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Cold Spring Harbor Perspectives in... Jan 2015With worldwide expansion of the aging population, research on age-related pathologies is receiving growing interest. In this review, we discuss current knowledge... (Review)
Review
With worldwide expansion of the aging population, research on age-related pathologies is receiving growing interest. In this review, we discuss current knowledge regarding the decline of skin structure and function induced by the passage of time (chronological aging) and chronic exposure to solar UV irradiation (photoaging). Nearly every aspect of skin biology is affected by aging. The self-renewing capability of the epidermis, which provides vital barrier function, is diminished with age. Vital thermoregulation function of eccrine sweat glands is also altered with age. The dermal collagenous extracellular matrix, which comprises the bulk of skin and confers strength and resiliency, undergoes gradual fragmentation, which deleteriously impacts skin mechanical properties and dermal cell functions. Aging also affects wound repair, pigmentation, innervation, immunity, vasculature, and subcutaneous fat homeostasis. Altogether, age-related alterations of skin lead to age-related skin fragility and diseases.
Topics: Body Temperature Regulation; Collagen; Extracellular Matrix; Humans; Regeneration; Skin; Skin Aging; Skin Pigmentation; Subcutaneous Fat; Sunlight; Ultraviolet Rays
PubMed: 25561721
DOI: 10.1101/cshperspect.a015370 -
International Journal of Environmental... Jul 2020This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from sun exposure, which suggests that... (Review)
Review
This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from sun exposure, which suggests that insufficient sun exposure is a significant public health problem. Studies in the past decade indicate that insufficient sun exposure may be responsible for 340,000 deaths in the United States and 480,000 deaths in Europe per year, and an increased incidence of breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer's disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of sun exposure. However, oral vitamin D supplementation has not been convincingly shown to prevent the above conditions; thus, serum 25(OH)D as an indicator of vitamin D status may be a proxy for and not a mediator of beneficial effects of sun exposure. New candidate mechanisms include the release of nitric oxide from the skin and direct effects of ultraviolet radiation (UVR) on peripheral blood cells. Collectively, this evidence indicates it would be wise for people living outside the tropics to ensure they expose their skin sufficiently to the sun. To minimize the harms of excessive sun exposure, great care must be taken to avoid sunburn, and sun exposure during high ambient UVR seasons should be obtained incrementally at not more than 5-30 min a day (depending on skin type and UV index), in season-appropriate clothing and with eyes closed or protected by sunglasses that filter UVR.
Topics: Europe; Humans; Public Health; Sunburn; Sunlight; Ultraviolet Rays; Vitamin D; Vitamin D Deficiency
PubMed: 32668607
DOI: 10.3390/ijerph17145014 -
Anales de Pediatria Jun 2020Sunburn, immunodepression, photoaging, and photocarcinogenesis, are some of the most significant adverse effects of solar radiation in humans. Children are population...
Sunburn, immunodepression, photoaging, and photocarcinogenesis, are some of the most significant adverse effects of solar radiation in humans. Children are population group of special vulnerability, due to the fact that exposure to the sun has more pronounced biological effects compared to adults. Furthermore, childhood is a critical period for promoting the development of photo damage and photocarcinogenesis in the later stages of life if adequate measures at not put into place. This is because it is estimated that between 18 and 20 years of age is when 40% to 50% of the accumulative exposure to ultraviolet radiation up to 60 years of age is received. The most important strategy for the photoprotection of children is changes in behaviour and habits associated with exposure to the sun at all levels (school, society, family, etc.). Resorting to the shade, reduction in overall time of exposure to the sun, and physical protection (clothes, hats, and sunglasses) are the best and least costly photoprotection strategies. The photoprotectors must be incorporated into the daily routine of children in the same way as adults, and must complete a series of requirements in order to make them effective, safe, and in line with the environment.
