Dr Paul Lubitz, The Association Between Alcohol and Melanoma

For the past 30 years, melanoma has been on the rise across Canada.

Melanoma is a form of skin cancer, and although it is less common than other skin cancers, it is more serious. Melanoma typically appears as brown or black spots on the skin; in some cases, it can appear as pink, tan or even white discolorations. This skin cancer can form anywhere on the skin, but is most commonly found on the chest and back in men and on the legs in women.

The American Cancer Society estimates that approximately 76,000 people are diagnosed with melanoma every year and roughly 10,000 people die annually from this form of skin cancer.

Generally, the risk of developing melanoma increases with age, with the average age of those diagnosed with the cancer being roughly 63.

UV rays and sun exposure are often blamed for the development of the skin cancer, and while being sun smart is incredibly important and something I regularly advise, there are other risk factors that can lead to the cancer that people should be aware of.

Having a history of melanoma in one’s family makes one a high-risk candidate for the cancer. Similarly, anyone who has a lot of irregular or large moles has been shown to have an increased risk. Those who have fair skin, freckling and light hair should be aware that they are also at a higher risk for melanoma.

Outside of genetic predisposition, new research published by the American Association for Cancer Research indicates that there also may be a correlation between alcohol consumption and the development of this skin cancer.

Eunyoung Cho, ScD, an Associate Professor of Dermatology and Epidemiology at the Warren Alpert Medical School of Brown University, recently published the study, Cancer Epidemiology, Biomarkers & Prevention, which suggests that alcohol intake is linked with an increased risk for melanoma.

The study used data taken from 210,252 participants who were followed for an average of 18.3 years; the study used food-frequency questionnaires to measure alcohol consumption and frequency.

In a powerful takeaway from the research, Cho and her colleagues concluded that alcohol intake was linked to a 14 per cent increase in melanoma risk per drink, per day, with the association between alcohol and melanoma being the greatest for parts of the body that normally get less sun exposure.

Those who consumed 20 or more grams of alcohol a day were two per cent more likely to develop melanoma on their head, neck, arms or legs, but 73 per cent more likely to develop melanoma on their back or stomach.

The research also concluded that the largest risk for melanoma came from consumption of white wine, with each drink per day of white wine associated with a 13 per cent increased risk.

Eunyoung Cho’s study is only the most recent research that supports the fact that alcohol is a carcinogen. Outside of skin health and melanoma risk, alcohol has been considered a carcinogen by the International Agency for Research on Cancer (IARC) for many years, and in 2014 a World Cancer Report found that alcohol accounts for 3.5 per cent of cancers around the world.

Now, the point of this article is not to urge readers to stop drinking alcohol entirely. But rather, to urge moderation when it comes to drinking alcohol, and as always, to emphasize skin health by staying sun smart, living a healthy, active lifestyle, getting regular skin exams by a Board Certified Dermatologist and regularly examining one’s skin for irregularities.  

Dr Paul Lubitz: Adult Acne – How to treat it.

Often dismissed as an adolescent condition, many people don’t realize that acne is a skin condition that many adults suffer from. In fact, some patients don’t experience acne for the first time until well into their adult years. It’s estimated that five percent of all adults over the age of 45 suffer from adult acne, and one in five women between age 25 and 40 experience regular acne breakouts.

The most recent research has demonstrated that the majority of adult acne is the result of a genetically predetermined abnormality of the pilosebaceous (oil producing) glands of the body. While multiple factors, such as hormonal changes, can contribute to exacerbations of the acne at different times in a patient’s life, including during adulthood, the root cause of acne is a fundamentally abnormal gland to some degree.

Unlike teenage skin, adult acne is more challenging to treat due to the special needs of adult skin. Older skin is much more prone to dryness; adult skin is also more prone to showing signs of aging and may be more sensitive to acne treatments designed for oilier, more resilient teenage skin.

“People used to think that acne was just a cosmetic issue, but it’s a chronic skin condition with intermittent flare-ups and relapses,’ says Dr. Bethanee Schlosser, director of the Women’s Skin Health Program at Northwestern University in Chicago.

As we age, collagen production slows down, which in turn slows the skin’s healing process. This delayed healing response commonly increases the duration of each acne episode of adult acne as compared to teenage acne and increases the possibility for post-acne scarring. This means that treating adult acne needs to done as early as possible and on a case-by-case basis.

While adult acne is challenging to treat, there are some things adults can avoid to decrease the intensity and frequency of acne flare-ups.

 Adult Acne Skin Care Tips 

 1. Avoid Stress 

It’s been proven that stress both physiological and psychological causes an increase in androgens, which stimulate sebaceous and pilo-sebaceous glands. These glands produce the oil that moisturizes our face and hair follicles. But, when sent into overdrive, these glands can overproduce oil, and become irritated and that can clog pores and contribute to acne.

2. Changing Birth Control 

Oral contraceptives contain estrogen and progesterone hormones, which can control androgen activity. Changing pill brands or coming off of it completely can create acne flare-ups because androgen activity is increased. Certain IUDs contain progesterone and can also contribute to acne.

