Skin Debates

Imagine that you are a dermatology nurse practitioner. Imagine you have spent the past 12 years of your career working at keeping people healthy. You are married to a police officer whose health knowledge goes as far as knowing the difference between tylenol and aspirin, if that. You have a beautiful little baby girl. One day you are about to take the family to the park and of course, you are applying sunscreen on your daughter. Your husband notices that you are using a spray sunscreen on your daughter and angrily states “Haven’t you heard you can’t use that on kids, guess you’re just going to give our daughter asthma?”. Really? Wouldn’t you think you would be the skin expert? Well obviously this is me. And this was the moment when I realized that if my own husband believes what he heard on television over his skin expert wife then obviously the whole world is thinking the same thing.

Side effects. Every medication has them. Side effects are risks we take when we use a medication. have recently read a lot of articles becoming popular in social media about the dangers of spray sunscreen, too little sunexposure being detrimental to your health, the dangers of benzoyl peroxide and the lists goes on. So how do you decide who has the best advice? Do you still take a tylenol even though it could cause damage to your kidney? Do you eat gluten even though it has been linked to joint pain and bowel diseases? How do you know if the benefit of something is greater than the risk? How to you know which risks are more likely to occur?  I don’t know what the right answer is but here are some of the things that I consider to help me decide what risks to take in the world of skin health care.

1. How likely is the risk to occur? For example, the spray sunscreen. We don’t know what happens when you inhale spray sunscreen so until the FDA has that figured out they just said don’t use/inhale it. In my opinion if I spray it on my legs or my daughters back we probably won’t inhale it. Therefore making the inhalation risk unlikely to occur.

2. How serious is the risk? When a child stands behind a running car do adults yell out “get that kid she is going to inhale exhaust and get asthma!”? No, we yell “get that kid before she gets run over by a car backing up!”. I use that analogy with sunscreen. It’s more important to me that my little girl doesn’t age her skin prematurely and get skin cancer (get hit by the car) than if she inhales a little sunscreen (smells exhaust). But that’s just me.

3. Does the benefit outweigh the risk? My child is a wild woman. To hold her down and rub sunscreen all over her is a serious task. It’s like mud wrestling with sunscreen instead of mud. We are both worn out and sunscreen is EVERYWHERE by the time we are done. So for her, I choose a combination of spray sunscreen to her extremities and back where she is less likely to inhale it and then powder sunscreen everywhere else. I take the “inhalation of spray sunscreen risk” because the benefit of ease of application is more important to me.

4. Majority rules. So one Swedish study comes out talking about women who sunbathe having a lower mortality rate than woman who avoid sunbathing and all of the sudden everyone wants to get a tan? No. It’s one article, with lots of factors to be examined closer. There are hundreds, likely thousands of research papers done showing that sun exposure is linked to premature aging and skin cancer. Obviously, I gotta go with the majority.

5. I like the motto “everything is okay in moderation”. Even dermatologist prescribe a little UV light sometimes. We use UV light treatments to help people that suffer from psoriasis, occult pruritus, vitiligo and more. Sometimes you just have to realize some things are good for you and bad for you, simultaneously.

If you ever want to talk more about sun protection, side effects of medication or anything else skin you know you can just come by the clinic and see me! I just love giving my opinion! Thank you for trusting me and the Johnson Dermatology team with your skin.

In the words of Rowan Nath, “Don’t just dance, move the world!”

Hugs, Nina


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