Skin Cancer Awareness

What to Know About Sunscreens

Because May is Skin Cancer Awareness Month, our primary care doctors in Jupiter want to remind you of the dangers of sun exposure and remind you of the best way to avoid it.

It’s important to know the facts about skin cancer and the sun, along with exposure to tanning beds, because the National Cancer Institute (NCI) estimates that this year 99,780 people in the U.S. will be diagnosed with melanomas of the skin, and that 7,650 people will die from this most deadly form of cancer.

But a proper use of an effective sunscreen can prevent most skin cancers.

About sunscreen

“Unfortunately, skin cancer rates are still rising, and we do everything we can to try to minimize that, and using sunscreen is one component of that,” Darrell Rigel, clinical professor of dermatology at Mount Sinai Icahn School of Medicine in New York City, told CNN earlier this month.

Exposure to the ultraviolet (UV) rays of the sun is the leading cause of both skin cancer and premature wrinkling of the skin. There are two main types of sunscreens used to protect yourself from UV rays: chemical and mineral-based.

When they were first manufactured, most sunscreens had a sun-protection factor (SPF) of 15. That means that if you’d normally burn with ten minutes’ exposure to the sun, an SPF of 15 would allow you to safely stay in the sun for 15 times longer than that, or 150 minutes. As more research was done on sun exposure’s effect on the skin, researchers recognized the need for greater protection, so SPF factors were boosted to 30 and higher.

Chemical issues

There are some problems with chemical sunscreens.

First, because they break down when exposed to the sun, they lose their protective ability after less than two hours, and must be reapplied frequently. They can also be affected by excessive heat exposure, which means if you store them in hot places like a car or beach bag, they can lose effectiveness well before their expiration dates. But there’s no way to tell this just by looking at the product.

Another problem with chemical sunscreens is that, when applied, they are absorbed into the skin.

This is concerning because the active ingredients in many sunscreens, especially oxybenzone, may cause endocrine disruption in the body. That is, once absorbed into the bloodstream they may disrupt normal functioning of the hormones, including thyroid, estrogen, progesterone, and testosterone.

In addition, some studies have linked oxybenzone to harm in marine life when it gets into the water, leading some regions and countries to ban it. And the U.S. Food and Drug Administration (FDA) cautions that the ingredient may not be safe for use in children “because of the higher potential for higher absorption and bioaccumulation.”

A better alternative

The other main type of sunscreen is mineral-based, containing either zinc oxide or titanium dioxide or a combination of both. Comprising these crushed minerals, the sunscreen remains on top of the skin, forming a barrier against the sun’s rays. And unlike chemical sunscreens, these do not break down in the sun. Proposed regulations from the FDA say that these two ingredients are the only sunscreen ingredients that are considered to be both safe and effective.

In the past, these types of sunscreens left a telltale white coating on the skin.

But a newer generation of mineral sunscreen has addressed this problem by crushing the minerals into even smaller particles, which makes the whitening effect negligible. Mineral sunscreens also are better tolerated by far more users, including those with sensitive skin.

The non-profit Environmental Working Group (EWG) released its annual list of recommended sunscreens this month, including options for kids.

So which one should you use?

“There’s not one product that is going to be appropriate for everyone,” Adam Friedman, professor and chair of the department of dermatology at the George Washington School of Medicine and Health Sciences, told CNN.

“The best sunscreen is the one you will use again and again and again,” he said.

The right way to apply sunscreens

Whichever type you select, it’s important to use it correctly.

The American Academy of Dermatology (AAD) offers the following tips for applying sunscreen:

1. Your sunscreen should have an SPF of at least 30 and say “broad-spectrum protection” on the label. If your skin is sensitive to sunscreen, use one that is free of all preservatives, para-aminobenzoic acid (PABA), chemicals, perfumes, and alcohol.

2. Apply sunscreen generously before going outdoors.  It takes approximately 15 minutes for your skin to absorb it enough to protect you.

3. Apply enough sunscreen to cover all exposed skin. Most adults need about one ounce—enough to fill a shot glass—to fully cover their body. Rub the sunscreen thoroughly into your skin.

4. Apply sunscreen to all bare skin. Remember your neck, face, ears, tops of your feet, and legs. For hard-to-reach places, ask someone to help or use a spray sunscreen. If you have thinning hair, either apply sunscreen to your scalp or wear a wide-brimmed hat. To protect your lips, apply a lip balm with an SPF of at least 15.

5. Reapply sunscreen every two hours, or immediately after swimming or sweating.

6. Sunscreen stored in hot areas like a car can lose potency more quickly. The ideal storage temperature is 77 degrees Fahrenheit.

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From the time we’re little kids, any mention of bowel habits can trigger giggling embarrassment. We’re not sure why that is, because the intestine is simply another organ in the body. Nevertheless, our concierge primary care doctors in Jupiter know that talking about bowel disorders can be uncomfortable for our patients.

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omicron news

What We’ve Learned About the Omicron Variant

As we’ve just passed the second-year anniversary of the SARS-CoV-2 pandemic, our concierge primary care doctors in Jupiter think we should take a moment to reflect on how far we’ve come in dealing with this often-deadly disease.

It may not seem like it, because we still have to wear masks many places and haven’t fully returned to pre-pandemic life, but we have made progress.

For instance, we know more about how it spreads (through the air, especially in enclosed spaces), and how to protect ourselves (safe, effective vaccines and high-quality masks). And even though we’re still in the grip of of this still-relatively new coronavirus, and we’ve also found effective ways to treat it (monoclonal antibodies and anti-viral drugs).

Omicron a good thing?

