Sunscreens for non-dermatologists: what you should know when counseling patients.

Ultraviolet (UV) radiation is a notorious environmental carcinogen. Acute and chronic UV radiation exposure increase the risk for skin cancer. Protecting oneself from both UVA and UVB radiation with broad-based sunscreen can prevent certain skin cancers, their precursors, and photoaging. Although sun protection factor only measures UVB protection, it is essential to consider protection from UVA radiation when deciding on a particular sunscreen product. Awareness of particular controversies associated with sunscreen, such as vitamin D deficiency and sunscreen toxicity, is necessary to adequately counsel patients with sunscreen concerns. Additionally, all physicians should be familiar with sunscreen composition, proper use, and benefits while encouraging patient compliance.

Vitamin D: bone and beyond, rationale and recommendations for supplementation.

Adequate vitamin D status is necessary and beneficial for health, although deficiency plagues much of the world's population. In addition to reducing the risk for bone disease, vitamin D plays a role in reduction of falls, as well as decreases in pain, autoimmune diseases, cancer, heart disease, mortality, and cognitive function. On the basis of this emerging understanding, improving patients' vitamin D status has become an essential aspect of primary care. Although some have suggested increased sun exposure to increase serum vitamin D levels, this has the potential to induce photoaging and skin cancer, especially in patients at risk for these conditions. Vitamin D deficiency and insufficiency can be both corrected and prevented safely through supplementation.

Moisturizer allergy: diagnosis and management.

BACKGROUND: Moisturizers are used by patients with dry skin conditions as well as those with healthy skin to enhance and preserve the smoothness of the skin and to interrupt the dry-skin cycle. Moisturizers are generally considered safe, although skin reactions, such as allergic contact dermatitis from topical preparations may occur. Cosmetic products including moisturizers are among the main culprits of allergic contact dermatitis. METHODS: Utilizing a recently published database of all moisturizers available at Walgreens Pharmacies (Chicago, Illinois), which listed each product's allergens from the North American Contact Dermatitis Group (NACDG) screening panel, we evaluated the number of moisturizers containing each allergen. RESULTS: Of the 276 moisturizers accounted for in the database, 68 percent contained fragrance making it the most common allergen found in these moisturizers. Parabens were discovered in 62 percent of moisturizers, followed by Vitamin E in 55 percent of products. Essential oils and biologic additives were found in 45 percent of products, followed by benzyl alcohol in 24 percent of moisturizers. Propylene glycol was found in 20 percent of moisturizers, followed by formaldehyde releasers in 20 percent of products. Iodopropynyl butylcarbamate was discovered in 16 percent of products, followed by lanolin in 10 percent of moisturizers. Methylisothiazolinone/methylchloroisothiazolinone was found in six percent of available products. CONCLUSIONS: Many ingredients of moisturizers have the potential to cause irritant and allergic contact dermatitis; therefore, it is necessary for clinicians to be aware of such potential allergens in order to manage and advise their patients accordingly.