Vol. 150 June 1, 2016 Blockers of Sun and Bugs

June 15, 2016

Hub thumbnail 2015It is that time of year again.
The 4th annual review of sunscreens (can’t call them “blockers” anymore per the FDA) and insect repellents was just published by Consumer Reports (July 2016 issue). For those of you who don’t wish to read all that chaff-like verbiage under the new editor here are some bullet points to guide your purchases. (If you wish to wade through all the CR words,  the July issue also has recommendations about beach umbrellas that don’t blow away, replacing 15-year-old furnaces with a central heating and A/C unit, and the coolest coolers of them all.

SUNSCREENS 

  • An SPF (Sun Protection Factor) of 30 blocks 97% of UVB rays (the cause of sunburn)and is the minimum SPF recommended by the American Academy of Dermatology. An SPF of 50 blocks 1% more for more money. SPF 100 blocks 99%.
  • Almost half (48%) of the sun screens tested by CR actually provided LESS SPF then stated on the package. This has been true over the four years of CR analysis, and this year CR is sending their results to the FDA and asking, “How come you guys don’t test this stuff?” Use SPF 30 product as a minimum.
  • Mineral sunscreens (those with titanium or zinc oxide in them) were the poorest UNLESS the sunscreen left a whitish glow on your skin. Nano-particle mineral sunscreens do not leave a whitish glaze (customers prefer that), but they don’t work well. The FDA is “still studying the unknown unintended consequences of nano-particles in skin lotions”. Non-mineral manufacturers are jumping on this uncertainty by promoting “no nano-particles” advertising, just another meaningless advert phrase.
  • “Broad-spectrum” sunscreens penetrate deeper into the skin to also block UVA light which is associated with increased risk for melanoma and accelerated aging of the skin. UVA rays pass through clouds and glass. There is NO SPF number for UVA ray blockers. CR used a “standard from Europe” in judging UVA blocking ability.
  • “Natural sunscreens” (as opposed to “chemical sunscreens”) are labeled as such because they contain natural minerals, aka “chemicals from the earth”, like titanium and/or zinc oxide. All of them came in under SPF of 15 in CR ratings unless they left white streaks on your skin when applied.
  • The only real difference between kids’ and the adults’ sunscreens are the cartoons on the package. Sprays are NOT recommended for kids because of inhalation occurrences. If you want to use a spray, spray it on your hand and rub it on.
  • No sunscreen is waterproof and reapplication is recommended after coming out of the water. “Waterproof” and “sweatproof” are terms prohibited to sunscreen manufacturers by the FDA.
  • Most sunscreens lose effectiveness after three years in their container, and the FDA requires them to date them now.

CR’s TOP PICKS?
No-Ad Sport SPF 50: super protective, non-greasy, fragrance-free, no white streaks, at a great price of 63 cents an ounce.  (“No-AD” means the company does not run ads on TV; it does not refer to “no additives”.)
Coppertone Water Babies SPF 50: $1.31 per ounce

HIGHEST RATING?
#1 – La Roche-Posey Anthelios 60 Melt-in Sunscreen Milk SPF 60: $7.20 per ounce
#2 – Pure Sun Defense SPF 50 Disney “Frozen”: 79 cents per ounce! (go figure!?); other models with different Disney names like “Avengers”, “Spiderman”, etc. should be equally good.

WORST?
CVS Kids Sun Lotion SPF 50:
an actual SPF of 8
Banana Boat Kids Tear-free, Sting-free Lotion SPF 50: is also apparently sunscreen-free with an SPF of 8

BUG REPELLENTS

Choosing a mosquito and tick repellent is easier. Just buy one with either 20% Picaridin or at least 15 % DEET. Both provide protection for 5-8 hours.  Repellent concentration is key. 30% DEET gives a full 8 hours protection. 5% Picaridin (found in some OFF products) gives less than an hour protection.