Topics: Adolescent; Child; Child Health; Child, Preschool; Humans; Infant; Protective Clothing; Skin Aging; Skin Neoplasms; Sunburn; Sunlight; Sunscreening Agents; Young Adult
PubMed: 32513601
DOI: 10.1016/j.anpedi.2020.04.014 -
International Journal of Cosmetic... Apr 2008As the proportion of the ageing population in industrialized countries continues to increase, the dermatological concerns of the aged grow in medical importance.... (Review)
Review
As the proportion of the ageing population in industrialized countries continues to increase, the dermatological concerns of the aged grow in medical importance. Intrinsic structural changes occur as a natural consequence of ageing and are genetically determined. The rate of ageing is significantly different among different populations, as well as among different anatomical sites even within a single individual. The intrinsic rate of skin ageing in any individual can also be dramatically influenced by personal and environmental factors, particularly the amount of exposure to ultraviolet light. Photodamage, which considerably accelerates the visible ageing of skin, also greatly increases the risk of cutaneous neoplasms. As the population ages, dermatological focus must shift from ameliorating the cosmetic consequences of skin ageing to decreasing the genuine morbidity associated with problems of the ageing skin. A better understanding of both the intrinsic and extrinsic influences on the ageing of the skin, as well as distinguishing the retractable aspects of cutaneous ageing (primarily hormonal and lifestyle influences) from the irretractable (primarily intrinsic ageing), is crucial to this endeavour.
Topics: Female; Humans; Life Style; Male; Skin Aging; Skin Neoplasms; Sunlight
PubMed: 18377617
DOI: 10.1111/j.1468-2494.2007.00415.x -
Journal of Internal Medicine Oct 2016Women with active sunlight exposure habits experience a lower mortality rate than women who avoid sun exposure; however, they are at an increased risk of skin cancer. We...
OBJECTIVE
Women with active sunlight exposure habits experience a lower mortality rate than women who avoid sun exposure; however, they are at an increased risk of skin cancer. We aimed to explore the differences in main causes of death according to sun exposure.
METHODS
We assessed the differences in sun exposure as a risk factor for all-cause mortality in a competing risk scenario for 29 518 Swedish women in a prospective 20-year follow-up of the Melanoma in Southern Sweden (MISS) cohort. Women were recruited from 1990 to 1992 (aged 25-64 years at the start of the study). We obtained detailed information at baseline on sun exposure habits and potential confounders. The data were analysed using modern survival statistics.
RESULTS
Women with active sun exposure habits were mainly at a lower risk of cardiovascular disease (CVD) and noncancer/non-CVD death as compared to those who avoided sun exposure. As a result of their increased survival, the relative contribution of cancer death increased in these women. Nonsmokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun exposure group, indicating that avoidance of sun exposure is a risk factor for death of a similar magnitude as smoking. Compared to the highest sun exposure group, life expectancy of avoiders of sun exposure was reduced by 0.6-2.1 years.
CONCLUSION
The longer life expectancy amongst women with active sun exposure habits was related to a decrease in CVD and noncancer/non-CVD mortality, causing the relative contribution of death due to cancer to increase.
Topics: Adult; Cardiovascular Diseases; Cause of Death; Environmental Exposure; Female; Follow-Up Studies; Humans; Life Expectancy; Melanoma; Middle Aged; Neoplasms; Risk Factors; Skin Neoplasms; Sunlight; Sweden
PubMed: 26992108
DOI: 10.1111/joim.12496 -
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 -
Current Oncology (Toronto, Ont.) Feb 2023Sun exposure carries both harms and benefits. Exposing the skin to the sun is the main modifiable cause of skin cancers, which exert a considerable health and economic...
Sun exposure carries both harms and benefits. Exposing the skin to the sun is the main modifiable cause of skin cancers, which exert a considerable health and economic burden in Australia. The most well-established benefit of exposure to ultraviolet (UV) radiation is vitamin D production. Australia has the highest incidence of skin cancer in the world but, despite the high ambient UV radiation, approximately one quarter of the population is estimated to be vitamin D deficient. Balancing the risks and benefits is challenging and requires effective communication. We sought to provide a snapshot of public knowledge and attitudes regarding sun exposure and vitamin D and to examine the associations between these factors and sun protective behaviors. In 2020 we administered an online survey; 4824 participants with self-reported fair or medium skin color were included in this analysis. Only 25% and 34% of participants were able to identify the amount of time outdoors needed to maintain adequate vitamin D status in summer and winter, respectively and 25% were concerned that sunscreen use inhibits vitamin D synthesis. This lack of knowledge was associated with suboptimal sun protection practices. Public education is warranted to prevent over-exposure, while supporting natural vitamin D production.
