Category: Health & Lifestyle

Skin Cancer – All you need to know

Posted on by antonellovona

The article in one paragraph:

Skin cancer is one of the most common types of cancer that does not discriminate when it comes to age, gender, or skin type. Everyone can get it. Skin cancers are subdivided into two broad categories: Non-melanoma and melanoma skin cancers.

There are multiple risk factors for skin cancers, with the most preventible one being exposure to Ultra-Violet Rays (UVR). They come in all shapes, colours and sizes and some are more aggressive than others. Early detection and diagnosis is crucial as some of them can be fatal for their potential to spread.

Article objectives:

  • Learn basic concepts about skin cancer;
  • Learn what to look out for when assessing a skin lesion;
  • Learn about what you can do to prevent skin cancer;

Questions answered in this article:

  • How do you get skin cancer?
  • What are the risk factors for skin cancer?
  • What can I do to prevent skin cancer?
  • How to know if a mole is cancerous?
  • Is skin cancer hereditary?
  • Can sunbeds cause skin cancer?
  • How to recognise skin cancer?
  • How to recognise melanoma?
  • Is melanoma deadly?

Lies and myths you keep telling yourself about skin cancer:

  • It’s just a mole!
  • It’s normal if it changes;
  • It’s normal if it crusts or bleeds;
  • Sunbeds are safe;
  • If I apply sunscreen it’s impossible to have skin cancer;

Disclaimer

All medical-related content and media on this website is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.

Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional, or delay in seeking it because of something you have read on this website.

If you think you may have a medical emergency, call your doctor, go to the nearest hospital emergency department, or call the emergency services immediately. If you choose to rely on any information provided by Antonello Vona, you do so solely at your own risk.

External (outbound) links to other websites or educational material (e.g. pdf’s, websites…) that are not explicitly created by Antonello Vona are followed at your own risk. Under no circumstances is Antonello Vona responsible for the claims of third party websites or educational providers.

Skin cancer can be very insidious since, in its early stages, it looks similar if not identical to an harmless mole (nevi). Moles change… that’s what they do. Up to the age of 40 years old new ones appear and existing ones tend to change. Since skin cancer can pose a real risk to health and life, it is crucial to be able to recognise and differentiate between a healthy, normal mole that it’s changing as per its physiological path, and a skin cancer.

Skin cancers are subdivided into two broad categories: Non-melanoma and melanoma skin cancers. So, let’s dive into these two categories.

Layers of skin showing different kinds of skin cancer

Non-Melanoma Skin Cancer

Non melanoma skin cancer refers to all types of cancer affecting the skin that are not melanomas. Several skin cancers fall under this category, but in this article we will just focus on the two most common types: Basal Cell Carcinoma and Squamous Cell Carcinoma.

Basal Cell Carcinoma

Basal Cell Carcinoma (BCC) is the most common type of cancer in humans, which arises on sun-damaged skin. The good news about it is that it is a slow-growing tumour, metastases are rare and it’s rarely fatal. [1]

It can present itself as:

  • An open, non-healing sore – this is the most common warning sign of BCC. A persistent sore that oozes, bleeds, and crusts for weeks.
  • A pinkish growth – Growths often have an elevated and rounded border with an indentation in the centre.
  • Red patch or irritated area of skin – Sometimes patches can crust or itch and are located on the face, shoulders, chest, legs and arms.
  • A shiny nodule or bump – These are often pearly or translucent. Can be pink, red or white.
  • A scar-like patch – scar with undefined borders. They look white, pale and waxy.

Squamous Cell Carcinoma

Squamous Cell Carcinoma (SCC) is the second most common type of non-melanoma skin cancer. It occurs on sun exposed areas like face, head, ears and nose. If left untreated it can spread throughout the body and in extreme cases it can also be life-threatening. [2]

It can present itself as:

  • A persistent scaly patch – It is often red in colour with uneven borders. Often these patches will crust and bleed.
  • An elevated growth with central depression – These growths are raised with an indentation to the centre. They grow rapidly in size and can also bleed and crust.
  • Open sore – A sore that consistently crusts or bleeds and won’t heal over weeks.

