Your Health: New Sunscreen Ingredient

Joining [music] us is Dr. Zainab Faksumi, dermatologic surgeon at the University of Maryland Medical Center and associate professor of dermatology at the University of Maryland School of Medicine. Doctor, thanks for joining us again. It's like the the summer solstice followed shortly thereafter by a visit from our favorite dermatologist. >> I'm happy to be back. Thank you so much. I know it's like changing your tires or getting your oil changed before July hits. >> And it's time to talk about sunscreen and there's some news on sunscreen. There's a new ingredient uh which apparently has been used in Europe and it is coming here. Um is it a big deal? >> Um it's exciting. It's a a new chemical. You know, when we talk about sunscreens, we talk about physical and chemical blockers. This is a new chemical blocker and it has been um I think over 20 years since the FDA has approved a new chemical sunscreen. This new uh ingredient bemotrizinol is is exciting in the sense that it has less systemic absorption than the other chemical uh blockers, avobenzone and oxybenzone. >> Which scares people when you start thinking about I'm absorbing this. >> Yeah, when you think about long-term some some people are worried about long-term side effects of the chemical blockers. So it it is exciting that we have a new chemical blocker that has shown to have less systemic absorption. Um you know, when we talk about game changers, I don't think this is necessarily game changer. I think it will reassure people who do have concerns about systemic absorption. One of the things I think is really exciting about this new sunscreen is that it has a little bit of a less of a white tint. So a lot of people don't like that the sort of white cast that the the physical blockers can leave and this new BMT, this new sunscreen essentially leaves a clear finish. So you don't have that, you know, sort of white cast. I, you know, as a I've sort of leaned into the white cast and I kind of get a kick out of it, but some people don't like that. So, that gives a more appealing option. >> Well, dermatologists, I mean, if you go to a convention of dermatologists, you don't want to be the one without the white cast, right? >> meme that shows the dermatologist convention in Hawaii and they essentially look like beekeepers. That's basically what I look like when I play tennis. It's like a running joke, though. Yeah. >> Importance of sunscreen, which we've talked about before. Um, the stuff works. I mean, not only prevent sunburn, but skin cancer. >> Absolutely, it works. We know it works. The data's there, the science is there. We don't tend to fixate as much on the brand, the number, the sun protection factor number. You know, once you get above 30, 35, you're not really achieving any added benefit. As long as you wear the sunscreen, you reapply when you're outside, and you're mindful about being outside at peak sun hours, which tend to be between 10 and 2, uh, you follow these general rules, sunscreen works. We, you know, we know that one sunburn doubles your risk for the most deadly form of skin cancer that we see and treat, which is malignant melanoma. So, we know sunscreen is safe, we know it's effective. We as dermatologist urge people to to just wear the sunscreen, use the sunscreen. >> And within the stuff currently on the market, um, I guess you see a different SPF number. Um, UVA, UVB, do we care about that? We want both. >> we want both. We want a broad spectrum, exactly. And that's one of the exciting things about BMT is that it is a broad spectrum blocker, UVA and UVB blocker. But the the physical blockers, the titanium, the zinc, those sort of white cast ones are also really good, um, broad spectrum blockers. But you absolutely do want something that can block UVA and UVB. What we really don't fixate as much on now is the number, the SPF, the sun protection factor number. If you look at the the graphs of the the sort of um blocking capabilities of the SPF, once you get above 35, you're not really achieving any any added benefit. It's more gimmick or, you know, they make SPF 100, and that's just it's great, but you really do need to reapply every 90 every 90 to 120 minutes when you're outside. >> A reminder viewers, if you have a question about dermatology, you can send us an email. We'll have the email address on the screen. Um we have a couple of um pictures of various types of skin cancer that people maybe don't want to look at, but probably ought to see. These came from uh the NIH, and all three of these are different um melanoma cases, which is the most serious, life-threatening. >> Yes, they are. Melanoma is by far and away the most deadly form of skin cancer. As a matter of fact, skin cancers are really lumped into two broad categories. Non-melanoma skin cancer, which is everything except for melanoma, and melanoma. Melanoma has its own category because it's so deadly and it's so aggressive and invasive, and it has such a a capability of spreading to distant organs, the lymph nodes and distant organs. And what I usually will counsel people about um are the ABCDE criteria, which the American Academy of Dermatology has put out. So, you want to take sort of this this acronym and apply it to your moles, and if three or more fit, you want to call your dermatologist. >> And A is asymmetry, cuz these things all look like, you know, some weird island somewhere. >> Exactly. If you can't, if it's not perfectly symmetric, you can, you know, draw a line down the center and it's the same on both sides, that's worrisome. The B stands for border irregularity, so you want to have a nice smooth border. If you have a mole with jagged edges, scalloped edges, one, you know, sort of offshoot that's that's suspicious. C stands for color. So benign moles or safe moles typically have one even color. Brown, pink, um they can be dark as long as they're evenly pigmented. Once you get different colors within the same mole, brown and pink and and light brown, dark brown, that's very concerning. >> All right, there's a second image that has one um melanoma image and a basal cell on the left and a squamous, is that how it's pronounced, in the middle. Now, the thing on the right says melanoma, but it's not all that asymmetrical, is it? >> I agree. I agree. The one on the right is not all that concerning and that's a mole that some people might look at and say that seems fine. I've had it for years, but what we have to remember Jeff, is that 50% of melanomas develop from pre-existing benign nevi. So 50% of this highly aggressive form of skin cancer is developing from a pre-existing benign mole. So if I biopsy a mole and it's comes back as benign, I say, you know, that's fine. If I biopsy that mole 5 6 7 8 years from now, there's no telling that that couldn't become a