Service Posting: Sunscreen, Skin Cancer, and 'the Science™'
Just in time for summer, here's the available evidence of a large-scale meta review on the safety and efficacy of sunscreen products
Just in time for a new, certainly ‘cruel™’ and ‘unprecedentedly™’ hot summer, of course due to ‘the Climate Catastrophe™’, I thought you might want to read about—sunscreen products.
Remember last year? It was the allegedly ‘hottest summer in 125,000 years’, and ‘the Science™’ was out in force to gaslight the public. Highlights incl.
Of course, us mere mortals are not expected to do anything but ‘follow the Science™’, hence we better do so and get prepared for summer, sun, and fun.
References omitted for readability; if non-English content appears, it comes to you in my translation; emphases mine, by the way.
The Sunscreen Paradox: Skin Cancer Increases Due to a Sense of False Security
Via Deutsches Gesundheitsportal and Conventus Congressmanagement & Marketing Gmbh, 21 June 2024 [source]
(ka) Sun cream protects against sunburn…? Two studies now show the opposite, the so-called sun cream paradox: people who apply sun cream are lulled into a false sense of security and stay in the sun too long—in the good belief that they are well protected against skin cancer. But this is not the case. Sunscreen is by no means a licence to tan for a long time without risk. Every time you sunbathe, the risk of skin cancer increases—still the most common form of cancer in Germany, and the trend is still rising. Prof. Carola Berking, U of Erlangen, and Dr. Peter Heppt, Erlangen, give tips on how effective skin protection can be practised.
More and more people are using sun protection, applying plenty of cream, feeling protected against skin cancer and staying out in the sun for long periods with a clear conscience. What is wrong with this feeling of safety? And what are the consequences?
Prof Berking: No sunscreen provides 100% protection against all the sun’s harmful rays. Some of the UV radiation still reaches the skin, despite the use of sunscreen. In addition, the cream is usually not applied to all areas of the skin, does not cover the entire surface, and is not thick enough [if if doesn’t work, apply more: ‘the Science™’ hard at work]. By using sunscreen, prolonged exposure to the sun can lead to prolonged exposure to UVA rays, which are less well blocked by sunscreen. They can not only cause wrinkles in the skin, but can also cause carcinogenic damage to the DNA of skin cells via indirect pathways.
Dr Heppt: I completely agree with that. Applying sunscreen is also just one component of skin cancer prevention, which unfortunately is often not enough on its own. Intense midday sun should be avoided, especially if you have a high sensitivity to light and a light skin type, and textile sun protection should also be used, such as wearing tightly woven and long-sleeved clothing [which is why, e.g., people in desert countries wear long clothes all day long when outside: more insights from ‘the Science™’].
This ‘sunscreen paradox’ can even lead to more cases of skin cancer. We don't realise how dangerous UV radiation is. How can we minimise the risk of skin cancer and still have fun outdoors?
Prof Berking: Always avoid intensive sunbathing and sunbeds. When the weather is sunny, move outdoor activities to the morning and late afternoon hours and seek out shady spots wherever possible. Pay attention to the UV index. Set up parasols and awnings, wear UV-protective clothing, a hat or cap and sunglasses. And apply sun protection creams to the skin before going out, in sufficient quantity and on all parts of the body that are exposed to the sun. Reapply after sweating or swimming [told you: use more sunscreen, even if its protective effects are in doubt].
Dr Heppt: Nevertheless, effective sun protection must of course also be practical. Today, most chemical sun protection filters have a very pleasant texture and can therefore be applied daily [we already mentioned that this is at best ineffective, so…is applying sunscreen daily, or multiple times a day, safe?], e.g., in the form of day creams or moisturisers. However, areas that cannot be adequately moisturised must be additionally protected, e.g., with headgear. If you have a high UV index, I also recommend staying indoors and going for a walk or playing tennis in the morning or evening. This is more pleasant in summer anyway.
What should we bear in mind when exposing ourselves to UV radiation outdoors?
Prof Berking: Tightly woven clothing provides particularly good protection. In the case of very strong sun exposure—for example water sports—specially UV-protected clothing may be advisable. A hat should not have any holes like a straw hat. Sunglasses should have UV protection labelling, e.g., UV-400, to protect the eyes as well [I’m a historian, and at this point, I do wonder how on earth humans have survived the past, say, 200K years without such glorious advice offered by ‘the Science™’?].
Dr Heppt: I also actively point out that a thin, white cotton T-shirt, for example, does not provide sufficient sun protection. Even spending time in shaded areas outdoors on sunny days leads to significant UV exposure due to reflection. I have often found that many of my patients do not realise this and are therefore lulled into a false sense of security [this is, by the way, where the header comes from: notice what they’re talking about in this context, as opposed to the sun screen issue?].
