Field Notes from the 73rd Annual Meeting of the American Academy of Dermatology
San Francisco, California USA, March 20-24, 2015
by Howard Epstein, Ph.D.
EMD Perfoemance Materials
Approximately 10,400 physicians, research investigators and others involved in skin care attended the annual meeting of the American academy of Dermatology in San Francisco, California from March 20-24, 2015.
A highlight of the first day of the meeting was a section on Hot Topics for dermatologists. Members of the Academy had the opportunity to list the top ten topics of interest when they registered for the meeting. Sunscreens, photoprotection, controversies in vitamin D, cosmeceuticals and new approaches to treating acne were voted as five of the top ten.
Sunscreens and Photoprotection
Dr. Henry Lim, a dermatologist from Detroit, Michigan, USA spoke on photoprotection. Dr. Lim stated that some authorities suggest that “a little sun is acceptable.” His response to this comment was that “there is no safe dose of ultraviolet (UV) exposure. Even suberythemogenic doses of UV can induce photoaging. The regular use of photoprotection prevents photoaging and skin cancers.” A second photoprotection concern in the United States is the limited number of sunscreen filters permitted for use by the Food and Drug Administration (FDA). Dr. Lim noted that only four UVB filters, one UVA and three UVB and A filters are permitted for use in the United States. Octinoxate is the most widely used UVB filter, however when used with Butyl Methoxydibenzoylmethane (Avobenzone) it will destabilize the Avobenzone. Oxybenzone (Benzophenone-3) is frequently found to be a common allergen by dermatologists. Recently President Obama signed the Sunscreen Innovation Act, a legislation intended to accelerate FDA approval of additional UV filters. The FDA has requested additional safety information for the filters, and it is uncertain when they will be approved for use at this time.
Controversies in Vitamin D
There is concern that the rigorous use of sunscreens and other photoprotection strategies can lead to vitamin D deficiency. Because most people do not use sunscreens adequately or properly, vitamin D deficiency is rarely an issue. Vitamin D supplementation can ensure adequate serum levels no matter how rigorous sunscreen use. Dr. Lim referenced a study (Petersen et al., JID 2014 Nov; 134(11):2806) that concluded that while UVB exposure induced vitamin D synthesis in skin there was also significant DNA damage. Dr. Lim advised that consumption of food high in vitamin D and supplements can help to increase vitamin D levels in the body.
Cosmeceuticals: Fact or Fancy
Dr. Zoe Draelos, consulting professor of dermatology at Duke University, Durham, North Carolina presented on cosmeceuticals. She stated that cosmeceuticals are a conundrum. It is a category of cosmetics with claimed medicinal benefits that is not recognized by the FDA and the FDA advises this term has no meaning under the law. Dr. Draelos commented that cosmeceutical products are highly promoted, and ingredient concentrations are not disclosed. Dr. Draelos noted that, "two- thirds of the ingredients are moisturizers,“ and “these products may not actually contain the advertised ingredients.” Understanding how to read the ingredient disclosure is key to understanding how effective a cosmecutical product might be.
Are Cosmeceutical Ingredients Dangerous?
Dr. Draelos noted that a survey of 36,811 cosmeceutical formulations resulted in a frequency of use of the following preservatives;
Methylparaben 13,434, propylparaben 10,421, phenoxyethanol 8,878, butylparaben 5,289, ethylparaben 4,869, isobutylparaben 2,639 and methylisothiazolinone 2,408.
She noted that the parabens have been used as preservatives since the 1950’s and are found in 90% of the foods purchased in groceries. Methylparaben is found naturally in blueberries and the concern regarding the estrogenic effect of the parabens was only observed at a dose 25,000 times higher than typically used as a preservative in cosmetic products.
Pthalates in Cosmetic Products
Phthalates are used to fix or hold color and fragrance. They are naturally found in milk, butter and meats. They are not physically or chemically bound and can easily be released into the environment. They may be found in cosmetic products including moisturizers, nail polish and as anti-foaming agents in aerosols. The FDA currently states that they are not harmful to consumers at the levels currently formulated, but is continuing to monitor products, particularly baby products.
Hair Dye Exposure
Dr. Draelos commented that permanent hair dyes are of concern, more so for the darker colors. Dr. Draelos advised against using permanent hair dyes immediately before and during pregnancy and while breastfeeding.
Dr. Draelos concluded with the following remarks; it is possible that some cosmeceuticals may not directly contain the advertised ingredients. Preservatives in cosmeceuticals are probably not dangerous in low concentration. Hair dyes should not be used immediately before pregnancy, during pregnancy and while breast feeding and cosmetics are not intentionally contaminated with dangerous ingredients. Finally the topic of topical probiotics was addressed. Dr. Draeols concluded that more studies are needed to determine if they have anti-inflammatory or other useful health effects for skin.
New Hope for the Balding Head
Dr. George Cotsarelis, professor of dermatology, at the Perlman School of Medicine, University of Pennsylvania, Pennsylvania, USA, a hair loss expert gave the Marion Sulzberger Award Lecture. He focused on current researech of male hair loss. He reported that recent finding in male pattern hair loss suggest that new treatment s trategies might include stimulating new hair growth via a wound healing response triggered and by inhibition of the PGD2 lipid pathway, an enzyme that is elevated in balding scalps. If PGD2 can be blocked, this may help to stimulate hair regrowth. He hypothesized that hair growth might be stimulated vis wound healing using this pathway. PGD2 is an enzyme found expressed in wound healing. Currently there are drugs available to treat allergies and asthema that work through this pathway. Perhaps in the future a similar drug will stimulate hair grow th on the balding head.
The Golden Age of Molecular Biology
The field of molecular biology was established many years ago, only in more recent years has this science advanced considerably. The identification of genes and the regulatory mechanism responsible for regulating skin physiology is an on-going process. Information advancing the understanding of skin at this level is advancing every year. This was certainly no exception this year.