Being sun-smart just got smarter

photo credit: actcancer.org

photo credit: actcancer.org

Just when you were feeling really good about being sun-savvy with your daily sunscreen use, wide-brimmed hat and love of shade, I’m here to give you a huge shout out and be your biggest cheerleader to keep it going! Being sun-smart isn’t just good for your skin, it’s good for your whole body, a point reiterated by a recent study published by researchers from the Brigham and Women’s Hospital and Harvard Medical School.

This current study supports and expands upon findings of previous work which shows that people who have had non-melanoma skin cancers (NMSC), specifically basal and squamous cell carcinoma, are approximately twice as likely as people without such history to develop melanoma as well as non-skin cancers including cancer of the breast and lung. After researchers accounted for other potential risk factors for developing cancer, they found that a history of NMSC was associated with an 11% higher risk of other primary cancers (including lung cancer) in men and a 20% higher risk of other primary cancers (including breast cancer) in women. Moreover, they found that having NMSC had about twice the risk of developing melanoma in both men and women (melanoma, like NMSC, is linked to overexposure to UV light). These findings are significant because NMSC is the most common malignancy, with nearly 3 million cases diagnosed annually in the United States. To break it down further, it’s estimated that one in five Americans will develop NMSC at some point in their lives and 90 percent of these cancers are associated with exposure to the sun’s harmful ultraviolet (UV) radiation.

The full implications of this research are not yet known, and while further research needs to be done to determine if there may be a genetic link between the development of cutaneous and non-cutaneous malignancies, the findings at least serve as a reminder to minimize our preventable risk for skin cancer (shout out for hats, sunglasses, sunscreen, protective clothing and shade) and to have a skin cancer screening performed by dermatologist.

There is no time like the present! May is skin cancer awareness month. Mark your calendars for Monday May 6th which is Melanoma Monday. The American Academy of Dermatology and my dermatology colleagues across the country will be hosting free skin cancer screenings that day and throughout the coming months. Women’s Dermatologic Society also has their fantastic Coast to Coast Sun Safety and Skin Cancer screening events throughout the year. I have participated in some of these events and they are great. Check out these sites to find an event near you!

Just remember, I’m here to cheer you on while you get sun-smart, sun-savvy and shade-sational! (Yes, I know that isn’t a word, but I got a little carried away. I can’t help myself).

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Ladies, got aspirin?

photo credit: top news

photo credit: top news

Got aspirin?

Perhaps you’ve heard that adding an aspirin to your daily regimen may help prevent heart attacks, strokes and decrease incidence of cancers including lung, colon, prostate and breast (good stuff right?), but I wanted to bring your attention this recent study by the derm folks at Stanford. (click on the link above to check it out)

Ladies, this is worth a read. Researchers found that women who took a daily aspirin had a lower incidence of melanoma compared to women who did not take the drug. They also found that the risk continued to decrease the longer duration the drug was taken. The study had it’s limitations, and additional research needs to be done, but it’s something to think about. Guys….I am really hoping the additional research will include you, but it looks like this research was chivalrous, “Ladies, first.” Sorry.

It’s important to note that taking aspirin is not a safe option for everyone depending on any underlying medical conditions you may have, so please, before you start any medicine consult with your physician.

-See you in the shade

Did you smell that?

photo credit: Zazzle.com

photo credit: Zazzle.com


Depending on what it is you may hope you didn’t right? Well as a Mom of two kids and two dogs, needless to say there are some er..um, unpleasant odors permeating the house on a not so infrequent basis. Now I realize that offensive smells are not directly related to skin care, but the fragrances and products used to camouflage said scents can be irritating if they come in contact with your skin so I thought this would be a good segue, yes? Bad smells are not the kind of thing most people like to talk about at the bus stop, in the coffee shop, or in the grocery checkout lane (although quite frankly it may help pass the time when you’re stuck behind the person with 50 items in the express 15 item limit line, did she not see the sign?), but I’m not like most people. So bear with me.

I wouldn’t say I have a huge nose by most standards but it’s certainly not petite. Not one of those cute button noses. Any hopes of having a “cute” nose washed out at sea when I got kicked playing water polo at the beach as a kid. I know, I know, who plays water polo in the ocean with strong undercurrents right? Exactly, so I get pulled underwater by the current, get kicked in the nose, blood everywhere….The good news was that my nose wasn’t “broken” per-se, more like “adjusted to the right slightly”, but the end result is that my nose doesn’t quite work like it used to, making breathing a bit more difficult. What I lack in breathing prowess however, I make up for with olfaction. It’s like my sense of smell went into overdrive after that fateful day at the beach. There are many times I wish this was not the case, believe me…I am constantly asking people, “Do you smell that?” and of course they don’t so I am left to endure the stink in solitude. Spending more time indoors since our move to the perpetually soggy Northwest, my inner voice is still yapping away, and she says she’s had it with all the over-chemicaled, synthetic, “can’t pronounce a single ingredient on the bottle”, skin irritating air fresheners, so I have indulged her again and found a solution for my lonely sniffer…homemade air freshener spray!