What role does age play in developing skin cancer? Why is it so important to protect children in particular from the sun? [I call BS on this one]
Prof Berking: Children’s skin is particularly sensitive and sunburns can change the genetic material of the skin cells particularly quickly [would that same logic also apply to, say, repeated administration of ‘vaccines™’?]. The skin does not forget! The prevalence of skin cancer increases with age. Sun damage accumulates over the years and decades and the risk of developing skin cancer increases [well, at least a half-answer in terms of me calling the question BS].
Dr Heppt: There are also studies and fairly accurate estimates that show that a large proportion of lifelong cumulative UV exposure is acquired during childhood. Therefore, the ‘preventive’ window is particularly important here and parents should set a good example. Unfortunately, I still see far too many playgrounds without sufficient shaded areas…[so, dear parents, prevent your kids from being outside, which children have done for…well, ever; also, if its outdoor play that is responsible for so much UV exposure, why do older people tend to get skin cancer more easily even though they stay outside less than kids?]
The risk of skin cancer varies from person to person. What can be early indications of a disease? And who should have their skin examined more frequently?
Prof Berking: Indications are changes on the skin that no longer disappear, such as redness, roughness or a raised appearance with increased keratinisation. Furthermore, pigmented moles that are getting larger, are multi-coloured and asymmetrical should be shown to the dermatologist. People who have a large number of pigmented moles, who have already been diagnosed with atypical pigmented moles or who have a close relative with skin cancer should undergo skin cancer screening more frequently. In addition, very light skin types, blondes or redheads, and people with blue or green eyes are particularly at risk.
Dr Heppt: Some occupational groups that mainly work outdoors are also particularly at risk. In some cases, skin cancer can even be recognised as an occupational disease, which offers many advantages for those affected because, for example, sun protection is also covered by the insurance provider [grifters of the world, unite]. In the early stages, skin cancer is very treatable in most cases and has a good prognosis. This is why early detection is so important!
Background via Deutsches Gesundheitsportal
Skin cancer is still the most common cancer in Germany with the highest rate of increase—despite the immense medical progress made in recent years [which doesn’t seem to ‘work’ in this case, eh?]. The number of new cases has doubled in the last ten years to around 300,000 per year. UV-related skin damage due to intensive sun exposure in childhood and adolescence is partly responsible for this. Basal cell carcinoma (white skin cancer) is in first place, followed by cutaneous squamous cell carcinoma and malignant melanoma (black skin cancer).
The ADO (Dermatological Oncology Working Group of the DKG and DDG) organises training courses, research projects and clinical studies to improve the quality of dermato-oncological patient care in Germany, Austria, and Switzerland and to promote scientific collaboration. An important focus is on the development of diagnostic and therapeutic guidelines for various types of skin cancer such as malignant melanoma, basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, Kaposi’s sarcoma and cutaneous lymphomas.
See the Media Spin, Do Your Own Research
While in and of itself not completely useless, this is about as obvious a cheap agip-prop stunt as any we’ve seen in recent years.
Why am I so dismissive of the good professors and doctors warning us for our own benefit?
Well, you see, here’s how I learned about this ‘story’:
Many legacy media outlets have been pushing the above piece last week, mainly, I’d suspect, because the school year is ending and the summer break is upon us. Just take a look at, e.g., this piece in Switzerland’s main tabloid Blick (dated 26 June 2024), which is how I learned about it; here’s Germany’s tabloid outlet T-Online with a piece about it, and here’s the German Pharmazeutische Zeitung, all of these pieces appeared last week.
Then I did a brief search (with DuckDuckGo), and there’s a bunch of websites all pushing the same narrative. Note that I’ve used the German words ‘Sonnencreme-Paradoxon’ (sunscreen paradox); if you use the English term, however, you’ll learn, still using DuckDuckGo, that there were two ‘recent studies’ that both appeared in autumn of last year.
I’m quoting their references from this piece that appeared in SciTechDaily (dated 23 Oct. 2023):
‘Understanding the Perceived Relationship between Sun Exposure and Melanoma in Atlantic Canada: A Consensual Qualitative Study Highlighting a “Sunscreen Paradox”’ by Sauliha Alli, Jonathan LeBeau, Agustina Hasbani, François Lagacé, Ivan V. Litvinov and Sandra Peláez, 26 September 2023, Cancers. DOI: 10.3390/cancers15194726
‘Gene–Environment Analyses in a UK Biobank Skin Cancer Cohort Identifies Important SNPs in DNA Repair Genes That May Help Prognosticate Disease Risk’ by Richie Jeremian, Pingxing Xie, Misha Fotovati, Philippe Lefrançois and Ivan V. Litvinov, 13 September 2023, Cancer Epidemiology, Biomarkers & Prevention. DOI: 10.1158/1055-9965.EPI-23-0545
If you’d take the time to read through that SciTechDaily piece, you’d see how much of it literally overlaps with what the good professor and doctor from Germany said ‘recently’ in the above-reproduced piece:
‘The problem is that people use sunscreen as a “permission slip” to tan’, said Dr. Ivan Litvinov, an Associate Professor in the Department of Medicine and Chair of the Dermatology Division at McGill University and co-author with Dr. Sandra Peláez, Dr. Richie Jeremian and Dr. Pingxing Xie of two recent studies that explore the sunscreen paradox.
