Tag: skin care

My Homemade Sunscreen Experiment

Published on by jackiedosal1 Comment

Why, might you ask, did I attempt to try to make my own sunscreen?  Boredom on vacation?

I think many of us are attracted to do-it-yourself home remedies.  They seem cheaper and it might make sense to use things that are already in the cupboard. For instance, apple cider vinegar seems to be the internet/Facebook “cure-all” – it can fix everything!  Pretty soon I started noticing links for how to make your own sunscreen.  I haven’t tried apple cider vinegar yet, but had to try this one.

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My homemade sunscreen experiment.  Can anyone spot the most essential ingredient in the realization of this blog?  Hint – it’s in blue (baby monitor a.k.a nap time).
But does it really work?  In the case of sunscreen, I wanted to find out for myself.

Those looking for natural or organic solutions are particularly ripe for getting misinformation or potentially dangerous advice.  There are MANY excellent natural solutions, but usually those giving advice  (i.e. your friend on Facebook) don’t have any medical background, making it hard to vet what is SAFE and effective.

As many of you already know, I’m very passionate about sun protection, and wanted to make sure that people weren’t getting bad information.  I was optimistic, hoping to be surprised!  With this in mind, I set out to make my own sunscreen.

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Zinc oxide powder ready to be added to the base.
Here were the pros:

  • It was relatively easy and fast to make.
  • There were only a few ingredients, which should please simplistic and naturally oriented people. (Ingredients: coconut oil, shea butter, zinc oxide, pomegranate oil, and lavender oil).
  • I did not burn while wearing it for 2 hours in the noon Florida summer sun.

Here were the cons:

  • It cost me $57.70 to get all the materials!  
  • It was messy to apply.  Commercially formulated containers exist for a reason. Next time I would transfer it to a squeeze bottle.
  • Forget re-applying (one of the most common mistakes people make is not reapplying their sunscreen) – it would be way too messy to transport this DIY sunscreen.
  • I felt like a human version of “Slip-N-Slide” after applying.  The texture was way too greasy for my taste.
  • The true SPF of the concoction is unknown – a major no-no for me.
  • The stability and expiration date is unknown – I would guess that you could keep this mixture for 60 days, and then have to repeat the process. (I have absolutely no data to support this, which is the point… how do you know if it’s still good?)
  • The ingredients separated after mixing – not a big deal – just required mixing again before applying. A few days later the mixture was more consistent and paste like.
  • I would not recommend using this on your face if you are break-out prone. The oils might cause an acne flare.

My conclusions:

Save the $57.70, buy a $15 sunscreen with SPF 30+ and UVA protection, and use the rest of the $$ for a good sun shirt!  (Find my sun shirt picks here!)

And a last few words.  Some websites advocate using coconut oil alone as sunscreen – this is NOT OK!  Coconut oil has an SPF of about 4-6.  Would you ever consider buying a sunscreen with SPF 5?  No, so don’t consider it adequate protection for your skin.  The American Academy of Dermatology recommends a broad-spectrum sunscreen with an SPF of at least 30.  We are talking about a serious cancer risk (1 in 5 Americans will develop a skin cancer in their lifetime), as opposed to any hypothetical concerns about ingredients – see my in-depth post about sunscreen safety here.  The mixture above includes zinc oxide powder to beef up the SPF.  Even easier, you can also very easily find some simple commercial sunscreens with zinc oxide.

While my experiment “worked” in that I didn’t get burned, the practical aspects of the homemade sunscreen made it a no-go for me.  It was too expensive, too greasy, too messy, and in my humble dermatologist opinion, a little too risky for me.  I’m ok with using a homemade milk mask, but I don’t like risking DNA damage to my skin cells because I messed up the SPF formulation.  I’ll leave that to the experts.

It takes just two painful sunburns to increase your risk of melanoma, so for me, it’s really not ok to experiment with sun safety.  I did it for you, so that you won’t have to!

In the end, my main message is to use something that you know has an SPF of over 30, reapply every two hours, and practice sun safe behaviors.

Dr. Jacquelyn Dosal is a Board-Certified Dermatologist practicing dermatology in Miami, FL at Skin Associates of South Florida and is a voluntary Assistant Professor at the University of Miami.

The Best Sun Protective Clothing – and why you should wear it!

Published on by jackiedosal11 Comments

After many years of battling with unpleasant sunscreens, I have finally come around to the notion that sun clothes (clothes that have built in SPF, or more technically, UPF) are much more convenient and more effective and protecting from UV damage.  And most surprisingly, I am MUCH COOLER in the sun when I wear a long sleeve sun shirt!  New technology has made sun protecting clothing the ultimate multi-taskers; protecting from UV rays, cooling down the skin, wicking away moisture, and ventilating at the same time.

