Sun safety: how to protect your child from the greatest cause of skin cancer

It is well known that exposure to UV radiation from the sun or indoor tanning devices is a primary cause of skin cancer - the most common form of cancer in the US. What appears to be less well known is the risk UV radiation can pose to children, with a recent survey revealing that 1 in 5 parents are unaware that their children's skin is sensitive to the sun.

Sun protection is a key factor for reducing skin cancer risk.

According to Dr. Lisa Chipps, assistant clinical professor of the David Geffen School of Medicine at the University of California-Los Angeles (UCLA), director of dermatologic surgery at Harbor-UCLA Medical Center, skin cancer is primarily viewed as a disease of adulthood, meaning many parents may not consider their child is at risk.

"However," Dr. Chipps told, "melanoma accounts for up to 3% of pediatric cancers and 6% of cancer cases in teens 15-19 years old."

There is currently no registry or database that tracks cases of skin cancer among children in the US, but a 2013 study published in the journal Pediatrics found the rate of melanoma - the deadliest form of skin cancer - rose 2% annually among children aged 0-19 between 1973 and 2009.

Though a diagnosis of skin cancer is rare during childhood, excessive sun exposure at a young age can increase the risk of skin cancer later in life. Last year, MNT reported on a study revealing that multiple sunburns during adolescence can raise the risk of melanoma by 80%.

"Overexposure to the sun and sunburns that happen during childhood are important and preventable risk factors for developing skin cancer as an adult," says Dawn Holman, a behavioral scientist in the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention (CDC), told MNT. "This is why it's so important for us all to use sun protection at every age."

However, as the aforementioned survey revealed, many parents seem to be unaware that the sun poses a risk to their child's skin. That same survey - conducted by Nivea Sun - also found that more than half of parents are unaware that multiple sunburns cause long-lasting damage to their child's skin, while 77% do not think pink or sore skin necessarily indicates sun damage.

In this Spotlight, we look at the best ways to protect children of all ages against the damaging effects of UV (ultraviolet) radiation and look at ways to overcome some of the major challenges that threaten children's sun safety.

Shade is the best sun protection for infants

According to the Skin Cancer Foundation, infants aged 6 months and under should be kept out of direct sunlight. This is because they have low levels of melanin in their skin - the substance that gives pigment to the skin, hair and eyes and protects against the sun - meaning they are very sensitive to UV radiation.

As such, the Skin Cancer Foundation recommend that parents take their infant for walks in a stroller with a sun-protective cover before 10 am and after 4 pm - when UV radiation is lowest.

"The best protection is to keep your baby in the shade," says Dr. Hari Cheryl Sachs.

Infants should be dressed in lightweight clothing that covers the arms and legs, and their face neck and ears should be protected with a wide-brimmed hat or bonnet.

When an infant is traveling in a vehicle, it is wise to cover the windows with removable mesh window shields or UV window film to reduce sun exposure.

While sunscreen is regarded as a key form of sun protection, it is not recommended for use on infants under the age of 6 months.

"Babies' skin is less mature compared to adults, and infants have a higher surface-area to body-weight ratio compared to older children and adults," explains Dr. Hari Cheryl Sachs, a pediatrician at the Food and Drug Administration (FDA). "Both these factors mean that an infant's exposure to the chemicals in sunscreens may be much greater, increasing the risk of side effects from the sunscreen."

"The best protection is to keep your baby in the shade, if possible," she adds. "If there's no natural shade, create your own with an umbrella or the canopy of the stroller."

If it is not possible to protect an infant from the sun with protective clothing or shade, sunscreen may be applied on the advice if a pediatrician.

It is safe to use sunscreen in babies aged 6-12 months, according to the Skin Cancer Foundation, who note that a broad-spectrum sunscreen with a minimum sun protection factor (SPF) of 15 should be applied.

Wearing protective clothing and seeking shade are still key factors for protecting a baby against the sun; sunscreen should be applied on areas that are not covered - such as the hands and face - 30 minutes before sun exposure and reapplied every 2 hours after swimming or sweating.

Children aged 6 months and older should also wear wraparound sunglasses that block 99-100% of UV radiation.

The challenges of sun protection in toddlers

As a child grows, protecting them against the sun can become more difficult. They are more likely to be exposed to sunlight by playing outdoors, and they are also more likely to disobey requests to wear a hat or sunglasses.

In 2004, Dr. Lori Steinberg Benjes, a dermatologist in Cambridge, MA, led a study published in JAMA Dermatology that looked at rates of sun protection among children aged 6 and 18 months.

The results revealed that while 22% of children experienced tanned or sunburnt skin at the age of 6 months, this figure rose to 54% at 18 months. The researchers claim one reason for this is due to the difficulties parents face in controlling their children as they reach toddler age.

"Keeping babies out of the sun is often manageable, but consistent, effective sun protection of toddlers requires more effort and is more challenging," Dr. Benjes notes.

The study also revealed that while there was a higher incidence of tanned and sunburnt skin among children aged 18 months, the use of sunscreen increased. This, the team says, indicates that parents fail to action other sun-protection methods.