Melanoma

Melanoma is no joke. In fact, it is the deadliest form of skin cancer. [3]. Survival rates are pretty high in its early stages as it can be successfully treated with surgery alone. However, survival rates can drastically drop once it metastasises. For this reason, early diagnosis and treatment are crucial for the best outcome. Melanoma has a sub-category known as Nodular Melanoma (NM), which behave and present themselves slightly differently than regular melanomas (read below in the section Nodular Melanoma to learn more).

What are the risk factors of melanoma?

The risk factors for melanoma re multi-factorial and shift between genetic susceptibility and environmental exposure.

Here’s a list of risk factors of melanoma [4]:

  • UV rays exposure;
  • History of sunburns;
  • Family history of skin cancer;
  • Personal history of melanoma or other skin cancers;
  • Fair skin, freckling and light hair;
  • Being male;
  • Xeroderma Pigmentosum;
  • Number of melanocytic nevi;

UV rays exposure

UV rays are an important, if not the most important, and modifiable environmental risk factor for developing malignant melanoma because of their genotoxic effect. [4].

Fun fact, the damage occurred as a consequence of uv exposure is cumulative and irreversible. It means that if you go out in the sun without SPF for one hour, the skin damage done in this one hour session will add up to the 30 minutes session you had yesterday, and to the 8 hours sunbathing session you had on holiday in Tenerife 3 years ago, and to the 2 hours session you had while you were learning to cycle in your childhood.

Studies concluded that intermittent sun exposure appears to be a major determinant of risk of melanoma [5].

History of sunburns

History of sunburns are associated with the highest risk of developing melanoma. [6] This may be due to the cumulative and irreversible sun damage caused by continues UV rays exposure, as discussed in the previous section.

Family history of skin cancer

Another strong risk factor for developing melanoma is a family history of melanoma. Studies have looked at the reasons as to why family history predisposes an individual to melanoma and they demonstrated the presence of a clear pattern of autosomal-dominant inheritance with multiple members affected in more than the first generation. [7].

The people who are mostly affected by melanoma that have an underlying genetic predisposition are usually young and up to 40 years old. [8].

Personal history of melanoma and other skin cancers

Previous melanomas, history of previous skin cancers or precursor lesions such as dysplastic skin nevi are all risk factors for developing melanoma. However, this category of risk factor seems to cause tumours that are superficially invasive and have a better prognosis. [8].

Fair skin, freckling and light hair

Red hair, fair skin, freckly skin, light eyes, inability to tan, and predisposition to burn all raise the risk of developing melanoma by approximately 50%; [9].

Being male

Studies show that males are approximately 1.5 times more lively to develop melanoma than female up to the age of 40 years old. After that, females seem to be more likely to develop melanoma than males. [10].

Xeroderma Pigmentosum

Xeroderma Pigmentosum (XP) is a rare, inherited condition that affects skin cells’ ability to repair damage to their DNA. Therefore, skin cells will have a hard time repairing the DNA damaged by the UV rays. (XP reference)

Number of melanocytic nevi

A meta-analysis showed that patient with more than 100 nevi (moles) have a 7 fold increased risk of melanoma. (nevi). Also, the presence of atypical or dysplastic nevi are associated with an increased risk too.

Diagnosis

The diagnosis of a melanoma is the result of a thorough medical history, which takes into account family medical history and sun exposure hygiene, and a physical examination with a magnification tool called Dermatoscope, which helps the clinical to appreciate the features of the mole in great details.

As a general screening tool, melanomas can be diagnosed with the simple mnemonic “A B C D E”.

A – (Asymmetry)

If you draw a line through the middle of the mole, the halves of a melanoma won’t match in size;

Melanoma screening tool - A for asymmetry

B – (Borders)

The borders of a melanoma tend to be irregular, crusty, uneven or notched.

Melanoma screening B - Border

C – (Color)

Healthy benign moles have an even homogenous colour. Watch out for discolouration that tend to the white or blue. That is bad.

Melanoma ABCDE screening tool - C - Colour

D – (Diameter)

Melanomas can be larger than a pencil eraser (>5mm). Although they can also be smaller.