I have come across recipes that use only water or only vodka, but I have found that an equal ratio of both works best for me, but feel free to experiment. The alcohol will break down the oil while leaving the scent intact, allowing you to mix it with water. The added bonus is that alcohol has anti-bacterial, anti-viral and anti-fungal properties, so if the spray gets on any surfaces, you can pat yourself on the back for multi-tasking…disinfecting and deodorizing!

So here are the basics:
4 ounce spray bottle (I prefer glass. Essential oils are stored in glass to prevent degradation, so I figured why mess with it, I can’t afford to have the good smell go away!)
2 ounces distilled water
2 ounces vodka (Any kind will do, but the cheaper the better because you may go through it fast if you get spritz happy.)
20-40 drops essential oils (The potency of oils vary so you can tailor the amount used to your preference. Also, several oils have anti-bacterial properties so in case you really do want to multi-task you may want to try: lavender, maleluca oil(tea tree), geranium and lemon.)

My favorite combinations are:
a. lavender and rosemary
b. lavender and sweet orange
c. cedar wood, rosemary, rose geranium, lavender (I know, I know, I can’t help it, I really like lavender)
d. eucalyptus and spearmint (seriously refreshing)

So the next time someone asks you, “Did you smell that?”, you can be armed and ready with your homemade air freshener. And who knows, you may actually enjoy talking about bad smells to total strangers once you find your olfactory bliss like me!

Sticks and stones….

photo credit: lyceum group

photo credit: lyceum group

Most of you know how this saying goes, but I’ve added my own spin on it so I’m giving it a whirl:

Sticks and stones may break your bones

But Sunburns can really hurt you!

For those of you who are willing to entertain my version of nursery rhymes, thank you because I’ve taken liberties to take it one step further…

I’m rubber and you’re glue

I hope what I tell you about sun safety, skin cancer and melanoma bounces off me and sticks to you!

I know what you are probably thinking. That’s so juvenile right? Maybe Dr. Barr washed down some goldfish with too many glasses of red wine. Could she be more childish?

But that is the whole point of this post…children. Your children, my children and children all over the world. Anyone with a relationship with a child (could be your best friends’ child, a niece/nephew or your own)  has experienced that undeniable instinct to protect them from harm. It doesn’t matter what form the threat of harm may take, whether it be psychological or physical, we as adults, put on our proverbial armor and prepare ourselves to defeat the perpetrator to a child’s well-being.  Somewhere along the way however, our armor got a chink in it and we have failed to adequately protect our children (let alone ourselves) from the damaging effects of the sun. Research recently presented at the American Association of Cancer Research meeting confirms our shortcomings. Although the incidence of melanoma in childhood is rare, statistics show that the frequency of children and adolescents diagnosed with melanoma is on the rise.

Data pooled from numerous U.S. cancer registries highlighted that the incidence of childhood and adolescent melanoma has increased an average of 2 percent per year spanning the time period from 1973 to 2009. Of note, girls had higher incidence rates than boys, and compared to younger children so did those aged 15-19. Similar to their adult counterparts, girls had higher rates on their lower limbs and hips, while boys had higher incidence on the face and trunk. While further research needs to be performed to determine the factors contributing to the rising incidence, we don’t have to wait for additional data to be pro-active about vigilant protection of children and adolescents from the damaging effects of UV radiation.

Wearing wide-brimmed hats, sunscreen (with re-application at least every 2 hours) and wearing UPF rated clothing (30 and above) coupled with modifying hours spent outdoors to avoid high intensity UV-radiation (currently recommended between 10a-4p but that may be hard to do, so doing your best to avoid 12-3p may be easier) are crucial steps in protecting children and adolescents more delicate skin. But that’s only part of the solution.

Artificial UV radiation sources found at tanning salons are a significant contributing factor as I touched on in my What’s the big deal post. UV radiation from tanning devices are a significant contributor to the rising rates of both non-melanoma and melanoma skin cancer.

