It’s the first day of summer and I doubt you’ll be itchin’ to get into the hot tub but here’s yet another reason not to! Remember our previous post on hot tub folliculitis? Well, in addition to little bumpies around your follicles, you can also end up with painful bumpies of your hands and feet. These kids who went to a party involving a hot tub ended up with tender bumps on the palms and soles and/or with hot tub folliculitis. There are also previous reports of kids who got these bumps on their feet from a contaminated public wading pool. (Wading pools are a bit more summer-appropriate than hot tubs.) So if you end up with bumps around your follicles, or painful bumps of your hands or feet and you’ve been in a hot tub or wading pool, this could be the cause.
Recently, a group of us dermatologists were lamenting that fact that there is no sunscreen in pill form. Wouldn’t it great if there were an oral sunscreen out there? You could just take it with your daily multivitamin. Or rather, it could be incorporated into your daily multivitamin.
Then we remembered the Polypodium leucotomos fern. Polypodium leucotomos is a fern that has been used as a folk remedy for years for many different conditions due to its antioxidant properties. The product Heliocare or Fernblock contains an extract from this fern and has been marketed to protect you “against sun-related effects and aging.”
So is this fern extract really an oral sunscreen? Not quite. So far, the published studies have been small. Some of these small studies suggest that in various skin conditions, this extract may help decrease sensitivity to the sun. For example, in a rash called polymorphous light eruption (PMLE), this extract may prevent flares of this rash in some individuals (Journal of the American Academy of Dermatology 2012; 66(1)). In a more recent study evaluating whether this extract can be used in melasma which is strongly influenced by the sun (JAMA Dermatology, 2013; 5(1-2)), the extract didn’t help in the treatment of melasma.
So what’s the bottom line? Keep up with sun protection by seeking the shade, sun protective clothing and sunscreen use. The Polypodium leucotomos fern may provide extra protection but more studies are needed.
Recently published research shows that diligent use of daily sunscreen helps keep the skin young. Researchers in Australia followed patients for 4 and a half years. At the end of that time, they looked at the back of the patients’ hands, assessing for evidence of skin aging by making molds of the back of the patients’ hands.
They found that those who used sunscreen at least 3 to 4 days a week showed less skin aging than those that stuck to their usual habits of sunscreen use.
The researchers also studied whether beta-carotene ingestion by supplementation would make a difference in skin aging. It did not.
So what’s the take home lesson? As dermatologists have encouraged for some time, sun protection and sunscreen use is important for decreasing risk of skin cancer, but also to keep you looking young! If you need to see a picture to convince yourself, just look at the photo here of a trucker whose left side of the face was exposed to sun while driving.
So what SPF (sun protection factor) should you really be using when you look for sunscreen? The American Academy of Dermatology (AAD) recommends SPF 30 or higher.
But in a recent article by Yang, et al in the Journal of the American Academy of Dermatology (JAAD), researchers found that the actual SPF that is getting onto the skin is less. Why is this? While we recommend to our patients to use 2 mg/cm^2 of skin (e.g. a shot glass full to cover the entire body), practically it gets applied unevenly and people use much less and don’t reapply the sunscreen as frequently as they should. So, instead, these authors suggest that applying a sunscreen with higher SPF like 70+ is a good idea to account for potential under-application of sunscreen. Interestingly, the cost of high SPF sunscreen is often about the same price as the lower SPF sunscreens, so hey, why not?