Melanoma ABCDE screening tool - D diameter

E – (Evolving)

When a mole changes in size, shape or colour or it begins to bleed or scab it is not a good sign.

Melanoma ABCDE screening tool - E - Evolution

Nodular Melanoma

Another category of melanoma is Nodular Melanoma (NM). They are the most aggressive type of melanoma. They can be a bit more tricky to detect as they do not follow the “ABCDE” screening rule and can look as benign lesions because they can appear more even in shape and colour. They are usually grey, blue, white, brown, tan, red or skin colour and often occurs in sun exposed areas. Because of its fast-growing nature in a downward direction, early detection is vital as it is usually invasive by the time of diagnosis.

How is Nodular Melanoma Diagnosed?

Nodular Melanoma do not follow the “ABCDE” screening tool like regular melanoma, but they can be detected with the “E F G” screening tool.

E – (Elevated)

Look out for an elevated bump that can vary in colour.

F – (Firm)

Nodular Melanoma are firm to touch and more even in shape.

G – (Growing)

Any lumps or bumps that is persistently growing.

How does the sun damage the skin?

This topic is discussed in depth here, where you can learn how ultraviolet rays (UVR) damage the skin leading to premature ageing and skin cancer.

Skin Cancer Prevention

Here’s what you can do to prevent skin cancer:

  • Speak to your GP or dermatologist about your concerns and get regularly checked;
  • Monitor any mole that looks suspicious by taking pictures every month with a measuring tape on the side – look out for any changes and promptly speak to your doctor if you notice any;
  • If you are concerned about a mole or skin lesion and cannot get an appointment with your GP or dermatologist, try online services like Skindoc. Answer to some questions and upload your pictures to get those skin lesions checked by a dermatologist. They will get in touch with your GP and will also provide professional advice and reassurance.
  • Apply sunscreen regularly. I cannot stress this point enough. Even on a cloudy day, even if you’re working in the office or at home and are close to a window, you need to apply it on regularly. To learn everything you need to know about sunscreens, go ahead and read this article.
  • Avoid sunbeds – yes! they may cause skin cancer.
  • Avoid sunbathing between 11am and 4pm.
  • Get educated and informed! This is a major issue. Lack of information will lead you to ignore that suspicious skin lesions because, after all, “it’s just a mole”, and will also keep you in the same, old, harmful habits that increase the risk of skin cancer.

References

[1]. Dai J, Lin K, Huang Y, Lu Y, Chen WQ, Zhang XR, He BS, Pan YQ, Wang SK, Fan WX. Identification of critically carcinogenesis-related genes in basal cell carcinoma. Onco Targets Ther. 2018;11:6957-6967

[2]. Weber P, Tschandl P, Sinz C, Kittler H. Dermatoscopy of Neoplastic Skin Lesions: Recent Advances, Updates, and Revisions. Curr Treat Options Oncol. 2018 Sep 20;19(11):56.

[3]. Lauren E. Davis, et al. Current State of melanoma diagnosis and treatment. 2019.Cancer Biol Ther. 2019;20(11):1366-1379. doi: 10.1080/15384047.2019.1640032. Epub 2019 Aug 1.

[4]. M. Rastrelli et al., Melanoma: Epidemiology, Risk Factors, Pathogenesis, Diagnosis and Classification. 2014. In Vivo, 28(6) 1005-1011;

[5]. Sera  F,  Gandini  S,  Cattaruzza  MS,  Pasquini  P,  Picconi  O,  Boyle  P, Melchi  CF: Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer 41: 45-60, 2015.

[6]. Elwood  JM, Jopson  J: Melanoma and sun exposure: an overview of published studies. Int J Cancer 73: 198-203, 1997

[7]. Tsao  H, Niendorf  K: Genetic testing in hereditary melanoma. J Am Acad Dermatol 51: 803-808, 2004.

[8]. Veierød  MB. et al.: A prospective study of pigmentation, sun exposure, and risk of cutaneous malignant melanoma in women. J Natl Cancer Inst 95: 1530-1538, 2003.

[9]. Friedman  RJ, at al.: Early detection of malignant melanoma: the role of physician examination and self-examination of the skin. CA Cancer J Clin 35: 130-151, 1985.