Topics: Humans; Vitamin D; Sunlight; Vitamin D Deficiency; Ultraviolet Rays; Surveys and Questionnaires; Skin Neoplasms
PubMed: 36826149
DOI: 10.3390/curroncol30020188 -
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 -
Photodermatology, Photoimmunology &... Jul 2022Transplant recipients are particularly prone to the development of skin cancer, and overexposure to UV radiation during outdoor activities increases the risk of...
BACKGROUND
Transplant recipients are particularly prone to the development of skin cancer, and overexposure to UV radiation during outdoor activities increases the risk of carcinogenesis.
OBJECTIVE
The aim of this study was to analyze sun-related behaviors and knowledge in transplant athletes, examine the frequency of sunburns, and explore associations with a history of skin cancer.
MATERIALS AND METHODS
Cross-sectional descriptive study. Participants (n = 170) in the XXI World Transplant Games from >50 countries completed a questionnaire on sun protection habits and knowledge, type of transplant, immunosuppressive therapy, and personal history of skin cancer.
RESULTS
The most common transplanted organs were the kidney (n = 79), the liver (n = 33), and the heart (n = 31). Overall, 61.3% of athletes had been doing sport for >15 years and 79.5% spent >1-2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes aged <50 years (37.2%); without a primary school education (58.3%), not taking cyclosporin (32.6%), and athletes who played basketball (75%). The main sun protection measures used were sunscreen (68.9%) and sunglasses (67.3%). Use of a hat or cap was the only measure significantly associated with a reduced prevalence of sunburn.
CONCLUSIONS
Despite high awareness that sun exposure increases the risk of skin cancer, sunburn was common in transplant athletes. Efforts should be made to strengthen multidisciplinary sun protection education strategies and ensure periodic dermatologic follow-up to prevent sun-induced skin cancer in this population.
Topics: Athletes; Cross-Sectional Studies; Habits; Health Knowledge, Attitudes, Practice; Humans; Skin Neoplasms; Sunburn; Sunlight; Sunscreening Agents; Surveys and Questionnaires
PubMed: 34817897
DOI: 10.1111/phpp.12755 -
The British Journal of Dermatology Feb 2021Individual studies have suggested that the association between occupational exposure to solar ultraviolet radiation (UVR) and the development of keratinocyte cancers... (Review)
Review
Individual studies have suggested that the association between occupational exposure to solar ultraviolet radiation (UVR) and the development of keratinocyte cancers (KCs) may only be valid in populations of European ancestry living in certain geographical regions. Comparative global data are scarce and so this review aimed to summarize current evidence on the association between occupational exposure to solar UVR and the development of KCs, with a specific focus on geographical location and skin colour. Ovid MEDLINE, PubMed, Embase and Web of Science were searched for potentially relevant records. Extracted data were summarized by study, country and region. We included one prospective cohort study and 18 case-control studies (n = 15 233) from 12 countries in regions where the majority of the population is white skinned (Americas, Europe and Oceania). Eighteen of the 19 studies reported effect estimates suggesting an increased risk of basal cell carcinoma (BCC) and/or squamous cell carcinoma (SCC) among outdoor workers. Only 11 studies found a significantly increased risk and many had imprecise estimates. There was a significantly increased risk of BCC and SCC in individual studies in North America, Latin America and the Caribbean, Western Europe and Southern Europe, but not across regions or countries. Overall, 95% of studies reported higher risks among outdoor workers, although the increases in risk were statistically significant in just over half of the studies. Well-designed and sufficiently powered occupational case-control and cohort studies with adequate adjustment for confounding factors and other risk factors are required to provide more accurate risk estimates for occupational KC.
Topics: Carcinoma, Basal Cell; Caribbean Region; Europe; Humans; Keratinocytes; North America; Occupational Diseases; Occupational Exposure; Prospective Studies; Skin Neoplasms; Sunlight; Ultraviolet Rays
PubMed: 32320481
DOI: 10.1111/bjd.19152