I think it would have been tough if I was still a teenager, dealing with the peer pressure to sunbathe in an itty bitty bikini, to instead wear a full coverage sun shirt.  But I should give our society more credit.  More and more people are starting to realize that the sunbathing you do as a youngster to “look good,” or “have a base tan,” is passé.  Pale is beautiful, and the very sunbathing done for aesthetic purposes has very ugly consequences even as short as 15 years later (think sun spots, wrinkles, blotchy skin).

Here are some benefits of UV clothing:

  1. You feel COOLER in the sun!  Amazing, but true.
  2. You don’t need to reapply sunscreen!  Who wants to reapply every two hours?
  3. You won’t miss any spots and have awkward geometric burns on your back.
  4. Prevention of skin cancer and skin aging.

So, here are my reviews and recommendations of some of the best sun protecting clothes that are cute and fashionable.

Coolibar – the company performs vigorous testing on all lots of clothing to ensure excellent UV protection. These were my first sun shirts.

Columbia – OmniShade and Omni-Freeze Zero – One of my personal favorites.  The Omni-Freeze Zero technology cools down a person when exposed to sweat.  We find it most commonly in their Performance Fishing Gear.  Great for the beach or any hot day.  My family knows that if it’s hot out, my hubby will only be wearing this shirt.  It’s now a joke that he doesn’t own any other clothes.

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Good dermatology family!  We are covered up and cool (both temperature-wise and figuratively). My hubby is sporting his favorite Columbia shirt.

UV Skinz – nice selection of outerwear for the family (nice kids selection), plus sun “sleeves” which are great for driving, gardening, golfing, etc.  I just bought some of the sleeves for myself and my husband!  Plus I LOVE their May Skin Cancer Awareness campaign – any purchase comes with a free baby sun shirt!

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UV Skinz Save a Baby’s Skin Campaign – free baby sun shirt with any purchase during Skin Cancer Awareness Month (May).

Lands’ End – I was surprised myself, but after seeing a tweet by Deborah Messing, I checked them out.  They have surprisingly cute swim wear!

SwimZip – As seen on Shark Tank.  This company makes it easy to find cute swimwear with zippers – we all know how hard it is to take off a wet bathing suit from a squirmy toddler!  SwimZip makes it super easy.

Mott50 Sun Protective Fashion – Co-founder Anne Reilly wanted to capitalize on the more noticeable trend of young ladies covering up.  Nice variety of casual and swim wear for women and kids.

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Dr. Dosal modeling a Bloxsun scarf at the Miami Open 2015

BloxSun – a local Miami company, offering beautiful UPF scarfs to cover you up in any occasion.  Check me out modeling my scarf at the Miami Open, where the sun can be unbearable.  This beauty kept me cool!  I also use their sun gloves while driving and gel manicure to keep my hands looking young.

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SunSoaked – Australian beach outwear line.  Designed to offer more fashionable, feminine, elegant sunwear.

Cover – Founded by the sister of a melanoma survivor and former investment banker, founder Lisa Moore offers luxury sun protective clothing that is runway worthy.

SanSoleil – makes golf, tennis, and other sports apparel out of Newport Beach, CA.

BloqUV – Excellent beach and sporting apparel. Great selections for golf, tennis, running, yoga, swim.

Any clothing with “Coldblack” – coldblack is a special dye added to clothing to reflect light and infrared heat.  Used to keep men cool in dark suits, it also provides a UPF factor of 30 to its clothing.  It can notably be found in Ermenegildo Zegna suits and in Under Armour golfing wear.

These retailers have earned the Skin Cancer Foundation’s Seal of Recommendation for sun protective clothing and hats.

  • Boys Scouts of America
  • Columbia Sportswear
  • Coolibar
  • J. Crew
  • Lands’ End
  • O’Neill Wetsuits
  • Quiksilver
  • Roxy
  • Specialized Bicycles
  • Sundrive
  • Wollaroo Hats Company (I like their hats a lot)
  • Whitworth Hats

I encourage you to pack (and wear) a sun shirt the next time you are going to be somewhere sunny.  I think you will be pleasantly surprised how much you like it!

References

The Skin Cancer Foundation Journal, Vol XXXII, 2014.  skincancer.org

Dr. Dosal is a practicing dermatologist at the Skin Associates of South Florida in Miami, FL.  She is also on voluntary faculty at the University of Miami.

I LOVE my Gel Manicures! But should I worry?

