The Skin Cancer Foundation Journal

MAY 2014

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

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23 A ustralia has long been a world leader in sun protection and skin cancer prevention, and over the past two decades, Dr. Green has stayed in the forefront of these eforts. In the late 1990s, she and colleagues published research showing that daily sunscreen use helps prevent squa- mous cell carcinoma, 2 and in 2010, their unique community-based trial provided the frst di- rect evidence suggesting that it could cut melanoma incidence in half. 3 Now, drawing data from the same controlled clinical trial as the melanoma study, Dr. Green and colleagues have shown that sunscreen helps prevent not only skin cancers, but also photoaging (premature skin aging caused by UV exposure). Executive Editor Mark Teich interviewed Dr. Green about the importance of these new fndings. MT: In your previous studies, you found that daily sunscreen use reduces squamous cell carcinoma inci- dence by 40 percent and melanoma incidence by 50 percent. How convincing were your new fndings? Dr. Green: Our results were signifcant, showing that daily users of an SPF 15+ sunscreen had 24 percent less pho- toaging than non-users. In fact, the regular users had no detectable increase in photoaging after 4 ½ years. MT: Just how did you measure photoaging? Dr. Green: Photoaging describes ap- pearance changes and tissue changes induced by sun damage. The skin loses collagen and elasticity and can appear dry, wrinkled, and hyperpigmented (mottled). However, we wanted some- thing we could measure objectively, so we used a very particular measure – the natural criss-cross patterns of the skin on the backs of the hands. We took silicone impressions and made molds or casts of the backs of our par- ticipants' hands, both at the start and at the end of 4 ½ years. As our hands photoage, the tight criss-cross patterns decrease and fade; the fne network is destroyed and fattens out, refecting the loss of elasticity underneath. You can lit- erally see the diference. In highly pho- toaged skin, most of the elastic tissue is gone. In young hands, or on a baby's hand, the skin bounces back if you press it. On photodamaged skin, it does not bounce back. We asked the sunscreen interven- tion group to apply sunscreen to the head and neck, arms and hands, but we've found that the ideal measure of 24 *People who use sunscreen daily show 24 percent less skin aging than those who do not use sunscreen daily. 50 *Daily sunscreen users reduce their risk of developing melanoma by 50 percent. 40 *Daily sunscreen users have 40 percent fewer squamous cell carcinomas than those who do not use sunscreen daily. "Our results were signifcant, showing that daily users of an SPF 15+ sunscreen had 24 percent less photoaging than non-users."

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