"Parents need to understand that sunscreen is only one vital line of defense in sun protection," says Dr. Perry Robins, president of the Skin Cancer Foundation, adding:

"Strategies such as seeking shade and dressing children in sun-protective clothing are just as important and can't be abandoned in the second year, since sunscreen cannot keep all of the sun's rays away from the skin. Teaching these techniques early to children can leave them with sun safety habits that will help prevent skin cancer later in life."

Schools: a help or hindrance to sun safety?

For school-age children, the rules for sun protection remain the same; they should use sunscreen, wear protective clothing and seek shade when UV radiation is at its strongest, which is normally around midday.

Of course, parents have a lot to think about when they are getting their child ready for school, which means they may be less likely to focus on sun protection.

"Getting a few kids ready for school in the morning involves making breakfasts, packing lunches, choosing outfits, finding shoes/homework/backpacks, so yes, sometimes parents slack on the sunscreen," Dr. Chipps told.

The Skin Cancer Foundation say schools can be a hindrance to sun safety, but they can also play an important role in increasing sun safety.

She does, however, provide a useful tip to help combat this problem: "As a parent, I advise making sunscreen part of the childrens' daily morning routine. I keep the sunscreen on the bathroom counter so my kids can apply it when they brush their teeth and comb their hair."

But how can parents ensure their children receive adequate sun protection when they are at school and out of their sight?

According to the Skin Cancer Foundation, sometimes schools can be the "biggest block" to children's sun safety. "Many schools see sunscreen as a medicine, and require either written permission to use it, or require that the school nurse apply it," they note. "Many schools also ban the wearing of hats and sunglasses during school hours, including recess."

The Foundation recommend parents talk to their child's school to find out what their policy is on sun safety. If the school is not doing enough to protect children, they recommend alerting other parents and getting them involved in encouraging the school to take action.

Schools, however, can also play an important role in increasing children's sun safety. "Evidence suggests that sun-safety interventions in child care centers, elementary schools and middle schools are effective in increasing children's use of sun protection," says Holman.

Such interventions - detailed in The Community Guide from the Community Preventive Services Task Force - include educating children about the risks of UV radiation and what can be done to protect against them, as well as implementing activities designed to influence children's, teachers' and parents' behaviors and attitudes toward sun safety.

"In addition," added Holman, "the public health community can work with partners to ensure parents have the information they need to keep their families sun-safe and that other community sectors - such as those working at schools and outdoor recreational settings - have the tools they need to support sun-safety."

Teens and tanning

We all know what it's like to be a teenager. It is a time when you may feel pressured to look a certain way and conform to common perceptions of what is attractive. For many teens - particularly girls - attractiveness means having tanned skin.

What many people - both teenagers and adults - fail to realize is that any form of tan is a reflection of skin damage. The skin turns brown because of an increase in melanin production in an attempt to protect it from further damage.

But many individuals - particularly teens - put their desire for a tan over the associated health risks. In a Spotlight investigating the dangers of UV exposure last year, Tim Turnham, executive director of the Melanoma Research Foundation, told us:

"Despite elevated awareness of the dangers of UV radiation, people still choose to ignore the dangers in the pursuit of what they consider to be a 'healthy tan.' This is particularly an issue among young people who tend to ignore health risks in favor of enhancing their social status and popularity. We know that tanning appeals to people who are interested in being included, and this is a primary driver for teens - being part of the 'in' crowd."

Unfortunately, the desire for being part of the "in" crowd pushes many teenagers toward indoor tanning. According to the American Academy of Dermatology, around 17% of teenagers have reported using a tanning bed at some point in their lives.

Indoor tanning can dramatically raise the risk of skin cancer - with the rays that tanning devices emit being around 10-15 times stronger than those given off by the midday sun.

A 2014 study estimated that each year, around 400,000 cases of skin cancer in the US may be related to indoor tanning, while a study reported by MNT last year linked the use of tanning beds in teenagers to greater risk of basal cell carcinoma (BCC) - the most common skin cancer in the US.

The dangers of indoor tanning have hit the headlines recently after a 29-year-old woman shared a picture of wounds caused by treatment for skin cancer. Tawny Willoughby, from Kentucky, was first diagnosed with BCC aged 21 - a diagnosis she puts down to her excessive sunbed use as a teenager.

"If anyone needs a little motivation to not lay in the tanning bed and sun here ya go! This is what skin cancer treatment can look like," she wrote alongside her posted picture. "Wear sunscreen and get a spray tan. You only get one skin and you should take care of it."

A spray tan is certainly a healthier alternative to using indoor tanning devices for those who yearn for a golden glow, though it should be noted that a spray tan does not protect the skin against the sun. The use of sunscreen is still required. Another alternative is tanning lotions, some of which have an SPF of 15 and above.

As well as the use of sunscreen, it is recommended that teenagers also seek shade during midday hours and wear sun-protective clothing. If your teen complains that such clothing isn't fashionable, try to find items that are more stylish that still cover them up - like a pretty sarong for a teenage girl, for example.

But of course, one of the best ways to encourage sun safety in children - no matter what their age - is to lead by example. As the Skin Cancer Foundation say:

"The most important thing to remember when thinking about sun protection is this: you are your children's role model. Be sure to let them see you protecting yourself from the sun. If you have great skin, so will they."