And, believe it or not, the omicron variant of the virus may have turned out to be relatively good news, even though over 2,000 Americans a day are still dying from it.

But because it appears less lethal than its predecessors, omicron may make the pandemic more manageable.

The Centers for Disease Control and Prevention (CDC) released the results of a study late last month showing that the omicron variant—which is now the dominant variant both here in the U.S. and around the world—causes less severe illness, fewer hospitalizations, and requires less time in isolation following exposure.

This is partly due to the large numbers of people who have been vaccinated and/or infected with COVID-19, as well as to the fact that the virus appears to concentrate its effects in the upper airways instead of settling deep in the lungs.

The downside is that omicron is far more transmissible than earlier variants or the original virus. This is why so many people are catching it, and why—due to the sheer numbers of infections— hospitals are still being overwhelmed and an average of 2,200 people a day are still dying from the coronavirus.

Light at the end of the tunnel?

But an NBC News analysis of COVID-19 case numbers at the end of January showed that Florida is one of the many states where omicron is no longer surging.

And chief White House medical advisor Anthony Fauci said in an interview with ABC’s “This Week” that he expects the wave to subside in “most” states by the end of February.”

“As we get into February . . . it is very likely that most of the states in the country will have turned around with their peak and are starting to come down with regard to cases and then obviously hospitalizations,” he said.

While cautioning that “our work is not done,” Hans Kluge, regional director of the World Health Organization (WHO) for Europe, released a statement two weeks ago that offered a glimmer of hope to a pandemic-weary world.

“The pandemic is far from over, but I am hopeful we can end the emergency phase in 2022 and address other health threats that urgently require our attention,” he said in a statement.

“This pandemic, like all other pandemics before it, will end, but it is far too early to relax,” he added.

Effective weapons

One recent setback in the fight against SARS-CoV-2 was the finding from the CDC, confirmed by the drugs’ manufacturers, that two of the most common monoclonal antibodies used to keep at-risk individuals out of the hospital do not work against the omicron variant.

But again, there’s good news on that front, as well, because one monoclonal antibody—sotrovimab—is effective, and is still available at most hospitals even though Florida’s outpatient centers have closed.

Those who have mild to moderate symptoms of COVID-19 (fatigue, cough, loss of smell or taste, fever) or have underlying risk factors (those over 65, diabetes, obesity, kidney, heart, or lung disease or those who are immunocompromised) can check with area hospitals to see whether they’re offering this treatment.

In addition, other effective weapons in the arsenal against COVID-19 include the intravenous antiviral treatment remdesivir and the newly authorized oral antiviral drugs, Paxlovid or molnupiravir.

Still work to do

Two years in, we still don’t have all the answers, and until more people in this country and around the world are fully vaccinated, SARS-CoV-2 will not be fully manageable.

Each person who remains unvaccinated not only puts themselves at risk, but others around them, as well. And each infection offers the virus another chance to mutate.

Speaking of mutations, you may have heard of another new mutation of the omicron virus that some are calling “son of omicron” or “stealth omicron” because it’s so difficult to detect in PCR tests.

The new variant, designated BA.2 (omicron is BA.1), was first reported in California in November. It has since been seen in isolated cases in Texas as well as other countries. However, while remaining cautious, at this point most virologists don’t think it’s more dangerous or more transmissible than omicron BA.1. We’ll let you know if we learn otherwise.

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In the fight against COVID-19, the top weapon in our arsenal is the vaccine, which has been proven safe and effective. But when people refuse vaccination, or experience a breakthrough infection despite having received the vaccine, one extremely effective treatment is the use of monoclonal antibodies to stave off serious disease.

Our primary care doctors at MD 2.0 in Jupiter are surprised, however, at how few people are aware of this potentially lifesaving treatment. Florida opened a number of clinics where those not sick enough for hospitalization can receive monoclonal antibodies. We want to let you know what this treatment is and what it can do.

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Tea Leads to Good Overall Health

To our concierge family practice doctors in Jupiter, Florida, tea is the second-best beverage you can drink for good health. It comes as a close second, of course, to drinking water.

The practice of brewing leaves appears to go back at least 5,000 years, but its actual origins are hazy. The most persistent legend concerns a Chinese emperor who drank a bowl of hot water that was boiled for sanitary purposes. He was in his garden when a few leaves fell into his bowl, surprising him with the resulting pleasant flavor.

But a great deal of recent research has found there’s far more to be found in a cup of tea than a soothing drink.

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An estimated 60 million Americans experience heartburn at least once a month. Because it’s so common, our concierge doctors in Jupiter, Florida, want to explore the causes of heartburn, ways to prevent and treat it, and when you should be concerned about it.

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Which Type of Face Mask Is Best?

We’ve been living with the coronavirus pandemic for a year now. Our concierge doctors are seeing more and more claims regarding special types of face masks that will supposedly offer more protection from the virus.

We’re also getting more questions from our patients on this subject. Especially now that at least three variants (mutations) of the coronavirus have been identified as circulating in this country.

So we thought we’d tell you what we know to date on how to find the best face mask.

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Mental Health Still a Pandemic Challenge

It’s no surprise that mental health issues have soared due to pandemic stress in recent months. Between the loneliness resulting from the pandemic isolation to worrying about us or our loved ones contracting COVID-19 to financial concerns, people are suffering.

One survey by the CDC found 40 percent of respondents were experiencing mental health issues. These mental health issues reportedly arose from the pandemic, anxiety about the coronavirus itself and the containment measures related to it.

Our concierge doctors have seen this first hand from our patients, as well. In fact, it would be surprising if everyone wasn’t feeling stress to some degree. Especially if you consider all the stressors our nation has experienced over the last few months.

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