Is It A Myth?: Dermatologist Discusses Misinformation Around Dermatology Care

In an interview with Pharmacy Times, Muneeb Shah, DO, dermatologist and partner at PC Dermatology PLLC, and Reid Maclellan, MD, founder of Cortina Health Inc, tackle misinformation and myths surrounding sun screen, skin cancer, and acne.

thodonal - stock.adobe.com

Is it a Myth?

The more "natural" or "clean" the product, the better it is for your skin.

Muneeb Shah: I was talking on my platform about how natural and clean are both not FDA-regulated words. To some companies clean means safer; it means ingredients that don't cause allergy; ingredients that don't cause issues at all in the body; and then to other companies clean is just a marketing term. Because natural and clean are both unregulated terms, I don't think that they inherently make the product any better or worse, if you're using them. I think patients need to be educated on what's in a product, in order to know if it's going to be safer or better for them. We actually know that Sephora was recently sued over their Clean by Sephora claims, because consumers were saying, “Well, I don't think what you're calling clean is, in fact clean.” So, who is the arbiter of the definition and that becomes a big problem. There’s tons of products that are synthetic, that are completely safe, completely effective, well tested. Then there are tons of products that are natural, like poison ivy that you would not want to put on your skin. It really just comes on a case-by-case basis, but that's why we create educational content, so patients can feel armed with the education so that they can make good decisions.

The higher the SPF, the better the sunscreen.

Muneeb Shah: SPF, the level does determine you know, how much UVB protection that you're going to get. Now, once you get to SPF 30, you're getting a lot of the blockage that you need, 97% blockage of the sun. Going from there to 50, you go from 97 to 98, which can be significant, depending on how you use the thickness of the sunscreen that you're supposed to apply. With that being said once you get up into 100, it's not very helpful to continuously increase that. I would say SPF 30, SPF 50, would be perfectly fine to get the sun protection you need, as long as you're reapplying it every 2 hours, and you're using enough so a lot of people will use a pea-sized amount of sunscreen. For the face, neck and ears, you need to use at least 2 finger lengths of sunscreen to get the adequate protection to get the SPF claim that's on the bottle.

SPF causes cancer.

Muneeb Shah: This for some reason, seems to be a myth that is impossible to get off the internet. I don't know why this keeps coming up. In fact, I've even seen dermatologists propagate this misinformation, which is disappointing in a lot of ways. We have both mineral and chemical sunscreens; there was a study in 2020 that showed that chemical sunscreens absorb more than we initially anticipated, but the study didn't say that that was necessarily harmful. It just said, “Hey, it absorbs more than we thought, and that's worth investigating.” But there's no evidence that these things actually cause cancer.

So by and large, every scientific body out there has come to the consensus that the risk of sunscreen is definitely less than the reward of sunscreen. The benefit of sunscreen is definitely very important. It's going to protect you from skin cancer; it's also going to decrease fine lines and wrinkles, and it's going to decrease pigmentation. We know these as facts. Now, this theoretical risk of sunscreen I think is much smaller. So I always tell patients, find the sunscreen you like wear it every single day, we know for a fact it's going to prevent skin cancer. Every other misinformation out there is usually propagated by somebody trying to sell you a product.

Vitamin D can help prevent melanoma.

Muneeb Shah: There is a lot of benefits to vitamin D. In fact, it's a very, very, very important vitamin and having low vitamin D levels can have a lot of adverse effects, from increased risk of cancers to hair loss to weaker bones, so vitamin D very, very important. However, whether or not, taking supplements of vitamin D or getting exposed to the sun in order to improve your vitamin D levels, is going to be beneficial to preventing cancer or melanoma, I think is still unknown. There was a study that that showed something to this effect. However, I think that it shouldn't change your behavior other than to say you should try to maintain a normal vitamin D level through supplementation or otherwise, but a lot of people took that information and said, “Well, that means maybe we should get more sun exposure because that's how we produce most vitamin D.” We actually think is the wrong response because we do know that sun the sun causes melanoma. I think that there is some truth in that. However, just taking a vitamin D supplement would be a more effective way to get those vitamin D levels up.

Chocolate or junk food cause acne.

Reid Maclellan: Now, here's what I want to say exactly right now I am not a board-certified dermatologist. So at Cortina, you will never hear from me about that. I only allow my board-certified dermatologist to educate patients on everything. I do know, though that because I've learned from Dr. Shaw, that sugar is bad for the skin to a certain extent, not just chocolate, but sugar in general. Passed that, I would always put to my board-certified dermatologist to answer any patients question.

Muneeb Shah: Fair enough. So sugar we know is pro inflammatory; it causes inflammation inside of the body, it also damages your collagen through non enzymatic regulation, and it also can cause acne by increasing inflammation inside the skin. We know that sugar is not great for the skin or high glycemic load is not good for the skin. Now the data on chocolate actually seems to go back and forth. There are studies that say that chocolate doesn't cause acne. There are other studies that say that it does cause acne. They actually did this really interesting study where they gave people made them eat a chocolate bar and then follow them for a week to see if they had any increase in common information, and I think in that study, they actually did.

I always tell patients, when it comes to diet, the data is very poorly elucidated because it's very difficult to think when you're controlling a study to actually get data on diet because, throughout the day, you're going eat so many different things. You can't say for a fact that it was the chocolate that cause your acne, it could have been something else entirely. My advice to people when they when they asked me about diet and acne, I always say if you're noticing that if you eat something specific and a day or 2 later, 3 days later, you're noticing an increase in your acne and your breakouts, then cut it out of your diet for you personally, but I don't think that we can make any generalizations other than just saying to avoid as much sugar in the body because that's bad for your heart anyway and other organs. In general, it just depends on the person.