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Hair loss: how does it affect women?

 On seeing a bald man walk past, most of us wouldn't take a second glance. But would this be the case if a bald woman walked past? It is doubtful. Hair loss - although distressing - is generally more accepted in men, despite women accounting for 40% of all hair loss sufferers in the US. In this Spotlight, we look at the main causes of hair loss in women, the emotional toll it can take and why research is lagging behind in treatment for female hair loss.

Women account for 40% of all hair loss sufferers in the US.

The most common cause of hair loss in both men and women is androgenetic alopecia, also referred to as male or female pattern baldness.

A hereditary condition, androgenetic alopecia is believed to be caused by dihydrotestosterone (DHT), which derives from the male hormone testosterone.

An enzyme called Type 2 5-alpha reductase - present in the oil glands of hair follicles, the skin organs that produce hair - helps convert testosterone to DHT. This derivative then binds to and shrinks hair follicles, killing healthy hair.

Because men have higher testosterone levels than women, they are likely to produce higher DHT levels, leading to increased hair loss. As such, men with androgenetic alopecia often experience a receding hairline which can progress to partial or complete baldness, while women tend to experience hair thinning on the top and sides of the scalp.

"Hair thinning in female pattern baldness is different from that of male pattern baldness in that the frontal hairline remains unaffected except for normal recession, which happens to everyone as time passes, and hair loss rarely progresses to total or near total baldness, as it may in men," Dr. Marc Glashofer, a dermatologist and fellow of the American Academy of Dermatology, explained to Medical News Today.

But androgenetic alopecia is not the only cause of hair loss in women.

What are the other common causes of hair loss in women?

Telogen effluvium is a form of hair loss that can develop when the body is put through extreme stress, such as child birth, malnutrition or major surgery.

The condition involves a sudden shift from hair growth or resting phases to the hair shedding phase, known as telogen. This can occur within 6 weeks to 3 months after a stressful experience.

According to Dr. Shani Francis, also a fellow of the American Academy of Dermatology and director of the Hair Disorders Center of Excellence at Northshore University HealthSystem in Illinois, telogen effluvium is much more common in women than men. "It is the typical 'shedding' that happens after childbirth in some women," she told us.

Telogen effluvium is a common form of hair loss in women, which can develop when the body is put through extreme stress.

She added that some triggers of the condition - such as iron deficiency and changes in medication - are more likely to occur in women. "These triggers typically affect women more than men due to menstruation, the most common cause of iron deficiency in women, and the high prevalence of birth control use - some women change birth control quite frequently," she explained.

Traction alopecia is another form of hair loss that is more likely to occur in women. It is triggered by trauma to the hair follicles, most commonly through hair styling that continuously pulls at them - such as braiding, tight ponytails and hair extensions. "This type of hair loss is primarily seen in African-American patients," said Dr. Glashofer.

Another common cause of hair loss in both men and women is alopecia areata - an autoimmune disease that affects around 2% of the US population. The condition can be inherited; around 1 in 5 people who suffer from alopecia areata have a family member with the disorder.

It occurs when the immune system mistakenly attacks the cells in hair follicles, leading to hair loss on the scalp and other areas of the body. In alopecia areata, hair most commonly falls out in small patches. In some cases, however, the condition can lead to complete baldness.

Specific medical conditions - such as anemia and thyroid disorders - and the use of certain medications can also lead to hair loss.

The severe emotional impact of hair loss for women

It goes without saying that hair loss - regardless of gender - can be devastating. It can dent a person's self-esteem and negatively affect their overall quality of life.

"Studies on the psychosocial impact of hair loss have found patients' self-esteem, body image and self-confidence to be negatively impacted," Dr. Francis told MNT. "Known psychosocial complications include depression, low self-esteem, altered self-image and less frequent and enjoyable social engagement."

It seems experts are in agreement, however, that women are significantly more likely to suffer emotionally as a result of hair loss.

"Hair loss in a woman is so emotionally devastating that it can trigger a wide range of social and emotional issues that can negatively impact healthy daily living and overall quality of life. I have heard of women that retreat from social situations, have diminished work performance, and even alter their healthy living - avoiding exercise, overeating, not treating other medical illnesses - due to their hair loss," said Dr. Francis.

But why do women see a greater emotional impact from hair loss than men? According to Dr. Glashofer, it is down to society's perception of beauty. "Society unjustly puts an inordinate amount of pressure on beauty and a great deal of this comes from perceptions of hair," he told us.

Dr. Francis agrees. 

"For a women, the hair is the crown, a symbol of beauty/pride. It is typically what a woman identifies with as being feminine or attractive to a mate. If this starts to diminish, it can be devastating to a woman's identity and self-esteem, especially when affected at an early age. For older women, hair loss is perceived as accelerated aging and women have to deal with a sense of loss of virility and sexual attraction to their mate as well.

"Due to societal perception differences, it is much more emotional for women, as there is limited cosmetic acceptance of a bald woman and increased societal pressure on a woman to be attractive. The negative quality of life is likely worse in women."

Drug companies 'aren't falling over themselves' to test new hair loss drugs in women

It is not only support from society that is lacking for women with hair loss; it seems the medical world has been ignoring these women's needs.

