Dermatologist Dr. Joshua Fox, Even in the Smartest Cities in the U.S., Misconceptions Remain


Dermatologist Dr. Joshua Fox, Even in the Smartest Cities in the U.S., Misconceptions Remain

When it comes to safe sun habits, many Americans are still in the Dark Ages. A new report from the American Academy of Dermatology (AAD) shows there is plenty of room for improvement across the country, but especially in the cities that fared the worst in its “Suntelligence” survey, which measured both beliefs and behaviors related to sun exposure in more than 7,000 adults nationwide. That survey found the smartest people, sun-wise, in Hartford, Salt Lake City, Denver and Tampa. The least sun-savvy folks were in Pittsburgh, Chicago, Cleveland and Seattle.

“Most people know that getting a blistering sunburn—or baking themselves brown every summer—isn’t good for their skin,” says Joshua L. Fox, M.D., a leading dermatologist and Medical Director of Advanced Dermatology PC of New York and New Jersey PC. “But we’re fuzzy on some of the finer points of sun exposure,” he says. “Many people don’t like using lots of lotion, or want to look tan without getting wrinkles—or cancer—so they’re willing to believe that their unsafe habits are perfectly fine.”

The AAD survey brought up several common misconceptions about sun exposure. Here are the five biggest—and the reality behind them:

• Getting a “base tan” is a good way to avoid sunburn (and sun damage).
“Trying to save your skin through preemptive tanning is an exercise in insanity”, says Dr. Fox (but it still makes sense to more than half the respondents). “A tan gives the equivalent of an SPF 4—not a lot of protection, and certainly not worth the damage and risk. The base tan itself causes skin damage.” Repeated exposure to UV radiation—even if it’s done with good intentions—leads to premature aging and possibly cancer later in life.

• You need sun exposure to get the Vitamin D your body needs.
About sixty percent of the people in the AAD’s study said that sun exposure was good for one’s health. A big part of that misconception comes from news reports on sunlight’s role in producing Vitamin D, which the body uses to help build bone, among other things. “But these reports are misleading”, Dr. Fox says. “Vitamin D is essential,” he says, “but sun exposure is not essential for Vitamin D production.” “Instead”, he says, “you should eat a healthy diet, with plenty of natural and fortified foods, and take a supplement of up to 1000 units of Vitamin D to make up for any dietary shortfalls.”

• Tanning beds have gotten a bad rap, but they’re still better than natural sunlight.
Nearly 30 million Americans visit tanning salons every year, and the AAD report found that only about one-third of adults realize they’re unsafe. “However, indoor tanning is associated with a seventy-five percent increase in the risk of melanoma, the deadliest form of skin cancer”, says Dr. Fox. Last year, the International Agency for Research on Cancer -a division of the World Health Organization – labeled indoor tanning a carcinogenic and put it in the highest risk category, right next to tobacco smoke. Many states have recently put restrictions on tanning beds for people under age 18 – some states now require parental consent and other states are considering banning tanning beds altogether for minors.

• Sunscreen with SPF 30 gives twice the protection of SPF 15. And SPF 90 delivers three times as much as SPF 30—enough to keep you safe on the planet Mercury.
The AAD’s study found that eight out of ten people believe this (it does seem logical: If you’re driving at 90 miles per hour, you’re going three times as fast as if you were driving at 30 MPH). “But there are a few things wrong with this theory”, says Dr. Fox. First of all, the sun protection factor, or SPF, refers to UVB rays. To get UVA protection, you need a sunscreen labeled ’broad spectrum‘ or one that contains a physical block like titanium dioxide. Secondly, UVB protection doesn’t increase proportionately with the SPF number. For example, SPF 30 screens about ninety-seven percent of the UVB rays, whereas SPF 15 screens ninety-three percent (SPF 2 stops about only fifty percent). “The difference in protection between SPF 30 and anything higher is relatively negligible”, reports Dr. Fox.

“Another factor here is application”, adds Dr. Fox. Using too little or reapplying too infrequently effectively reduces a product’s SPF—and leaves you exposed to sun damage. “The rule is to apply about an ounce—an amount equal to that which would fill a standard shot glass—over your body and to reapply it every two hours, more often if you’re swimming, sweating or playing sports,” he advises. “Don’t let an astronomical SPF number give you a false sense of security. In fact, in 2009 the FDA came out with a new regulation prohibiting manufacturers from claiming SPF’s of greater than 50+.

• Let’s face it: You look better—and healthier—with a tan.
Many associate a suntan with wealth and success (picture those rich, leisure-class types on their tennis courts and yachts). “But a tan is nothing more than a record of sun damage”, says Dr. Fox. “It’s the evidence of all the ultraviolet radiation that your skin has been exposed to—and had to protect itself against.”
Indeed, despite the evidence to the contrary, more than seventy percent of survey participants think people look more attractive with a tan. So instead of bucking the trend, Dr. Fox suggests using a self-tanner (with sunscreen, of course). “You’ll get that tanned look, but without the damage”, recommends Dr. Fox.



