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Mark Nagel considered himself a conscientious
tanner.
Before basking in the Miami sun or baking in a tanning salon, the
Lakeview, Ill., resident would slather himself with sunscreen, following
the instructions on the bottle to the letter.
"I would do everything they said and more because I didn’t want to get
wrinkles," said Nagel, who stayed golden nine months out of the year.
Two years ago, Nagel was diagnosed with skin cancer. He didn’t see it
coming.
"I followed all the rules," said Nagel, now 44. "It’s something you don’t
expect to happen."
What Nagel sees as a wakeup call some lawyers see as fraud.
A class-action lawsuit filed recently in L.A. alleges that some
manufacturers in the $455 million U.S. sunscreen industry are misleading
consumers into thinking sunscreen gives them more protection than it
really does. Lawyers in the case have called sunscreen the "snake oil of
the 21 st century."
While the dermatology community has emphasized that sunscreen is
beneficial when used correctly, the message is clear: As the days grow
warmer and beaches beckon, people need to think twice before slapping on a
dab of sunscreen and declaring themselves protected.
Skin cancer continues to be the most common form of cancer in the United
States, with 1 million people diagnosed annually. The most severe kind,
melanoma, which accounts for about 4 percent of cases and kills almost
8,000 people a year, is on the rise among young adults.
That increase could be because young people are more aware of the symptoms
and are getting diagnosed earlier, said Dr. Susan Chon, assistant
professor of dermatology at the University of Texas M.D. Anderson Cancer
Center.
Or it could stem from people thinking they can stay out in the sun as long
as they want once they’ve put on sunscreen, Chon said.
The class-action lawsuit, which names the makers of Coppertone, Hawaiian
Tropic, Banana Boat, Neutrogena and Bull Frog as defendants, alleges the
companies give consumers a false sense of security by labeling their
products as "waterproof" or "sunblock," and claiming "all-day protection"
against both UVA and UVB rays.
"Members of the public believe they can spend more time in the sun without
risk," the suit states. "However, in reality, although protected from skin
burn (the skin’s natural warning system), they are not being protected
from harmful sun rays that can cause and have caused a variety of
dangerous skin conditions, such as skin cancer."
The sunscreen makers have disputed the claims, and Schering-Plough, parent
company of Coppertone, said in a statement that its labeling and
advertising comply with Food and Drug Administration regulations.
Nagel, who suffered from the more common, less lethal types of cancer —
basal cell carcinoma on his scalp and squamous cell carcinoma on his chest
— doesn’t think sunscreen makers misled him.
"They have known for years that the sun causes skin cancer," said Nagel,
whose hairdresser discovered the cancer on his scalp two years ago. "I
made a choice. I have to take responsibility for my own actions and my own
body."
For example, Nagel said he should have used sunscreen with SPF 30 given
the fairness of his skin, instead of smearing on SPF 15 and then dropping
to SPF 8 or 6 as his skin darkened.
Nagel’s dermatologist, Dr. Omeed Memar, called the lawsuit "ridiculous,"
as people should use their common sense rather than relying on a label.
But there is widespread misunderstanding of how and when to use sunscreen,
which dermatologists say should be only part of a regimen that includes
wearing a hat and staying in the shade.
Blacks, for example, are advised to use sunscreen with at least SPF 15,
even though dark skin commonly is thought to be protection enough.
"I do a lot of skin cancer surgery on African-American people," Memar
said.
Many people don’t get the full buffer promised in the SPF — which
indicates how much longer you can stay in the sun than without sunscreen
before getting burned — because the SPF rating corresponds to lotion
applied as thick as cake frosting, Memar said.
"When you rub it in, you’re not getting the same SPF as the study," said
Memar, an assistant professor of dermatology at Northwestern University
and medical director at the Academic Dermatology and Skin Cancer
Institute.
Many sunbathers also neglect to reapply sunscreen throughout the day or
after swimming, sweating or rubbing, perhaps unaware that "there’s no such
thing as a waterproof sunscreen," Memar said.
In addition, SPF only measures protection from UVB rays — the ultraviolet
rays that cause sunburn and skin cancer. It does not measure protection
from UVA rays, which cause wrinkles and suppress the immune system, which
can ultimately lead to cancer.
Because most skin cancers usually take 10 to 20 years to develop, people
often don’t know the harm they are doing to their skin, Memar said. While
studies have linked melanoma to genetics and severe sunburns, the more
common kinds could result from years of sun exposure.
"If you’re getting a tan, you’re getting skin damage," Memar said. "It’s a
pre-burn."
That’s bad news for people who put a premium on being bronze, but it’s
unlikely to steer them from their quest for a copper glow until attitudes
change and people consider pale skin to be attractive, Memar said.
Even for Nagel, whose surgical scars are a daily reminder of the sun’s
danger, it’s a tough adjustment to make.
The former sun worshiper now must wear SPF 30 or 50 and a hat in the sun
because he stands a greater chance of getting skin cancer again now that
he’s already had it. He relies on spray tans or bronzers to keep himself
looking golden.
"It’s an inconvenience," Nagel said. "It’s something I have to be aware of
the rest of my life."
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