There is only one medication approved by the Food and Drug Administration (FDA) for women with androgenetic alopecia - a topical treatment called minoxidil that works by stimulating the hair follicles.

As well as minoxidil, men with androgenetic alopecia can be treated with another medication called finasteride. This drug works by dramatically lowering DHT levels, halting the progression of hair loss.

Due to conflicting clinical trials, finasteride has not yet been approved for the treatment of androgenetic alopecia in women. Some studies have found that finasteride can cause fetal mutations in women of childbearing age.

Such findings, Dr. Francis believes, have deterred researchers from testing hormonally-active medications in women with hair loss. Even the American Hair Loss Association admit that women are in a "catch-22" situation when it comes to hair loss treatment.

"While many drugs may work to some degree for some women, doctors are reluctant to prescribe them, and drug companies aren't exactly falling over themselves to test existing or new drugs specifically for their ability to prevent and treat female pattern baldness," they state.

Dr. Francis also notes that researchers tend to sway more toward testing hair loss medications in men because it is easier to measure their response to treatment; their hair is generally shorter so their scalp is easier to see. "Also, women have very diverse styling and grooming practices - that many are unwilling to change - which makes research harder to standardize," she added.

Recent progress in hair loss treatment for both men and women shows promise

But while it is clear that progress in hair loss treatment for women has been slow, recent research has shown some promise - making hair loss breakthroughs that could be applied to both sexes.

In August 2014, for example, a study published in the journal Nature Medicine revealed how a drug already approved by the FDA for a rare bone marrow disease restored hair growth in patients with alopecia areata.

The researchers found that ruxolitinib fully restored patients' hair within 4-5 months by preventing immune system cells from attacking the hair follicles.

"Women are not able to have the same societal support [as men] for a smooth bald head," said Dr. Francis.

"There are few tools in the arsenal for the treatment of alopecia areata that have any demonstrated efficacy. This is a major step forward in improving the standard of care for patients suffering from this devastating disease," commented Dr. David Bickers, of the Department of Dermatology at Columbia University Medical Center.

More recently, in January 2015, researchers from Sanford-Burnham Medical Research Institute in La Jolla, CA, claimed they have found a way to generate hair growth using human pluripotent stem cells.

Dr. Glashofer believes such research moves us a step closer to finding effective hair loss treatments for both men and women.

"Most recent groundbreaking hair research is attempting to define the biologic and genetic basis for certain types of hair loss. This obviously has value to both sexes," he told MNT. "Research attempting to utilize stem cells has broad implications for both hair loss treatments for men and woman and may have a role in treatment within the next decade."

While it is good news that progress is being made in terms of treatment for female hair loss, it is clear that greater awareness is needed of how the condition can affect women - particularly how it can affect them emotionally.

Dr. Francis points out that most people may not realize the extent to which these women are suffering, pointing out that many of them cover up their hair loss with wigs, scalp concealer and other cosmetic devices.

Again, this comes down to the fact that hair loss is generally more accepted in men. "Men are much more willing to shave the rest of the heads if hair loss starts to take over and this is cosmetically acceptable and in some cases quite attractive. Women are not able to have the same societal support for a smooth bald head," Dr. Francis told MNT.

It should not be the case that female hair loss is deemed unacceptable. Scottish model and TV presenter Gail Porter - who was diagnosed with alopecia in 2005, which led to complete baldness - is testament to the fact women are beautiful with or without hair. In an interview with the Scottish Express last year, Porter spoke of her challenges with hair loss while being in the public eye.

"As much as they say that people don't judge you on the way you look on TV, they do," She told the newspaper. "They [television bosses] say things like 'Would you consider wearing a wig?' "When I refuse, they say 'Oh, okay, we'll get back to you.' In other words, 'We're not having you because you have no hair.' I'm in a good place and I'm not going to wear a wig for anybody."

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Plucking hairs could help treat baldness, study finds

 In a new study, researchers may have uncovered a promising - yet surprising - treatment for hair loss: plucking the remaining hairs.

Researchers found plucking 200 hairs from a 3-5 mm region of a mouse's back led to the growth of 450-1,300 new hairs.
Image credit: Cheng-Ming Chuong

Led by Prof. Cheng-Ming Chuong, of the Keck School of Medicine at the University of Southern California, the study reveals how individually plucking 200 hairs from the back of a mouse in a specific pattern led to the regeneration of up to 1,300 hairs.

Prof. Chuong and his team publish their findings in the journal Cell.

Male pattern baldness accounts for around 95% of hair loss in men, according to the American Hair Loss Association. By the age of 35, around two thirds of men in the US will have experienced some level of hair loss.

Common causes of hair loss in women - who account for 40% of all hair loss sufferers - include female pattern baldness and traction alopecia, which is hair loss caused by trauma to the hair follicles - skin organs that grow hair.

According to Prof. Chuong and colleagues, it is well established that damage to hair follicles can influence hair regeneration in the surrounding areas. As such, they hypothesized that hair follicle stimulation through hair plucking may lead to new hair growth, and they set out to test this theory.