We know that Ultraviolet A (UVA) and Ultraviolet B(UVB) rays contribute to the development of skin cancer of all types. UVB is primarily responsible for contributing to sunburns. UVA rays penetrate deeper into the skin and contribute to premature aging of the skin including: alterations in pigmentation (brown spots), fine lines, wrinkles and loss of elasticity that contributes to a leathery appearance. Together, the synergistic effect of UVA and UVB rays contribute to the development of skin cancer. Of note, an Australian-US study has demonstrated that UVA causes more genetic damage than UVB in skin cells where most skin cancers arise – the keratinocytes in the basal layer of the epidermis. This information is critical as most tanning devices emit UVA radiation.
So what’s the bottom line you ask? It’s pretty simple: don’t let kids go to tanning salons and practice sun-safe behavior every day. Being sun-safe doesn’t mean you have to stay indoors, rather it’s a lifestyle choice. Choosing clothing that protects a greater proportion of your skin, altering the times of day you pursue your outdoor activities and putting on sunscreen as part of your daily personal hygiene regimen can easily be incorporated into your daily routine.

So how does this nursery rhyme end? Here goes:
Sticks and stones can break your bones
But Sunburns can’t hurt you if you are sun-savvy!
Doesn’t rhyme but I never said I was Dr. Seuss. Cheers to finding your Shaded Bliss!

References:
1. Skin cancer foundation: skincancer.org
2. Pediatrics Vol. 131 No. 4 April 1, 2013 pp. 772 -785

The Versatile Blogger Award

versatile_blogger_award

My gratitude goes to Sheila, the goddess of The Summer Goddess of Dark Shadows for bestowing this award on me. Please visit her site! So the rules of this award require that I share seven things about myself, so here they are:
1. I could eat pizza for breakfast, lunch and dinner…the possibilities are endless
2. I may be tone deaf, but I still rock out in my car so no one else can hear me and complain
3. Princess Bride is still one of my all time favorite movies after all these years
4. I have lived in a lot of college towns, but I will always be a Wolverine, “GO BLUE!”
5. One of my guilty pleasures is looking at houses and scouring interior design websites…part of me really wants to be an interior designer/architect
6. I am married to my best friend (this really is my number one)
7. I am a perpetual klutz

Now for the fun part! I have the pleasure of bestowing this award to other blogs. As I am just getting starting with my blog and this experience, having the opportunity to explore so many of the amazing blogs out there is a wonderful opportunity to expand my community and highlight some seriously talented authors. There are countless of you out there so this is just a small sampling of what I have discovered so far…Please check them out!
1. Katie Hansen Brakeman
2. In Real Life
3. The Honest Toddler
4. The Jiggly Bits
5. What’s for Dinner Ma?
6. Learning to Hit the Curve
7. Hunting for Bliss

So…now that you know seven things about me and about seven amazing other blogs, here are the rules as I understand them from others who have received this award.
1. Thank the person who gave you the award and link back to their blog
2. Post the Versatile Blogger Award Picture on your post
3. Share seven things about yourself
4. Pass this award on to seven other blogs (Some have given it to more and sharing more love is always a good thing. Of course, this is an optional thing, so no pressure…pass it along if you wish, or just enjoy a mention. I think you’re fantastic!)

I hope you enjoy exploring the amazing community on WordPress as much as I do! Happy reading!

Like a fine wine…..

photo credit: www.trialx.com photo credit: http://www.trialx.com
We have heard the cliché countless times, “Aged like a fine wine.” But what does that really mean? What makes a wine so fine (aside from my rhyming ability)? As with many things, success is achieved through collaboration of multiple factors to produce a better end product. The same principle applies to winemaking. The creation of a fine wine rests upon factors including the varietal of grapes used, the light, temperature and soil conditions affecting the grapes and vines respectively, the length of the fermentation process and yes, you guessed it (this is a dermatology blog after all) the skin. Wine grapes, compared to table grapes, have a thicker skin; a desirable quality as the skin imparts the aroma to wine. Grape skin also contain tannins which produce the color of the wine. These tannins found in the skin help to preserve the wine for a longer period. Recently, it has been found that the skin of black grapes (used to make red wine, a personal favorite) contain a chemical called resveratrol; which is what provides the cardio and chemo-protective health benefits of red wine.

For those of you who love wine, these tidbits are good fodder to keep drinking, yes? Salut! But the point of all this information is not really about wine of course. It’s about skin. Your skin. Like the creation of a fine wine, the health of your skin is a significant contributing factor to the end product of your overall well-being.

Your skin is the largest organ of your body. As such, it is constantly exposed to the elements just like wine grapes, and light, in the form of UV-rays have a significant impact on the quality and appearance of your skin and your health. With regards to appearance, prolonged exposure to UV-radiation directly affects the color and texture of your skin. The acute changes may be a sunburn, followed by a tanned appearance. But what about the chronic changes? Those brown spots on your arms and hands that folks refer to as “liver spots” or “age spots” are in actuality the manifestations of chronic sun exposure and resultant sun-damage. They are irreversible.