Published on by jackiedosal2 Comments

I LOVE my gel manicures!  Lasting at least two weeks, gel manicures have finally made my pincers look pretty!  Like many of you, I had been wondering about the safety about the UV lamps that are used to cure the gel manicures.  They seem fairly benign, but there has been some press questioning its safety. nail polish

When I read a recent issue of JAMA Dermatology, I was relieved to read that the authors concluded that the risk of skin cancer was very very low with gel/UV manicures, even with regular use.  This is what I suspected, so I stopped worrying.  Additionally, my salon recently introduced an LED nail lamp, which also seemingly solved the issue of the UV lamp.

Well, imagine my surprise when this topic came up again at the most recent American Academy of Dermatology Annual Meeting.  Nail expert Dr. Chris Adigun reopened my concerns about the safety of UV lights. She argued that the lamps are notoriously variable in their UV exposure, nail salons hardly ever follow manufacturer recommendations, and that the UV exposure is more than we previously thought.

This really left me conflicted, since I adore my gel manicures, and I really hadn’t prepared myself to abandon them anytime soon. So I took it upon myself to read through all the relevant articles on the subject (I hate taking someone else’s word for it).  Luckily, several groups have studied a variety of nail lamps, with a variety of hand positioning and exposure times.

Here’s the summary:

The amount of UV exposure is WAY below anything close to skin-cancer-causing levels.  

Here are a few other important take-away points:

  • Out of 72,709 women getting regular manicures for 60 years (assuming generous exposure times), only one woman would develop skin cancer who wouldn’t otherwise (in statistics, this is called the “number needed to harm”).
  • It would take 250 years of weekly gel manicures to equal that of a therapeutic phototherapy session that I commonly prescribe for psoriasis (15–30 treatments over 5–10 weeks).  (Yes, phototherapy is often UVB, rather than UVA, but this JID study measured UV dose in J/cm2, and gives a risk comparison to something we already know to be safe).

From a skin cancer perspective, the risk of skin cancer from nail curing lamps is very low.  However, it is important to note that ALL lamps used to cure gel manicures emit UVA radiation, even the LED lamps.  Despite the lack of “UV” in the name, LED lamps are actually more intense than UV lamps and emit more UVA.

As a quick review: UVB rays cause sunburn and skin cancer, while UVA rays penetrate deeper into the skin, causing skin aging, cell damage, sun spots, and wrinkles by breaking down collagen and elastin (and to a lesser degree than UVB, also contribute to skin cancer).

UVA UVB infographic
UVA penetrates deep into the skin to affect collagen and elastin, causing wrinkling, blotchiness, and poor skin tone.
UVA radiation is responsible for the brown spots (“liver” spots or “sun” spots) on your grandmother’s hands, as well as the wrinkles and crepiness of the skin.

There’s nothing worse than a youthful face that has been preserved with good skin care, but “old” looking hands.  

While the risk of skin cancer is much less than ambient exposure to natural sunlight, the cumulative effects of UVA exposure can result in discoloration and premature aging of the skin.

 

Aging hands
The typical appearance of a photoaged hand.  Note the blotchy appearance of the skin, brown spots, and thinned skin overlying the veins and tendons of the hand.  This occurs with regular exposure to UV light, especially UVA, which is emitted in all nail curing lamps and penetrates windows.
So your gel manicure won’t significantly increase your risk for skin cancer, but why risk any UV exposure?

For the very sake of preserving the youthful appearance of your hands, I recommend at least the application of a broad-spectrum sunscreen with an SPF of 30+ (see here for recommendations), or sun gloves while having your hands in the lamp.  My feeling is the gloves are better.

  • I use these sun gloves made by BloxSun– I wear them driving and bring them to the salon. 
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  • YouVee sunshields are currently crowdfunding – they are very cheap disposable hand protectors that block 99% of all UV radiation.  Wouldn’t it be great if salons started carrying these?
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In summary, I’m going to keep getting my gel manicures (thank goodness)!

For many of us women on-the-go, the gel manicure is here to stay!  Just be sure to protect those hands! And as with anything, it’s good to take a break once in a while from manicures to give your nails a breather.

Dr. Jackie Dosal is a practicing dermatologist in Miami, FL at the University of Miami and Skin Associates of South Florida.  

 

References

Shipp et al.  Further investigation into the risk of skin cancer associated with the use of UV nail lamps.  JAMA Dermatology 2014;150(7):775-6.
Diffey BL.  The risk of squamous cell carcinoma in women from exposure to UVA lamps used in cosmetic nail treatment.  British Journal of Dermatology 2012;167:1175-1178.
Markova A, Weinstock MA.  Risk of skin cancer associated with the use of UV nail lamp.  Journal of Investigational Dermatology 2013;133:1097-1099.
Macfarlane DF, Alonso CA.  Occurrence of non melanoma skin cancers on the hands after UV nail light exposure.  JAMA Dermatology 2009;145(4):4479.
Curtis J, Tanner P, Judd C, Childs B, Hull C, Leachman S.  Acrylic nail curing UV lamps: High-intensity exposure warrants further research of skin cancer risk.  J Am Acad Dermatol 2013;69(6):1069-70.
Dowdy JC, Sayre RM.  Nail curing UV lamps: Trivial exposure not cause for public alarm.  J Am Acad Dermatol 2015;6(64):e185-6.