One by one, the team plucked 200 hairs from the back of a mouse in a number of different patterns.

They found that plucking the hairs from an area more than 6 mm in diameter failed to regenerate new hairs. Plucking hairs from a region 3-5 mm in diameter, however, led to the regeneration of 450-1,300 new hairs, and these new hairs even grew outside of the plucked area.

Commenting on their findings, Prof. Chuong says:

"It is a good example of how basic research can lead to work with potential translational value. The work leads to potential new targets for treating alopecia, a form of hair loss."

Hair plucking triggers 'distress signals' to encourage new hair growth

Through conducting molecular studies, the researchers found that plucking hairs from the back of the mouse generated new hair growth through a process called "quorum sensing."

Put simply, the damage to the hair follicles caused by hair plucking triggered the release of inflammatory proteins. These proteins send a "distress signal" to immune cells, calling them to the injury site.

Next, the team explains, the immune cells express signaling molecules - such as tumor necrosis factor alpha (TNF-α). At certain concentrations, these signaling molecules encourage both damaged and undamaged hair follicles to grow new hair.

Prof. Chuong says these findings may have wider implications; it is possible that minor damage to other organs could stimulate some form of regeneration. "The implication of the work is that parallel processes may also exist in the physiological or pathogenic processes of other organs," he adds, "although they are not as easily observed as hair regeneration."

Talking to BBC News, Prof. Chris Mason, a professor of regenerative medicine at University College London in the UK, said the idea of quorum sensing for hair regeneration is "smart," but it is unclear as to whether it could be an effective treatment for human hair loss.

"That's the million-dollar question. I'm not sure. As it stands here, you've got to have some hair to pluck." he said. "Could you tap into the pathway with a cream or injection? That could well be possible - or maybe don't wait until you're totally bald?"

In January, Medical News Today reported on a study by researchers from the Sanford-Burnham Medical Research Institute in La Jolla, CA, revealing a potential way to generate new hair using human pluripotent stem cells.

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New links between diet and acne

A review carried out by the University of Hull has shed new light on the relationship between acne and diet.
Published in Dermatological Nursing, the comprehensive review assesses the latest evidence and findings about the effects of food and nutrition on acne and suggest that high glycemic index foods such as milk could exacerbate the skin condition.
The review was carried out by HONEI (Humber Obesity Nutrition Education and Innovation) a centre for food research, based at the University of Hull.
Acne is one of the most common skin conditions and is often associated with adolescents but its prevalence among adults is increasing.
Facial acne can be stigmatising and deeply upsetting. Research has shown that the adverse social, psychological and emotional effects of acne can be comparable to those of more serious chronic conditions such as; epilepsy, diabetes arthritis or psoriasis.
Extensive studies have been carried out to assess the impact diet has on acne and research has so far suggested some diets, such as those containing high glycemic index foods e.g. milk can exacerbate acne.
HONEI is a world-leading centre of food related research and has previously conducted studies into the effect of dark chocolate on cholesterol levels as well as studies on soy to determine whether it could help combat certain health problems associated with osteoporosis and type 2 diabetes. HONEI is also currently undertaking extensive research into the benefits of polyphenols on cardiovascular health.
Dr Katerina Steventon, Research Fellow with HONEI and the University of Hull's Faculty of Health and Social Care, said: "There is growing evidence of the link between diet and acne which is becoming stronger as new evidence comes to light, although nothing has been fully proven yet, it is only a matter of time.
"The research review suggests a low glycemic index diet but also a healthy diet, rich in fruit and vegetables, can have a protective effect on acne. Further research is needed to fully understand the role diet plays in acne in specific populations."
HONEI will be carrying out its own primary research examining the effects of certain foods on acne later this year.

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Cure For Gray Hair And Vitiligo Found

A modified pseudocatalase, a new compound that reverses oxidative stress may provide a cure for loss of skin or hair color, i.e. gray hair or vitiligo, researchers from the United Kingdom and Germany reported in The FASEB Journal.

The need to use hair dyes to cover up a classic sign of aging - gray hair - may soon be a thing of the past.

Scientists from the Institute for Pigmentary Disorders in association with E.M. Arndt University of Greifswald, Germany and the Centre for Skin Sciences, School of Life Sciences at the University of Bradford, United Kingdom, explained that people's hair goes gray because of massive oxidative stress caused by a build up of hydrogen peroxide in hair follicles. This causes hair to bleach itself from the inside out.

The researchers found that this massive build up of hydrogen peroxide can be reversed with a UVB-activated compound called PC-KUS, a modified pseudocatalase. The research team developed this new proprietary treatment.

PC-KUS restores skin color in patients with vitiligo

The authors added that PC-KUS treatment is also effective for patients with vitiligo. Vitiligo is a long-term skin problem that produces white depigmentation patches that develop and grow in certain sections of skin.

Study author, Karin U. Schallreuter, M.D., said:

"To date, it is beyond any doubt that the sudden loss of the inherited skin and localized hair color can affect those individuals in many fundamental ways. The improvement of quality of life after total and even partial successful repigmentation has been documented."