BEAUTY: TRACTION ALOPECIA IN AFRICAN-AMERICAN WOMEN IS EASILY PREVENTABLE. Dr. Joshua Fox, leading dermatologist in the New York area, and founder and president of the New Age Research Foundation: “Nearly one-third of African-American women and more than 17 percent of African-American girls ages 6-21 will lose their hair due to a condition known as traction alopecia. By simply changing their hair care and styling practices, many of these girls and women will be able to retain and enjoy their hair for years to come. Traction alopecia is a condition most commonly seen in the African-American population and is caused by specific hair styling practices, including tight braids, cornrows or weaves, as well as the use of chemical hair straighteners, dyes or bleaches. An estimated three-quarters of African-American females straighten their hair. Ironically, the very hair care and styling practices designed to improve their appearance can actually cause these young girls and women to lose their hair and feel that they no longer look as good as they want to.”

How to Get Longer Eyelashes


Many a product claims to enhance your eyelashes and make them look longer. One such eyelash enhancer actually gets results, but is it safe?

By Marie Suszynski

Medically reviewed by Lindsey Marcellin, MD, MPH

It almost sounds too good to be true: Swipe an applicator over your eyelids and you’ll grow enviably thick, longer eyelashes. That’s what eyelash growth enhancers — both over-the-counter and prescription — claim to do.

And if you’ve lost your lashes, growing new ones isn’t just for cosmetic appeal. Your lashes protect your eyes from dust and fibers, says J. Greg Brady, DO, a dermatologist and surgeon at Advanced Dermatology Associates in Allentown, Pa.

Growing new lashes can help people who have lost their eyelashes due to chemotherapy or who have sparse eyelashes due to hypothyroidism or severe infections, says Mohiba Tareen, MD, a dermatologist at Advanced Dermatology, P.C./Center for Laser and Cosmetic Surgery and clinical instructor of dermatology at Columbia University, both in New York City.

But are these eyelash enhancers risky to use?

Over-the-Counter Eyelash Enhancers

A few products at the drugstore and online say they promote eyelash growth; they can cost anywhere from a few dollars to more than $100 per tube. One product that used to successfully grow eyelashes is RevitaLash, an eyelash conditioner that you could buy online or in dermatologists’ offices. RevitaLash was an effective eyelash enhancer because it contained a prostaglandin that stimulated eyelash growth, Dr. Tareen says. However, the maker of the prescription formula Latisse (bimatoprost ophthalmic solution) holds the patent for the prostaglandin ingredient, and RevitaLash was forced to take it out of its formula.

·         Pros: Over-the-counter eyelash enhancers can be very affordable.

·         Cons: According to Tareen, over-the-counter eyelash enhancers lack the essential ingredient that you can only get through a prescription, so they’re not nearly as effective.

Latisse, a Prescription Eyelash Enhancer

You’ve probably noticed times during your life when your hair grows faster and comes in fuller. When women are pregnant, for example, their hair and eyelashes become thicker and fuller, only to go back to normal once pregnancy is over. Latisse works by increasing the growth phase of the hair, allowing it to grow longer and fuller all the time.

Latisse is actually a drug developed to treat glaucoma; doctors noticed that eyelash growth was a side effect of Latisse. The solution has since been repackaged and approved by FDA as a topical eyelash enhancer.

·         Pros: It really does work. One of Tareen’s patients had to start trimming her eyelashes after using this product for several weeks because they became so long. And because the medication is used on the eyelid and shouldn’t go into the eye, it has very few side effects, Tareen says.

·         Cons: The benefits of Latisse go away once you stop using it. Tareen tells her patients to use it every day for three months, then once every two or three days to continue to see longer eyelashes. Another con of using the drug is irritation or redness in people with sensitive skin, but those problems often go away on their own and can be treated with a topical steroid, Tareen says.

Although the risk is low, there are concerns that if bimatoprost ophthalmic solution gets into your eye it could increase the pigmentation of your iris. “Especially for people with hazel eyes, their eyes could become brower,” Dr. Brady says. While it’s rare, the effect is permanent.

It’s also very important to tell your doctor if you have a history of glaucoma or eye problems because bimatoprost ophthalmic solution could cause a change in your eye pressure or aggravate an existing eye disease.

“Although it’s not required, it’s never bad advice for people to get an eye exam and have their pressure checked before starting any treatment that may affect the eyes,” Brady suggests. Pressure changes in the eye are silent, so you won’t know you have high pressure unless you get it checked.

Perhaps the biggest drawback is financial: Latisse costs about $120 a month. But if you can afford it and you want to thicken your lashes in a safe way, talk to your doctor about starting the treatment.