DOI: 10.17061/phrp3212202 -
BMC Public Health Jul 2022Keratinocyte cancer (KC) rates are increasing in the U.S., particularly in older age groups. Use of hydrochlorothiazide (HCTZ), due to its photosensitizing properties,...
BACKGROUND
Keratinocyte cancer (KC) rates are increasing in the U.S., particularly in older age groups. Use of hydrochlorothiazide (HCTZ), due to its photosensitizing properties, and high sun exposure are two known NMSC risk factors, but their synergistic effects are undetermined. The purpose of this study was to examine the development of NMSC between adults who did and did not use HCTZ, as well as those with high and low sun exposure.
METHODS
A retrospective case-control sample was assembled from adult patients in north-central Wisconsin (USA). Duration of HCTZ use and occupational sun exposure were extracted from electronic health records, along with a linked survey of lifetime sun exposure.
RESULTS
There were 333 cases and 666 controls in the analytical sample. A significant main effect was observed for HCTZ duration in the full sample. Under low sun exposure, the odds of NMSC was 14% greater for each additional year of HCTZ use (aOR = 1.14 [1.11, 1.18], p < 0.001). In a sensitivity analysis of participants age 70 years and over, there was a borderline significant (p = 0.086) HCTZ use by high sun exposure interaction, suggesting modestly increased HCTZ risk in older, high sun exposure adults.
CONCLUSIONS
Consistent with prior studies, longer duration of HCTZ use was a predictor of NMSC in north-central Wisconsin adults. NMSC may be accelerated in HCTZ users with outdoor lifestyles, but future studies should attempt to further disaggregate specific effects of sun exposure time, HCTZ duration, and age on NMSC development.
Topics: Adult; Aged; Humans; Hydrochlorothiazide; Keratinocytes; Retrospective Studies; Skin Neoplasms; Sunlight; United States
PubMed: 35780087
DOI: 10.1186/s12889-022-13705-9 -
Annales Pharmaceutiques Francaises Sep 2021Fear of dermocorticoids (DCs) or corticophobia is based on an overestimation of the risks of actual side effects and on unfounded beliefs such as DCs-induced...
INTRODUCTION
Fear of dermocorticoids (DCs) or corticophobia is based on an overestimation of the risks of actual side effects and on unfounded beliefs such as DCs-induced photosensitivity among community pharmacists. The objective of this study was to assess the community pharmacy teams' fear of dermocorticoids in atopic dermatitis (DA) in sunny weather and its impact on drug use advice.
MATERIAL ET METHODS
A questionnaire as a real case (a summer prescription for atopic dermatitis for an 18-month-old child) was posted on Facebook via groups of pharmacists, technicians and students. Data collected concerned the health professional, his or her reluctance to DCs, advice associated with dispensation, detailed concerns about the DC and sun association, and sources of information.
RESULTS
In total, 126 participants responded (48.4% pharmacists, 40.5% technicians, 10.3% students): 12% were reluctant to DCs, 36% were reluctant to DCs and considered them photosensitizing, and 51% were not reluctant but considered them photosensitizing. The impact on the patient advice was: a suggestion to stop DC during sun exposure (28%), to stop or limit DC (dose, duration) (43%). Concerns about the association DC/sun were mainly due to UV rays (46%). Sources cited were: monographs (54%), Internet (6%), training courses (13%).
CONCLUSION
The false belief of DC/sun incompatibility in DA is strong among pharmacists and impacts on patients' advice. The role of the official team in dispensing dermocorticoids is essential: training and information for professionals helps to fight false information.
Topics: Child; Community Pharmacy Services; Female; Health Personnel; Humans; Infant; Male; Pharmacies; Pharmacists; Professional Role; Sunlight; Surveys and Questionnaires
PubMed: 33515590
DOI: 10.1016/j.pharma.2021.01.001