Schallreuter and team analyzed 2,411 patients from several countries with vitiligo. Fifty-seven (2.4%) of them were diagnosed with SSV (strictly segmental vitiligo) and 76 (3.2%) were diagnosed with mixed vitiligo, which is SSV plus NSV (non-segmental vitiligo).

They discovered that those with SSV with a specific nerval distribution involving eyelashes and skin showed the same oxidative stress found in the much more common general NSV. General NSV is associated with decreased antioxidant capacities, including thioredoxin reductase, catalase, and the repair mechanisms methionine sulfoxide reductases.

They found that PC-KUS treatment led to successful patient outcomes - patients' pigmentation in their skin and eyelashes was restored - i.e. they recovered their original skin and hair color.

Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal, said:

"For generations, numerous remedies have been concocted to hide gray hair. but now, for the first time, an actual treatment that gets to the root of the problem has been developed.

While this is exciting news, what's even more exciting is that this also works for vitiligo. This condition, while technically cosmetic, can have serious socio-emotional effects of people. Developing an effective treatment for this condition has the potential to radically improve many people's lives."

Gray hair is caused by a massive accumulation of hydrogen peroxide in the hair follicles.

This report is a follow-up on a 2009 study that explained why our hair turns gray. Scientists from the Universities of Bradford, England, and Mainz and Luebeck, Germany, explained in The FASEB Journal (March 2009 issue) that graying hair has absolutely nothing to do with wisdom. They wrote that "Going gray is caused by a massive build up of hydrogen peroxide due to wear and tear of our hair follicles."

Hydrogen peroxide eventually blocks the normal production of melanin, the natural pigment responsible for hair color, as well as skin and eye color.

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What are Blackheads? How to Get Rid of Blackheads

A blackhead, or open comedo is a wide opening on the skin with a blackened mass of skin debris covering the opening. Despite their name, some blackheads can be yellowish in color. A comedo is a widened hair follicle which is filled with skin debris (keratin squamae), bacteria and oil (sebum).

A closed comedo is a whitehead, while an open comedo is a blackhead. the plural of "comedo" is comedomes".

Blackheads are said to be the first stage of acne. They form before bacteria invade the pores of the patient's skin. A blackhead can develop into a pimple, which is also known as a papule or pustule.

Blackheads, and acne in general, usually develop after puberty, when hormone levels surge and reach the skin. The presence of higher levels of hormones in the skin triggers the stimulation of the sebaceous glands, which produce oily substances. The sebaceous glands produce too much oil in the pores, which accumulates and gets stuck. When the occluded oil is exposed to air it becomes black.

Several conditions and circumstances can cause blackheads, or make them worse, such as the use of topical oils and make up. Blackheads can affect people with any type of skin, but are generally more common in those with oily skin.



Blackheads on a man's nose

What are the causes of blackheads

The overproduction of oil is the main cause of the emergence of blackheads. This is likely to occur in a high proportion of humans during puberty. Spikes in hormone production can result in the high levels of DHT (dihydrotestosterone), a hormone which triggers overactivity in the oil glands, resulting in clogged pores.

Clean skin - if the skin is not cleaned properly, more blackheads can appear, especially during those milestones in life when they are more prevalent, such as puberty. Improperly cleaned skin makes it more likely that dead skin cells build up within the pores. The pore openings can become clogged, which accelerates the build up of oil inside - thus causing blackheads to form. However, many experts warn that dirt does not cause blackheads to form - which frequently confuses and frustrates patients. Blackheads are caused by oxidized oil, not dirt, experts add. Over-cleaning the skin can lead to irritation.

In some cases, blackheads can emerge if moisturizers, sun screens, make up, or foundations are overused.

In the majority of cases, blackhead susceptibility is not heredity, with the exception of some severe acnes.

Food does not cause acne - although parents and grandparents commonly tell their teenage offspring not to eat chocolates and greasy foods, because they think they encourage the formation of acne - they do not cause blackheads or make them worse. Some studies have pointed towards a link between some dairy products and acne, but the evidence is not compelling.

Stress - stress does not directly affect blackhead occurrence. However, stress and anxiety can cause people to pick at their blackheads and acne, which may make them worse. Put simply, the behaviors resulting from stress and anxiety may worsen acne symptoms, but not the stress/anxiety itself.

What are the treatment options for blackheads

Hormonal treatments - contraceptives have often been used for the treatment of blackheads and acne, often with good results.

Cleaning the skin - clean your face with a good cleanser, ideally, one for oily skin, such as a salicylic acid cleanser.

Medications - adapalene is a third-generation topical retinoid, used mainly in the treatment of mild to moderate acne. Many patients with blackheads have had good results. In the USA adapalene is available under brand name Differin, in three preparations - 0.1% cream, 0.1% gel, and 0.3% gel. Since 2010, it has also been available in the USA under the generic name Teva, (0.1% gel). Only the 0.1% cream and 0.1% gel forms are available in Europe.

UV exposure - exposing the skin to sunlight or ultra-violet light encourages it to peel, which helps unblock pores. Sunbathing or using sunbeds may help. However, it is important to discuss this with your doctor. Exposing skin to sunlight, if overdone, also raises the risk of burning and developing skin cancer.

Hair - greasy hair touching the face of your skin can spread infection and in some cases encourage the spread of blackheads and acne. Keeping your hair away from your face may help keep blackheads to a minimum.