New Year, New Location

Published on by jackiedosal1 Comment

Happy 2016!  2015 was a spectacular year for me both professionally and personally.

Most importantly, 2015 was marked by my first year with my daughter Caroline, who turned one in November.  It’s been such a joy to see her grow and learn – more than I ever expected!  It’s been so fulfilling to be a “mommy” in addition to being a dermatologist – it gives me more depth to my overall perspective.  It has also helped ground my approach to both patient care and family life.

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Brian, Jackie, & Caroline Dosal at Moving Day Miami, a walk for the National Parkinson’s Foundation.

Looking ahead, 2016 marks a new and exciting chapter for me professionally!  I am thrilled to announce I will be joining the prestigious Skin Associates of South Florida, alongside the brilliant Dr. Joely Kaufman, Dr. Jeremy Green, Dr. Christopher O’Connell and Dr. Cynthia Golomb.

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Skin Associates of South Florida is one of the leading dermatology centers in the country, and pioneers many of the state-of-the-art dermatology and cosmetic services for non-invasive rejuvenation. I’m very excited to be joining this talented group of physicians.  My first appointments will be available in March 2016 – mark your calendar!

“A good beginning makes a good end” – English Proverb

Cheers to 2016!!

 

Dr. Jacquelyn Dosal practices general, cosmetic, surgical, and laser dermatology in Miami, FL.

#Getnaked. Check your skin!

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I diagnosed two melanomas last week. My partner diagnosed another one the same week. Three melanoms in one week!!! Much to your surprise, here was the order of the most dangerous:
#1 most deadly case last week — melanoma on the bottom of the foot.
#2 most deadly case last week — melanoma on the lower leg.
#3 most deadly case last week — melanoma on the face.
Now, most of this has to do with how advanced the melanoma was when it presented, but there is an important lesson here. Alot of people will poo-poo a dark or unusual lesion on the lower body, since they don’t feel like the lower body gets alot of sun exposure.
Melanoma can happen ANYWHERE! The most common location for women to develop melanoma is the legs (as illustrated above — patients #1 and #2 were women).
I’ve said it before:

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If your dermatologist doesn’t make you #getnaked, find another one.

When you come to me for a full body skin examination, I check everywhere (unless you absolutely decline, I will respect your privacy!). But seriously, your dermatologist should be checking in between your toes, looking through your scalp, and checking where the sun doesn’t shine! I used to have a teacher in dermatology residency that would drill into us that if we weren’t checking the buttocks, we had not finished our full body exam. It was a little embarassing when she asked in front of the patient, but the point was well taken.
Bob Marley died of melanoma on his foot.
In truth, some melanomas are not sun induced (how would sun get to the bottom of your foot?), and these melanomas are more similar to other cancers that happen spontaneously. Therefore, everyone should come in for an annual skin exam, even people with dark skin.
I also strongly urge all of you to take a look at your skin regularly. Take a hand mirror and look ALL around before you get in the shower. Look at your spouse’s and your children’s skin. Become a “skin checker.”

What should I be looking for?

Dermatologists will often talk about the ABCDE method of detecting of melanoma. This is a great tool to help identify potentially suspicious lesions. Each letter corresponds to a characteristic of a mole that may signal an issue:

A stands for asymmetry — if a mole is asymmetrical. One half is not like the other half.
B stands for border — if the edges are ragged, not smooth.
C stands for color — if there are more than 1 or 2 colors present.
D stands for diameter — if it is more than >6 mm or the size of a pencil eraser.
E stands for evolution — if any mole is changing.

https://www.aad.org/spot-skin-cancer/learn-about-skin-cancer/detect-skin-cancer/what-to-look-for
https://www.aad.org/spot-skin-cancer/learn-about-skin-cancer/detect-skin-cancer/what-to-look-for

If you feel that any of your moles have met these criteria, don’t panic, but please do see your dermatologist for a professional evaluation.
As an aside, you should never feel funny going to the dermatologist to check any spot on your skin. The spot in question may be benign, but just being in the office may help identify other problem areas. More often than not, the worrisome spot is fine, but I may subsequently locate an inconspicious lesion that is a problem (potentially a skin cancer). This was the case in patient #3.
90% of melanomas are curable if caught early. Take care of yourself and your family — #getnaked and check your skin!