‘People think they are protected from skin cancer because they are using a product marketed to prevent a condition.’
Most people don’t apply enough sunscreen or stay in the sun for hours after applying sunscreen in the morning. ‘This gives them a false sense of security’, said Litvinov…
‘These combined findings suggest a sunscreen paradox, whereby individuals with higher levels of sun exposure also tend to use more but not an adequate quantity of sunscreen or other sun-protection measures, providing a false sense of security’, said Litvinov…
‘Sunscreen is important, but it is also the least effective way to protect your skin when compared to sun protective clothing, rash guards, and sun avoidance. People can and should enjoy the outdoors, but without getting a sunburn or a suntan’, said Litvinov.
Now, isn’t that ‘strange’?
There are also plenty of other news items (sic) from last autumn in English that are virtually saying the same things as the good professor and doctor from Germany. See, e.g., this piece in Medical Express (24 Oct. 2023).
Isn’t it, well, a wee bit ‘weird’ that, while the underlying papers are ‘old news’, this ‘the sun will kill us all’ stuff is pushed in German legacy media just as the school year winds down?
Call me a cynic, but that hardly seems coincidental.
On Sunscreen, Skin Cancer, and Vitamin D
Oh, lest I forget, since ‘the Science™’ is telling us that sunscreen may not help prevent skin cancer, what about its safety?
You see, given the C-19 injection debacle, I suppose this, too, is a valid question to ask.
And, within a few moments of looking, I found two papers in PubMed that at least indicate that the good professor and doctor are less-than-convincing.
Disclaimer: I’m not a medical doctor, and I’m sure there’s plenty of stuff ‘out there’ about the issues mention in this sub-section’s header.
‘Use of sunscreen and risk of melanoma and non-melanoma skin cancer: a systematic review and meta-analysis’, Eur J Dermatol 2018 Apr 1;28(2):186-201. [paywalled]
Elizabet Saes da Silva, Roberto Tavares, Felipe da Silva Paulitsch, Linjie Zhang
Abstract
The use of sunscreen is a key component of public health campaigns for skin cancer prevention, but epidemiological studies have raised doubts on its effectiveness in the general population. This systematic review and meta-analysis aimed to assess the association between risk of skin cancer and sunscreen use. We searched PubMed, BIREME and Google Scholar from inception to May 17, 2017, to identify observational studies and controlled trials…overall meta-analysis did not show a significant association between skin cancer and sunscreen use…neither melanoma (25 studies; 9,813 cases) nor non-melanoma skin cancer (five studies; 857 cases) were associated with sunscreen use…cumulative evidence before the 1980s showed a relatively strong positive association between melanoma and sunscreen use…The strength of the association between risk of skin cancer and sunscreen use has constantly decreased since the early 1980s, and the association was no longer statistically significant from the early 1990s [I think it’s because sunscreen is less toxic these days: change my mind]. While the current evidence suggests no increased risk of skin cancer related to sunscreen use, this systematic review does not confirm the expected protective benefits of sunscreen against skin cancer in the general population.
So, you see, so far (i.e., as of 2018-ish), we know that simply applying ‘more’ sunscreen ‘suggests no increased risk of skin cancer’, but I’d add that, since ‘the Science™’ told us that melanomas develop over time, it’s probably too soon to tell conclusively.
So, what about vitamin D production?
‘The effect of sunscreen on vitamin D: a review’. Br J Dermatol. 2019 Nov;181(5):907-915. doi: 10.1111/bjd.17980. Epub 2019 Jul 9.
R E Neale, S R Khan, R M Lucas, M Waterhouse, D C Whiteman, C M Olsen
Abstract
Background: Sunscreen use can prevent skin cancer [look at the above paper], but there are concerns that it may increase the risk of vitamin D deficiency [that’s now good, right?].
Objectives: We aimed to review the literature to investigate associations between sunscreen use and vitamin D3 or 25 hydroxyvitamin D [25(OH)D] concentration.