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Plastic Surgeons Launch Skin Healing Gel

New 'Miracle' Skin Healing Cream Now Available to the Public

The wait is finally over as five of the UK's leading plastic surgeons launch HEAL: a revolutionary new healing gel originally created to soothe and reduce inflammation of the skin following surgery (thereby shortening recovery times), but which has also proven to effectively treat everyday injuries such as sprains, sunburn, bruises and scars, making it the ideal medical product to have in the home for all the family to use. The innovative preparation, now available for purchase online, has been developed by The Firm, a specialist skincare group formed by some of the best-known names in plastic and cosmetic surgery including Peter Butler, Martin Kelly, Patrick Mallucci, Simon Withey and Norman Waterhouse of London Plastic Surgery Associates (LPSA). Together, they combine their specialist knowledge in skin anti-ageing, healing and nanotechnology to bring products to the public that actually work.

Each surgeon at The Firm has specific expertise in skin healing: Peter Butler carried out his experimental research on skin ageing and transplantation in the United States (Harvard). Martin Kelly has an MD in antioxidant skin therapy, Patrick Mallucci wrote a thesis on nanotechnology delivery systems and both Simon Withey and Norman Waterhouse have published widely on skin repair in plastic surgery. With a combined clinical experience of over fifty years in treating skin wounds after surgical procedures, they are well equipped to understand the healing process of the skin. In addition, The Firm drafted top French chemist Colette Haydon to perfect the formula in order to achieve the optimal effect, which offers a triple method of action: anti-inflammatory, bruise-solving and scar maturation.

According to Mr Butler, who leads the UK Facial Transplantation team and whose skincare research is internationally acclaimed;

"HEAL was created because no single product existed that combines all the elements of reducing bruising and inflammation as well as accelerating the healing process. This unique gel combines all of this and is completely different to any other 'off the shelf' products that claim to have healing effects on the skin, as they do not contain enough of the active ingredients needed to have an effect. The difference with HEAL is that the key ingredients are present in the right formulations to ensure they penetrate the skin's surface and actually have a dramatic effect on the end result".

Mr Mallucci added; "Over the last three years with the help and expertise of leading French chemist Colette Haydon we have developed HEAL which has a unique combination of active ingredients Arnica Montana and Madecassoside, for the first time ever packaged in a liposomal system, which delivers the agents to where they are needed most - to the deeper layers of the skin. The nanotechnology is designed to deliver the products of HEAL with maximum efficiency to the damaged area".

HEAL combines a triple method of action which works to soothe the closed wound - using Arnica, Haloxyl and Glistin, to reduce heat sensation and discomfort; repair the damage - using Collaxyl protein fractions to promote cellular repair and optimise scar healing with Silicone. For the past two years The Firm have tested HEAL in their clinical practice, London Plastic Surgery Associates where every year hundreds of patients have undergone facelift, rhinoplasty and breast surgery. The feedback from their patients has been overwhelming, with:

- 94% of patients reporting that HEAL was very soothing to bruised areas
- 82% of patients reporting that HEAL reduced swelling after surgery
- 85% of patients reporting that HEAL highly effectively reduced post-surgery bruising
- 97% of patients would continue to use HEAL in the future and recommend the product to others

Fiona Kent, a 37-year-old Executive Personal Assistant - who had a Rhinoplasty and Chin Augmentation last year - says;

"I was amazed at how soothing and comforting the product felt on my tender skin after my operation and it reduced bruising within days. It smells divine and has a consistency that sinks into the skin. HEAL is truly amazing and is certainly a product that I will always have in the home."

HEAL is available online at http://www.healgel.com and costs £28 for a 30 ml jar.

About The Firm

The Firm is a specialist group developing a new brand of skincare, created by founding Partners of thriving practice London Plastic Surgery Associates (http://www.lpsa.co.uk). The Firm draw on their expertise and worldwide acclaimed research to bring to the public skin healing solutions that work. All surgeons are members of the British Association of Aesthetic Plastic Surgeons (BAAPS) and BAPRAS (British Association of Plastic, Reconstructive and Aesthetic Surgeons). The Firm is based at 30 Devonshire Street, telephone 0207 908 3777.

London Plastic Surgery Associates

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New Emollient Cream Dexeryl(R) Preferred By Patients With Ichthyosis And Eczema

Dexeryl® cream, a new topical emollient and moisturising cream from Pierre Fabre Dermatologie is launched today. It has been shown to be effective but, importantly, patients significantly prefer using Dexeryl (p < 0.001).1 Dry skin conditions like ichthyosis and eczema are hugely prevalent in the UK with atopic eczema affecting a fifth of school-age children.2 In many cases, atopic eczema is associated with ichthyosis;3,4 a distressing condition involving continual widespread scaling of the skin.5

The impact of atopic eczema and ichthyosis on quality of life can be considerable; leading to time lost from work or school; impacting social relationships and also increasing anxiety, depression and other psychological problems.2,6 For the majority of people with atopic eczema and ichthyosis, their mainstay treatment will involve regular daily application of emollient.2 An emollient works by moisturising the skin, which is important to maintain the skin's natural barrier; reducing skin perspiration; keeping irritants or disease out and preventing painful cracking.2

"One of the key skin treatments in looking after eczema and ichthyosis is to use emollients as often as possible; they are the foundation on which all additional treatment is based. However, the most important consideration is whether the patient finds the emollient recommended by their physician acceptable to use. The most greasy that is tolerated should be used and this may vary during the day so that a lighter cream may be more appropriate for daytime use and a greasier one at night. Sticky, messy or difficult-to-apply emollients will simply not be used as often as they should be so the patient's skin condition can easily get out of control," comments Dr David Paige, Chairman of the Medical Advisory Board to the Ichthyosis Support Group.