For a grape, dried by the sun, the texture and quality of the skin transforms to a wrinkled, flaccid and shriveled form which we call a raisin. Our skin is very similar to the grape. Premature wrinkling, loss of elasticity and leathery feel to the skin (think Magda from “There’s something about Mary”) are direct by-products of extensive sun-exposure. So which would you rather be, a grape or a raisin? In a society where people are paying a premium for a youthful appearance with products like Botox, dermal fillers and plastic surgery, why not save money and be pro-active: protect your skin from the sun everyday!

With regards to health, it is known that UV-radiation suppresses the immune system. Suppression of the immune system leads to cancer. It has been reported that 90% of skin cancers are induced by UV-radiation exposure. 90%! This statistic is a vital reason that I encourage you to seek shade (where your bliss awaits), wear sunscreen and protective clothing on a daily basis.

Now some of you may be thinking, what? How can that be? Maybe Dr. Barr (that’s me) has been drinking too much of that red wine, because I know that phototherapy (delivery of UVB rays in a very controlled and time limited setting) make my psoriasis better! Psoriasis (a chronic skin condition +/- joint involvement) is known to be driven by an up-regulation of aspects of the immune system…so suppression of these “jazzed up” factors so to speak, is the desired end result. This principle applies to several conditions in dermatology, but these are the exceptions not the rule, and most importantly, the exposure to UV-radiation administered in a dermatologist’s office is tightly regulated and controlled to minimize adverse effects of said exposure.

Like a fine wine, your skin will age, but there’s a big difference between chronologic aging and physiologic aging. The latter of which is accelerated significantly by extensive sun-exposure. So the choice is yours, grape or raisin…which would you rather be?

What’s the big deal?

IMG_1934

Skin cancer is a big deal. More than 3.5 million cases of nonmelanoma skin cancer in over two million people and over 70,000 cases of melanoma are reported each year, which makes skin cancer the most commonly diagnosed cancer the United States. This means that on an annual basis there are more new cases of skin cancer than the incidence of cancers of the breast, prostate, lung and colon combined. To break this down further, one in five Americans (one in three Caucasians) will develop skin cancer during the course of a lifetime. Bottom line…skin cancer is a big deal. In my skin cancer and sun safety basics post I go over a lot of the facts, so please refer back to it for a more in-depth discussion, and please feel free to reach out if you have any questions. Also check out skincancer.org for a wealth of great information and photos of all of the different types of skin cancers.

So if I already talked about these facts in a previous post, why am I all riled up and repeating myself you might ask? Contrary to what my kids may say (and my husband and possibly the neighbors, but who likes nosy neighbors anyway?) I have not lost my mind, but my mind is most certainly boggled. A recent study reported that greater than 27% of melanoma survivors never put on sunscreen when spending more than an hour in the sun. Researchers at Yale also found that 15.4% of skin cancer survivors rarely or never sought shade from the sun, and 2.1% used tanning beds. This is insanity. Tanning beds? Evidence from several studies has shown that exposure to UV radiation from indoor tanning beds is linked with an increased risk of melanoma, the deadliest form of skin cancer, and non-melanoma skin cancer. In fact, studies have demonstrated a 75 percent increase in the risk of melanoma in those who have been exposed to UV radiation from indoor tanning. 75 percent! This evidence is the basis for championing the passage of legislation to ban the use of tanning beds for minors (currently 33 states have restricted teen’s access to tanning beds). So if these are the facts, and people who have already been diagnosed with skin cancer have been educated about these facts, and believe me, as dermatologists we tell our patients, over and over again, then why are skin cancer patients still ignoring them? This is a dilemma. This is my dilemma and I want to help change these statistics. But I need your help to do it.

We know that protecting your skin from the damaging UVA and UVB rays of the sun is imperative to minimizing your risk of developing skin cancer. Sun protection is a multi-faceted process: practicing sun avoidance during the hottest parts of the day, seeking shade (I promise you can find bliss there), wearing sunscreen (daily and reapplying often) and wearing clothing that has a UPF rating greater than 30, are all important to keeping you safe in the sun.

Based on the staggering number of skin cancers diagnosed annually and the results of the recent study noted above, it would appear that telling people this information isn’t enough. It would appear that a cultural shift, a “shade revolution” if you will, is in order. For starters, we need to embrace vintage times, go retro…what’s old is new again. It works for current fashion trends (hello neon and leg warmers!) and toys (yes, cabbage patch kids I’m talking about you!) so why can’t we embrace the way we used to behave in the sun. Back in the day our ancestors spent plenty of time outdoors, but clothing protected the majority of their body. Being pale was in vogue, whereas having a tan was undesirable. We can do this! You don’t have to give up that Caribbean vacation or frolic on the beach, just be sun savvy! Tap into your sun-conscious and take the necessary steps to protect your skin. Together we can change the perception of what’s “hot” in the sun and you will find your shaded bliss, I promise!