3. Pregnancy and Menopause 

Pregnancy presents many changes in a woman’s body - one of those is the increase of the androgenic hormone, progesterone; the hormone responsible for causing sebaceous glands to be stimulated and can result in overproduction of oil that results in flares of acne.

Menopause is marked with strong fluctuations in hormones, which can lead to heightened sebaceous gland activity, causing pimples.

4. Prescription Drugs 

As we age, some of us require prescription medication to treat illnesses and conditions. While they are designed to improve our quality of life, some medications can trigger or worsen adult acne. Barbiturates used as sleep aids, lithium for treating depression, and corticosteroids are well known acne agitators.

5. Makeup 

Used to enhance beauty and self-confidence, oily skin care products and occlusive makeup can often be bad for the skin, especially acne-prone skin. Even though your skin may be dry, the additional oils in your skin care products can clog and irritate the skin. Look for non-oily, light coverage alternatives, which will hydrate the skin without clogging the pores.

To reduce and prevent adult acne flare-ups, get to know your skin. If you have sensitive or dry skin, it’s best to use a gentle cleanser and an alcohol-free toner along with a calming mask, as opposed to the oily skin acne treatments that may cause dryness. Harsh cleansers, toners and abrasive scrubs will only irritate the condition.

Drink lots of water. Drinking at least 6 - 8 glasses or 8 ounces of water daily will keep skin hydrated and help dilute the skin’s secretions, preventing pore congestion.

Look to changing your diet if you notice an increase in oil activity after certain meals. In some cases reducing the fat content of the diet can help slow the increase of sebum in the skin. Eating foods rich in antioxidant vitamins keeps the skin healthy and in good condition.

Protecting the skin from the sun may not prevent acne, but it will ensure your skin is healthy and able to combat irritants effectively, which is key to fighting adult acne. Unprotected UV radiation from the sun can also contribute to more noticeable acne scars as the skin’s collagen and elastin support structure break down.

Fortunately, there are many very successful treatment strategies available for adults suffering from acne. It is important though that adults with acne are correctly diagnosed early in the course of the disease so that an effective treatment can be initiated in order to prevent progression of the acne and morbidity including scarring.

Early Diagnosis and safe and effective treatment of adult acne most often requires the expertise of a dermatologist, a professional skin specialist, with experience treating a variety of skin types, familiarity with traditional acne medications, and knowledge of the many new medical and non-medical treatment options now available.

Dr Paul Lubitz: Remember Melanoma Awareness Starts with ‘Me’

It’s a little known fact that melanoma skin cancer is the most common type of cancer diagnosed in women aged 25 through 29. According to the Cure Melanoma Organization, one person dies every hour from this often-preventable disease.

May happens to be Melanoma Awareness month. The month is meant to spark conversation around this common cancer and encourage people to check their skin and visit a dermatologist regularly for their skin examinations.

One of the most notable initiatives during the May awareness campaign is Melanoma Monday. Held on the first Monday of the month, the event sees members of the Canadian Dermatology Association (CDA) visit Parliament Hill in the nation’s capital to provide skin cancer screenings for all Members of Parliament, Senators and their staff.

The annual May event highlights the importance of skin monitoring and draws nationwide media coverage, which the organization uses to promote skin cancer awareness. This year’s key area of focus is the dangers of tanning beds.

Ahead of this year’s event in Ottawa, the CDA released a video aimed at teenagers and tanning bed users. Capitalizing on Prom Season, the video entitled "You Got into That Bed", is a clever and informative discussion about the risks associated with tanning beds.

The video aims to drive home the important statistic that sunbed use before the age of 35 years increases the risk of melanoma by an incredible 35 percent.

"It seemed like a natural fit for us," said Dr. Vince Bertucci, President of the CDA, "targeting Canada's most important leaders, our elected officials, with one of Canada's most at-risk populations, teenagers. In this way we hope to avert tragedy in both current and future leaders."

In Canada and across the globe, skin cancer is the most common and prevalent form of cancer in humans. The number of those diagnosed with Melanoma and other forms of skin cancer such as Basal Cell and Squamous Cell Carcinomas continues to grow each year with roughly 85,100 new cases diagnosed in 2015.

At this point, you may be asking, “Dr Paul Lubitz, what should I do to protect myself?”

As this year’s Melanoma Awareness Campaign points out, avoiding all exposure to tanning bed rays is the first step in protecting your body’s largest organ.

Routine checks for changing moles, skin discoloration, easy bruising and other skin abnormalities are also key components to preventing skin cancer. Research indicates that high-risk patients (people who spend a lot of time in the sun, have a history of skin cancer in their family, or have a fair skin type) that routinely perform skin checks are much more likely to find any skin cancers including Melanoma in its earlier stages. Consequently, by having their skin cancer detected early, their chances of dying from the cancer were reduced by as much as a 63 percent.

Today, there are even mobile apps you can download on your phone or tablet that can help you track and monitor mole growth, colour, size and other changes. This data can be compared over time so you can stay on top of your skin health.

The regular application of sunscreen (an SPF of + 50 is recommended for the Bow Valley), wearing sun protective head gear and clothing while in the sun, and avoiding excessive sun exposure in the peak 10 – 2 hours of the day, are all important behaviours that will further reduce your risks of developing skin cancer.