"Ichthyosis varies enormously across and within the different types; it is therefore very important for sufferers to have a choice of emollients which are appropriate to the severity of their condition." Ichthyosis Support Group.

Bao-Tam Phan, a pharmacist and UK Marketing & Training Manager at Pierre Fabre Dermatologie, the manufacturers of Dexeryl comments on Dexeryl's formulation: "The combination of glycerol, which improves the stratum corneum elasticity and white, soft paraffin and liquid paraffin in Dexeryl offers a highly acceptable non-sticky and non-greasy formulation, which patients in our trials significantly prefer."

Dexeryl is available in 250g tubes and is fully reimbursed and available on prescription; the NHS price is £3.16. Product is available through Unichem, Phoenix, Mawdsley Brookes and K Waterhouse wholesalers.

About ichthyosis

Ichthyosis is the term used to describe continual and widespread scaling of the skin. It may be inherited (genetic) or acquired during life. The inherited forms are rare and are generally present from infancy and are usually lifelong conditions. Ichthyosis vulgaris is the commonest form of inherited ichthyosis affecting one in every 250 people. It is usually quite mild and develops in early childhood with fine, light grey scales and roughness on the arms and legs. It may be more widespread and is more obvious in the winter time and in temperate climates. It is sometimes associated with atopic or childhood allergic eczema and may cause an increased wrinkling of the palms and soles. It can be improved with regular application of moisturisers.3


About atopic eczema

Atopic eczema is a dry, itchy inflammation of the skin. The words 'eczema' and 'dermatitis' are interchangeable Atopic eczema can affect any part of the skin, including the face, but the areas most commonly affected are the bends of the elbows, around the knees, and around the wrists and neck. These are known as 'flexural' areas. It affects both sexes equally and usually starts in the first weeks or months of life. It is most common in children, affecting at least 10% of infants, although it can carry on into adult life or come back in the teenage or early adult years. The treatments used most often are moisturisers, and topical steroid creams or ointments.7

About Dexeryl®

Dexeryl combines Glycerol, which improves the stratum corneum elasticity, with white soft paraffin and liquid paraffin, which act as an emollient and helps restore the skin barrier. This combination helps to reduce skin perspiration, enhances moisturising and improves the skin barrier function helping therefore to help to reduce irritating itching and pruritus phenomena. Patient should apply a thin layer of cream to the skin once or twice daily, or more if needed. The safety, efficacy, and acceptability of Dexeryl®, was evaluated compared to gelified glycerol, a reference French National Formulary preparation for the symptomatic treatment of moderate ichthyosis. This randomised single-blind study was conducted on 70 patients with ichthyosis. Evaluation criteria were based on the progression and outcome of symptoms of ichthyosis (presence of scales, rough skin, thickness of the skin). The investigator's and each subject's overall opinions were collected. The statistically significant efficacy of the two products at the end of four weeks was demonstrated (p = 0.001). There was no significant difference between the two products of the following criteria: outcome of rough skin, skin thickness, and the investigator's overall opinion. The subject's opinion demonstrated a statistically significant difference in favor of Dexeryl® (p < 0.001), corresponding to a preference for use (ease of spreading and penetration of product, skin appearance, skin comfort).1

References

1. Single blinded randomised comparative study on Dexeryl efficacy and tolerance in the symptomatic treatment of ichthyosis. C. Blanchet, L. Parmentier, JM Pibourdin, P. Dupu Nouv. Dermatol. 2000 664-668

2. http://www.nice.org.uk/nicemedia/pdf/CG057FullGuideline.pdf

3. http://www.ichthyosis.org.uk/types.aspx

4. Prevalent and rare mutations in the gene encoding filaggrin cause ichthyosis vulgaris and predispose individuals to atopic dermatitis. Sandilands A, O'Regan GM, Liao H, et al. J Invest Dermatol. 2006 Aug;126(8):1770-5

5. http://www.scalyskin.org/column.cfm?ColumnID=11

6. http://www.scalyskin.org/content.cfm?ContentID=282&ColumnID=6

7. http://www.bad.org.uk/public/leaflets/atopiceczema.asp

Pierre Fabre Dermatologie

Pierre Fabre Laboratories is a leading French independent pharmaceutical company re-investing 13% of its turnover in R&D in 5 area of excellence: oncology, central nervous system, cardiovascular, immunology and dermatology. Pierre Fabre is organised in 3 divisions: ethical, OTC and dermatology-based cosmetics and hair care.

Pierre Fabre Dermatologie

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