Observations on UV Talks at WCD
World Congress of Dermatology
Dr John Gray’s Daily Blog
The rains have cleared but we are left with a tropical mugginess and nasty niffs from the drains.
I have realised that I have no hope of describing even a fraction of the hundreds of talks going on throughout the week.
So today, instead of describing the continued assault on the exhibitors, now reminiscent of the Alamo, I thought I would offer a few personal highlights of talks in a specific area important to us all – UV and its interaction with human skin.
Of the major areas of activity there is no doubt that skin cancers and their distant relatives, skin ageing, are attracting huge efforts from academics and industry. Throughout the week, both plenary and sponsored sessions have focused on basic research and treatment modalities (new posh word).
In Meeting of Minds on Monday, David Hill outlined a global strategy for skin cancer prevention. Recent public statements on the potential benefits of UV (vitamin D) have further hampered public health policies for an already sceptical populace. Evidence suggests that the key target group, teenagers, have little or no belief in the need for effective UV avoidance. This is a critical issue, as up to 80% of UV exposure occurs before age 18. Other areas included a discussion of the relevance of genetic screening for melanomata and the publishing of a UV index.
The old chestnut of whether the use of UV screens made cancers worse surfaced. You should sit in any GP practice with an ageing population (mine) handing out creams or sachets for the old soldiers AKs to know that ANY strategy (big hats and creams) would have helped this a lot – but men were men then!
From a personal perspective – I would love to have the time to do all this as would, I am sure, our local dermatologist. In an economic climate when there is no funding for any research at all in our health care system – this remains a pipe dream. Thank heavens that the cosmetic companies have pushed the use of sunscreens in their daily care ranges. At least if mothers teach their daughters to cleanse and moisturise with products containing these effective systems – by subterfuge protection is gained. Shoving it down a population’s throat will not work and unlike banning smoking in public places (hurray) forced application seems a might totalitarian.
I personally use Olay Total Effects as part of my pledge to take better care, and I have become quite fanatical about it – you can never beat a convert!,
On Monday in Photoprotection and Sunscreens, Professor Anthony Young (UK) gave his usual superb review of the pathogenesis of cutaneous tumors. The suspicion that UVA may have a greater role in all such lesions has been raised but at present no model can reproduce markers suggestive that UVB is not the more important. However, there is accumulating evidence that UVA is a major component of skin ageing with hitherto unexpected effects on collagen. Although the escalation of skin cancer is potentially a major public health issue, for most women the preservation of youth (sounds better than reversal of ageing) is a constant worry. New ingredients, such as niacinamide, in conjunction with effective moisturisers and a full range of screens in a formulation which encourages compliance, have been shown to be of significant use.
In the interactive session on ageing Bob Binder from P&G presented his highly commended presentation on epidermal barrier and differentiation markers. This sophisticated study set out in lucid detail the key regulators in skin which are down-regulated in old skin affecting epidermal differentiation and lipid biosynthesis leading to decreased barrier function. This occurs in both intrinsic and extrinsically aged skin but profoundly more so in sun damaged skin. This type of detailed work will lead to even more targeted cosmetic products.
In What’s New, Gillian Murphy (Ireland) described recent interesting developments in the genetics of photodynamic therapy for cutaneous cancers and rejuvenation. These are clearly on the horizon. This does raise the dilemma of developing clear public messages on where we stand on the management of the interaction of human skin and light.
The legions of ladies in their 50s who turn up each year with skin wrecked by a combination of holidays in Spain, weekly trips to the sun-parlour and smoking, and wish to line my pockets with gold in return for botox, bears testimony to our failure so far.
In the Meeting of the Minds session on antioxidants and their efficacy in dermatology, the presentation by Professor Jean Paul Ortonne addressed the issue of oxidative stress in skin disorders. The role of antioxidants is a hot topic but as yet he stressed, the efficacy of topical dietary treatments is not proven.
I hope this has offered a flavour of what went on.
Tomorrow is the first of the major P&G Satellite Symposia – Hair & Scalp Research Breakthroughs.
Chau,
John Gray