Methods: We systematically reviewed the literature following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. We identified manuscripts published in English between 1970 and 21 November 2017. Eligible studies were experimental [using an artificial ultraviolet radiation (UVR) source], field trials or observational studies. The results of each of the experimental studies and field trials are described in detail…
Results: We included four experimental studies, three field trials (two were randomized controlled trials) and 69 observational studies. In the experimental studies sunscreen use considerably abrogated the vitamin D3 or 25(OH)D production induced by exposure to artificially generated UVR. The randomized controlled field trials found no effect of daily sunscreen application, but the sunscreens used had moderate protection [sun protection factor SPF) ~16]. The observational studies mostly found no association or that self-reported sunscreen use was associated with higher 25(OH)D concentration.
Conclusions: There is little evidence that sunscreen decreases 25(OH)D concentration when used in real-life settings, suggesting that concerns about vitamin D should not negate skin cancer prevention advice. However, there have been no trials of the high-SPF sunscreens that are now widely recommended [follow ‘the Science™’]. What’s already known about this topic? Previous experimental studies suggest that sunscreen can block vitamin D production in the skin but use artificially generated ultraviolet radiation with a spectral output unlike that seen in terrestrial sunlight. Nonsystematic reviews of observational studies suggest that use in real life does not cause vitamin D deficiency. What does this study add? This study systematically reviewed all experimental studies, field trials and observational studies for the first time. While the experimental studies support the theoretical risk that sunscreen use may affect vitamin D, the weight of evidence from field trials and observational studies suggests that the risk is low. We highlight the lack of adequate evidence regarding use of the very high sun protection factor sunscreens that are now recommended and widely used.
Bottom Lines
So, we learned that low protective sunscreens were tested and they’re o.k.-ish to use—as in: there seems to be little, if any, evidence that low-protection sunscreens decrease vitamin D production.
There is no evidence that this also applies to the high-protection sunscreens currently marketed and sold.
In all, a mixed bag of things, I’d conclude, however tentatively.
We note, in closing, that there are concerns about the safety and efficacy of all medicinal-pharmaceutical products, with sunscreen and skin care (sic) products being certainly a lot of things but no exception.
Never in my life would I have thought about looking at such papers a few years ago; living at 61 degrees north, with plenty of sun exposure in summer, this is now quite interesting, though. I do have blue eyes and red-fair hair with the typical complexion of (mixed) European ancestry.
As a kid, I used to get sunburns very quickly, and I often put on sunscreen. These days, although, for instance, we spent three days outside in the sun making hay this week in hot and sunny conditions, I didn’t apply any. Yes, I was wearing long trousers, a t-shirt, and a hat, but I didn’t get a sunburn, and the sun’s arguably stronger up north relative to Austria.
As it stands, now I’ve learned that sunscreen is pretty ineffective and, on top of it, may decrease vitamin D production. Long-term safety profiles have not been established, hence I’ll getting to be a bit more sceptical about these products, too.
I thought you should know about these issues, too.
Have a nice summer, though.
I read about suncreams too, about the chemicals in them not being good for us. I agree that people will stay out too long - mad dogs and English men! Some naturopaths say people should be exposed for 20 mins before using creams to allow body to make Vit D. People who live in hot countries avoid sun anyway, unlike those seeking warmer clime holidays. I read that Vit D was essential for keeping healthy and yet it is not measured routinely in UK at annual check ups, only cholestrol and liver seem to be checked. Dark skinned people in hospital with the respiratory illness, were all very low on Vit D, whether living in colder places or hot where they either avoided the sun altogether or wore long sleeves, etc. Interestingly, too, some skin cancers appear on head, shoulders, but many appear on parts of the body where the sun don't shine, soles of feet, groin area, too. Moderation, in all things, is my philosophy. The sun shining, summer or winter, improves my mood.
As a kid growing up on the Adriatic coast I can share a technique we all used - start with short exposure to sun to build up the tan slowly. The more tanned you got, the longer you could stay in the sun. It isn’t because we had special Mediterranean skin in comparison to more Nordic types who, as tourists regularly turned into blistered red wonders. My father had blue eyes and fair skin and never burned using the above technique. He built up wonderful bronze tan every summer.
Since the mass fear campaign about the sun exposure started, we’ve had major reduction of vitamin D levels in population with a steady rise of all other, more dangerous cancers than most skin cancers. Since Vitamin D is created in skin I can only guess it plays a major role in skin protection. Because of this, I would build up my Vitamin D levels early in the season before major exposure to sun. Take 50,000 IU per day for a few days. That ought to prepare you well.
Speaking of my father, he always covered his skin with a copious amount of cold pressed olive oil. I’d be willing to bet olive oil does a better job protecting your skin than any of the industrial creams loaded with noxious chemicals. ;-)
Overall, exposure to sun is good for you, as long as you build up the tan slowly and don’t burn.