a) Once I get a tan I don’t need to use sun protection anymore. Tanning is an injury response of the skin to sun exposure. Some people tan very easily but still benefit from using sun protection.
b) I have very dark skin and therefore can’t get skin cancer. All skin types from fair (eg. light Irish skin) to dark (eg. African American) can get sun related skin cancer. It is true that in general the darker the skin type the smaller the incidence of skin cancer.
c) Skin cancer only occurs from sun exposure. Skin cancer occurs on both sun exposed as well as sun protected areas. Sun protected areas as an adult might have seen a lot of sun when the adult was younger but also it can occur where the sun never shined (eg buttocks and bottom of the feet). In fact the most common location for a melanoma in a black skinned individual is on the hands and feet (acral lentiginous melanoma)
d) once you get a skin cancer you should not go in the sun anymore. Not true. Life is short and people should use sun protective measures (clothing and sunscreens) but doing the fun stuff in life (eg golf) is ok.
There are two different types of lines on the face. Those caused by the contraction of muscles (dynamic rhytids) and those that are present all the time regardless of the muscles contracting (static rhytids). Most static rhytids have their origin in loss of cutaneous and subcutaneous volume that occurs as we age and from our weight status.
Botox addresses dynamic rhytids by relaxing the muscles that cause them. For example, in the frown it relaxes the two corrugator muscles and the procerus muscle and in the forehead it relaxes the frontalis muscle. Some muscles that contribute to lines, like in the cheeks, can’t be relaxed safely because they have other functions like chewing
Fillers replace volume in two ways or a combination of the both. In one way they place a substance within or just below the level of the skin that is generally slowly broken down by the body. Different products are broken down at different rates which is why they last different amounts of time. The more movement in an area also generally increases the rate of breakdown. There are other fillers that basically work by stimulating your own body’s production of collagen. These generally take longer to get the desired effect (several different sessions) but also frequently last much longer.
If you are not sure what your lines are caused by or what products might suit you the best, ask and we will discuss it.
There are many factors that contribute to the development of wrinkles – some can be controlled and others can’t.
A) Passage of time – there are no good alternatives that I am aware of, but I am always open to suggestions.
B) Genetics – again, no good alternatives. Thanks mom!
C) Smoking – absolutely contributes to wrinkles and “aging” of the skin. Smoking is bad for you in so many ways. Don’t smoke!
D) Sun exposure – aggressive sun protection, starting at a young age, will definitely make your skin age better and look better as you get older. Look at the number of freckles on your bum as compared to your face and ask your dermatologist where he removes more skin cancer – noses or buttocks.
There has been a lot in the news recently about a Vitamin D deficiency epidemic. Whether it is growing or being tested for more frequently is unclear. It is hard to imagine that here in New England where the winters are long, cold and dark (and have always been) that people haven’t had issues with their vitamin D for a long time. Some people are advising people to spend more time in the sun without protection (clothing and/or sunscreen). The data is weak and conflicting on the role sunscreen use plays in causing or exacerbating vitamin D deficiency. In contrast, the data is very strong on the role that UV exposure plays in causing skin cancer. It takes very little sun exposure to generate all the vitamin D that a person needs. Once someone generates that amount, the excess is broken down by the body. If someone applies ideal amounts of sunscreen and is extremely aggressive with their other sun protective habits and has very little dietary intake of Vitamin D, then they may have an issue. Most people wont have that problem.
Be very aggressive with your sun protection, take walks outside (like golfing) and consider a vitamin D supplement during the winter time (1000 IU/day).