melanoma. So half of these melanomas are arising from benign moles that with sun exposure, with sunburns, are accruing enough mutations, genetic mutations, that those benign cells are are becoming malignant. >> Um somebody a viewer with question wants to know what's the latest finding regarding sunscreen for darker skin tones. And I wanted to ask a question about different skin tones um for the um sunscreen, but also susceptibility to skin cancer and the ability to to see it, depending on your your coloring is. >> Absolutely. One of my favorite sayings, um cuz I get this question a lot from patients, is, you know they say but you know I'm I'm sort of heavier pigmentation or I'm darker can I get skin cancer and I say well if you have skin you can get skin cancer. Anybody who has skin can develop skin cancer. Now they will not develop skin cancer with the same rate as someone who perhaps is more fair-skinned. The more fair-skinned you are the higher your risk for skin cancer but I will say there are certain subset of skin cancers squamous cell carcinoma being squamous cell carcinoma being one of them that are actually quite common in um Asian skin type 4 type 5 skin African-American skin. There is a specific subset of squamous cell carcinoma that is actually quite common in that population. So just because you're more heavily pigmented absolutely does not mean you won't develop skin cancer. If you have skin you can get skin cancer. So you need to have your moles checked. You need to see a board-certified dermatologist to see with what frequency you need to be checked. The other thing is a lot of these squamous cell carcinomas are actually virally mediated. They're not necessarily caused by the sun. They can be caused by viruses. So once you know that some skin cancers are caused by viruses then you can understand that anybody with skin can be predisposed to skin cancer. >> And it can it's not necessarily triggered induced by the sun. You can get it someplace the sun >> Induced by viruses. >> doesn't shine. >> Induced by a virus. Exactly. >> Another viewer question do you need to reapply the sunscreen when you're outside because you sweat it off or because it loses effectiveness because of the time? >> Both. It's inactivated and you can sweat it off even though they do make some water-resistant waterproof sweat-proof sweat-resistant sunscreens. Um that's a mouthful. There's all these categories. You can call yourself sweat-proof sweat-resistant waterproof water-resistant. Um you do get some degradation of the product with sweat and with water. And then it also is naturally inactivated with time. These products have a half-life. So, we typically will tell people to reapply if you're going to be outside on a beach, um playing tennis, uh you want to reapply every 90 to 120 minutes. >> Um another viewer question on sunscreen. What's the latest finding regarding sunscreen for darker skin tones? Do people >> Mhm. >> Do you want a different product? Do people assume maybe I don't need it as much? >> There I think was an assumption that maybe perhaps because I'm darker I don't need sunscreen or I can safely tan. That's like one of my least favorite sayings I hear. It's kind of like What is that? Nails, you know, nails on a chalkboard for some like teachers. For me, that version is people saying, "Oh well, I'm darker, so I can tan and it's safe." There's no safe amount of sun, no matter what your skin tone is, your skin complexion. In terms of sunscreen, I will say one of the sort of more popular uses of the chemical sunscreen is in in sort of a darker skin population because it doesn't leave a white cast. A lot of people are bothered by the zinc and titanium because they leave a really apparent white cast, which a lot of people think is off-putting. I don't mind it, but >> days, half a century ago, we used to love that. You would get like the big dark sunglasses and the the white stuff on your And And still, I think I remember getting sunburns. You know, with my role as a lifeguard, it came with the territory. And And your point now is, you don't know sunburns. And And what do you do if you get a really bad sunburn despite everything? Is there anything you can do to uh to treat it and maybe to reverse the the damage? >> Yes, that's ex- an excellent question. And I can answer this question not only as a board-certified dermatologist and a mole surgeon, but as a mother. Because it's so shameful that my um my twin boys have had sunburns not on one but several occasions. So, I know exactly how to treat it as a physician but also as a mother. In the acute setting, sunburn really is painful. It's uncomfortable. You're you're talking about a superficial burn the the the top part of your epidermis. >> second degree burn, right? >> Absolutely. So, immediately what do you want to do is you want to do ice when possible, systemic pain relief typically with acetaminophen or ibuprofen and the use of topical steroids I have found in my own children to be really really useful in mitigating the both immediate and the the long-term effects of of acute sunburn. So, you use the the ibuprofen and acetaminophen immediately you know, you can call your dermatologist if you have prescription steroids on hand. I like to use topical steroids for those sunburns. It helps with the discomfort and it helps with the blistering that could that could come later. >> I just have half a minute or so. [clears throat] We've mentioned the term Mohs surgery a couple of times. For people not familiar with it, I first time I heard it I thought it was nose surgery. You can have Mohs surgery on your nose but it it tends to be on the face, right? >> Yes, sorry. Mohs surgery is uh my specialty. It's named after the individual who invented this technique, Frederic Mohs. What it is is it's removal of skin cancer typically on the face by one person, the surgeon who also is the pathologist. So, what I do um every day is I remove skin cancers on the face. I take the tissue myself to the lab. I have um a histotechnologist who's able to make slides. I look at it under the microscope and I can tell literally on a cellular level if the roots and traces of that cancer are indeed removed or if if I have to go back and take more and I basically repeat this process until all the cancer's removed. Once I'm sure the cancer's removed, then I do the reconstructions myself. >> Dr. Zaina Mazumi is a dermatologic surgeon, perhaps a Mohs surgeon at the University [music] of Maryland Medical Center and other places, and an associate professor at the University [music] of Maryland School of Medicine. Always a great pleasure. Thanks for the visit. >> Thank you so much for having me [music] back, Jeff. >> Your health segments are a co-production of Maryland Public Television [music] and the University of Maryland Medical System.