  • 5 of 6 “Natural ” plant-oil-based repellents tested did NOT work. Burt’s Bee Herbal gives you a scant 1 hour protection.
  • The “natural” 30% oil lemon eucalyptus “Repel” DID work for 7 hours, but should be used only on people over 3 years of age.
  • Picaridin 20% is safe for pregnant women and children over 2 months of age. Canada restricts its use to children over 6 months.
  • “Avon Skin So Soft” works only when it contains 20% Picaridin, but NOT without it.
  • DEET 15-30% is safe for children over 2 months of age.
  • Children under 2 months should be protected with mosquito netting and clothes.
  • Products including Vitamin B1, garlic, wristbands, or ultrasonic devices have no evidence of effectiveness.
  • Like sunscreens, don’t spray your face. Spray on your hands and rub on your face.

OFF, CUTTER, REPEL are familiar brand names, but buy the repellent with the right concentrations since some of these brand products have insufficient concentrations of either Picaridin or DEET to afford adequate protection.

Have fun at the beach … or the Olympics… or wherever!

 


Vol. 129 July 15, 2015 Update on FDA & Sunscreens and Bath Salts

July 15, 2015

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“Herbal incense” may sound organic,
but it sure ain’t good for you.

 

Sunscreens (1)
Previous blogs have noted that the FDA has limited authority over and regulations for sunscreens, but it does have some. Despite “the common wisdom” that the FDA is slow to approve new prescription drugs, its approval process is generally faster than Europe’s and in 2014 the FDA approved the highest number of new drugs in 18 years – 41 products. (1)

Over-the-counter (OTC) products like sunscreens are regulated by a different process using the standard:  “ generally recognized as safe and effective”. But, in 2014 the FDA declined to permit use of 8 new ingredients in sunscreens even though they have been in use in Europe for 5 years. It cited lack of safety studies, gaps in data, and reports of adverse events. This action prompted an understandable, if   a bit of an over-the-top reaction, from the Wall Street Journal calling to “strip the sunscreen police of all powers over the stuff.”

It is obvious that the FDA has mixed, and unfunded, responsibilities for review of OTC products. A new law, the Sunscreen Innovation Act of 2014 (only in America could we come up with a name like that), tried to clarify the situation, but no new resources were allocated to implement it. In the meantime both the FDA and the CDC continue their efforts to discourage use of tanning beds and promote prevention measures against melanoma which claim 10,000 deaths a year in the U.S.

Synthetic Cannabinoids (SC) (2)

Synthetic cannabinoids (SC) arrived in the U.S. from Europe in 2008 as herbal incense, spice, and bath salts “not for human consumption”. Since 2011 the DEA has placed over 40 SCs into Schedule I of controlled substances which means they are obtainable only by prescription. The problem is that manufacturers of these SCs merely change one or more chemical bonding group or a single chemical chain and the new compound falls outside such a regulation. The compounds are easily obtained on the internet for use in e-cigarettes or are added to energy drinks. They are still labeled “not for human consumption”, and may even carry the assurance that the product “contains no regulated compounds”.

Widespread distribution and marketing have led to recent clusters of serious illness and even deaths, particularly among the young and inexperienced users. Many users reported that they used SCs in order to get high without risking a positive drug test. SCs are NOT detected by the usual urine or blood lab tests, have no available antidote, and can produce serious symptoms which are not readily identifiable as symptoms specific to SC toxicity. Some users have died before reaching an emergency department.

The number of adverse events is increasing. During a two month period in early 2015 Mississippi reported 1200 SC-related visits to the ER and 17 deaths. One reason for this uptick may be the distribution of novel SC compounds that are easily and rapidly synthesized and marketed in response to regulatory actions. They can have new, unknown effects resulting in idiosyncratic toxicity such as delirium, seizures, psychosis, kidney failure, hallucinations, coma, and death.

Ninety-one per cent of users interviewed in one study inhaled vaporized SCs from refillable e-cigarette cartridges. E-cigarettes seem to be garnering more very bad “unintended consequences” than originally predicted by its advocates.

References:
1. NEJM July 9, 2015, pg. 101; A Spotlight on Sunscreen Regulation; J.A. Sharfstein, MD, Johns Hopkins School of Public Health
2. NEJM July 9, 2015, pg. 103, Synthetic Cannabinoids – Related Illnesses and Deaths, DEA, CDC, and University of California


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