Tuesday’s scientific programme was complemented by two Symposia on cosmetic dermatology. Advances in tissue lifting, previously the domain of medical surgery, have allowed the practice to be developed for use within the aesthetic dermatology sector. A range of energy-based approaches are available, including lasers and radiofrequency technologies that target collagen, the skin’s supporting structure, to improve tissue laxity. Now, devices using micro-focused ultrasonic (MFUS) energy can target the skin’s lower layers to lift sagging skin, with the potential for the results to last several years. A second symposium on the topic of skin ageing looked at emerging research into how targeting filaggrin might assist in the repair of sun damage, and how skin proteins protect against UV damage. Such research may pave the way for targeted anti-ageing therapies.
Sun protection was the focus of a fascinating symposium on Wednesday. Skin cancers in England are equal to all other cancers combined, and one in 24 Americans are set to develop melanoma, reflecting global trends.The need for photoprotection has never been more pertinent; but do high SPFs really deliver? The FDA are considering an SPF cap, meaning anything above SPF50 will be marked as SPF50+ rather than the specific factor, a move already instigated in several other countries. Part of the rationale is the argument that the increase in the SPF is not truly reflective of the actual increase in protection (for example, SPF15 absorbs 93% of UVB, with a modest increase to 98% for SPF30; and above SPF50 the increments are even more modest, yet consumers may assume that SPF 60 provides double the protection of SPF30). However it is not as simple as UVB absorption, according to Dr Darrell Rigel of the US, who stated that high SPFs give better protection in real-world (rather than testing) situations. Sunscreen is routinely applied too thinly and at 25% of the recommended application density, an SPF15 provides just SPF8, while an SPF50 provides SPF12.
A downside to the SPF cap is that higher SPF formulations are more costly to produce and, if SPF50+ can represent SPF51 through to SPF100, there will be little motivation for manufacturers to provide the higher SPFs in that category. On the other hand, higher SPFs may lull users into a false sense of security, borne out by a study in which users of SPF10 spent longer in the sun on holiday than those using SPF30. However, developments in photoprotection, such as personal DNA dosimeters, may render the SPF argument irrelevant in years to come.Those concerned about sunscreen safety and the inclusion of oxybenzone can take comfort from the findings of a study showing that it would take 200 years of daily use on exposed areas (face, hands) to cause the negative health impact demonstrated in rats, and 35 years of daily use on the full body.
Research taking place around the UK featured at the Congress’ Best of British session, spanning headline developments in common skin diseases such as eczema, psoriasis and skin cancer, to more detailed emphasis on cell biology and immunology. Attendees learnt that genetic factors are a key component in thinning hair, known as female pattern hair loss, in women whose hair loss starts young; whereas for older women, environmental factors may be more significant. The bad news? We don’t yet know what these factors are – but watch this space!
A myth-busting review of sun protection messaging and vitamin D from the UK echoed presentations from the US, emphasising that normal sunscreen use does not prevent us obtaining vitamin D from the sun, and moderate sun exposure in the summer can help maintain vitamin D levels in the winter.
The environmental and biological factors that impact on skin cancer survival were explored and attendees were warned that smoking increases risk of death from melanoma by a shocking 15%.
Atopic eczema, the inherited form of the disease, is another common skin disorder and several years ago, scientists discovered that eczema prevalence is higher in areas with hard water. However a subsequent trial of water softeners did not show a decrease in atopic eczema. A report from the UK revealed that a key ingredient of the softeners is responsible for this anomaly, and hard water in combination with the use of detergents is indeed an adverse combination for triggering symptoms. Research now focuses on how to maintain protease activity – beneficial to the disorder – through modifying wash products and potentially developing new formulas of emollients that may modulate the skin’s moisture function to the benefit of eczema patients.
Finally, there was much interest in a presentation by the Skin Health Alliance outlining the impact of humidity on skin health, click for the full report.