From Desperate Housewives to Brangelina, it seems that everyone loves a good controversy. And even the medical world is not exempt from being infected of a few of its own. Here are some of the most recent shockers in the world of dermatology (and while there isn’t one misplaced stocking in sight, they’re still pretty juicy…):
1. Sunscreen may increase free radical-induced damage (and signs of aging).
In a 2006 study in Free Radical Biology and Medicine, Kerry Hanson et al. demonstrated for the three sunscreen ingredients octocrylene, octylmethoxycinnamate, and benzophenone-3, the number of potentially damaging agents is heightened for the sunscreen user. These potentially damaging agents include reactive oxidative species (ROS), which affect DNA damage primarily by increased carbonyl formation in albumin, and free radical production.
Yet, as NYU medical student Laurel Naversen Geraghty points out in this month’s Allure, these ingredients were applied to the skin individually (not in conjunction with other sunscreen ingredients), and on the skin of mice. Furthermore, drinking green tea & antioxidant-rich beverages, and using antioxidants underneath sunscreen (such as Skinceuticals CE Ferulic or the organic Juice Beauty Antioxidant Serum), should combat some of the free radical production. Lastly, over 90% of the visible signs of aging have been attributed to sun damage, and sunscreen use is still considered a key component of prevention by dermatologists.
2. Use of retinoids may increase your likelihood of death.
A study in the January 2009 issue of Archives of Dermatology was halted when it was found that patients who use 0.1% tretinoin cream had a higher chance of dying than patients who used a placebo. The study, started in 1998, involved 1,131 veterans (97 percent men, average age 71) who were randomly assigned to apply either a cream containing 0.1 percent tretinoin or an unmedicated cream daily to their face and ears. Substantially more patients in the tretinoin group (108) died over a six-year period than those who applied the non-tretinoin cream (76).
However, the coincidence and likelihood of non-causality of the tretinoin is mentioned both by the study authors and in a recent article in Medical News Today. It is pointed out that the study did not screen for smokers, and in the tretinoin (treatment) group, 15 patients died of non-small cell lung cancer, 12 of vascular disorders and 15 of respiratory and other chest disorders. It is thereby likely that the tretinoin group coincidentally also included more smokers than did the non-tretinoin group. Furthermore, as the authors themselves point out, “The biological implausibility, lack of specificity of causes of death, inconsistency with previous experience, weakness of other supportive evidence in our data and weak statistical signal cast doubt on a potential causal association of topical tretinoin with death in the VATTC Trial. We do not conclude that this trial provides appropriate grounds for hesitating to use topical tretinoin in clinical practice in the absence of additional evidence.” I think, then, it’s pretty evident that tretinoin is not killing patients!
At any rate, thank you to one of my great readers, Anh, for making me aware of this controversy! 🙂
3. New eyelash growth serums may give you glaucoma.
A January 2009 New York Times article best summarizes the controversy: although it was pulled from the shelves just two years ago, Lumigan (a prostaglandin analog) originally used by opthalmalogists to reduce dangerous pressure in the eyeball, is now being marketed to increase eyelash growth in the $120/month brand-new Latisse. Allergan, the makers of Latisse, maintain that Lumigan (and hence Latisse) is safe, having reportedly paid a pretty penny to have the FDA re-review the ingredient efficiently.
How was the safety and efficacy of Latisse established? In the clinical trial, 280 volunteers were selected. Approximately half of the volunteers used Latisse daily for 16 weeks. The study results were reviewed by the Food and Drug Administration, which approved the drug in late December. According to the New York Times, the review found that only 3.6 percent of patients experienced eye itching and red eyes and none had a change of eye color. More excitingly, eyelashes typically grew 25 percent longer, 106 percent thicker and 18 percent darker.
Therefore, for now, evidence seems as though Latisse is safe, but talk to your physician or ophthamologist if you have specific eye concerns. Further, controversy-free options, like Marini Lash (free of prostaglandins!) still exist.
So, you can’t avoid controversy, even if you’re in a great field like dermatology. I’ll be sure to keep you posted on these topics with updates in the future! 🙂