[10]. Markovic  SN, et al.: Melanoma Study Group of the Mayo Clinic Cancer Center: Malignant melanoma in the 21st century, part 1: epidemiology, risk factors, screening, prevention, and diagnosis. Mayo Clin Proc 3: 364-380, 2007.

[11]. The American Cancer Society. Risk Factors for Melanoma Skin Cancer. 2019. Accessed on 14.05.2022. Available on: https://www.cancer.org/cancer/melanoma-skin-cancer/causes-risks-prevention/risk-factors.html

[12]. Gandini  S, et al.: Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi. Eur J Cancer 41: 28-44, 2005.

Niacinamide – Worth The Hype?

Posted on by antonellovona

Niacinamide, also known as nicotinamide, is an essential nutrient belonging to the group B3 vitamin (niacin). It is often confused with its precursor nicotinic acid (or niacin), which is a low-cost, evidence-based oral treatment option for actinic keratosis, squamous cell carcinomas, basal cell carcinomas, and bullous pemphigoid (1). Niacin can be also transformed into niacinamide in our body.

Deficiency of vitamin B3 leads to a condition called Pellagra, a disease characterised by inflamed skin, diarrhea, dementia, and sores in the mouth (2). The treatment for this condition is… yep! You guessed it! Niacin or nicotinamide supplements. However, niacinamide is preferred over niacin as the former is way more tolerated, and the latter creates severe flushes and redness in the patient.

Despite the hype that it is receiving recently, Niacinamide is not new and it has been around in the medical field for a very long time. Specifically, it is particularly appreciated in the skincare industry for its proven anti-blemishes and rejuvenating effects, in fact, in multiple chronic clinical studies, topical niacinamide (vitamin B3) has been observed to be well tolerated by skin and to provide a broad array of improvements in the appearance of aging facial skin (eg, reduction in the appearance of hyperpigmentated spots and red blotchiness). (3)

Actions

Niacinamide increases the biosynthesis of ceramides, which are the main component of the stratum corneum of the epidermis layer of human skin, creating a water-impermeable, protective organ to prevent excessive water loss due to evaporation as well as a barrier against the entry of microorganisms. Given a sufficient bioavailability, niacinamide has antipruritic, antimicrobial, vasoactive, photo-protective, sebostatic and lightening effects depending on its concentration. (4).

Niacinamide In Topical Application

In simpler words, niacinamde plays an important role in preserving and restoring the protective layer of our skin that has the function of both preventing offending microorganism penetrating it, and preventing water-loss from the skin. As such it helps soothing itching, killing dangerous micro-organisms, fights acne, protects us from the sun, regulates the sebum production of our skin, treats and prevents skin cancer and it lightens discolourations caused by melasma and/or inflammation. For the desired results, the niacinamide strength that you want to use is 5%-10%.

Niacin In Food

Since niacin is an essential nutrient that our body needs in order to function properly, it is essential that we eat niacin-rich foods:

Liver, chicken breast, tuna, turkey, salmon, anchovies, pork, ground beef, peanuts, avocado, brown rice, whole meat, mushrooms, green peas, and potatoes.(5)(6)(7)

Conclusion

Yes! Niacinamide is indeed worth the hype. It’s benefits in skin care have been well proven and documented across the medical literature, and it’s commonly used to treat skin conditions such as acne, hyperpigmentation, skin cancer, eczema and psoriasis at a concentration of 5%-10%.

Disclaimer:

All medical-related content and media on the Antonello Vona Website is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.

Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional, or delay in seeking it because of something you have read on this website.

If you think you may have a medical emergency, call your doctor, go to the nearest hospital emergency department, or call the emergency services immediately. If you choose to rely on any information provided by Antonello Vona, you do so solely at your own risk.

External (outbound) links to other websites or educational material (e.g. pdf’s, websites…) that are not explicitly created by Antonello Vona are followed at your own risk. Under no circumstances is Antonello Vona responsible for the claims of third party websites or educational providers.

References:

1 Reed H., Aaron W., (2020). Nicotinamide: An Update and Review of Safety & Differences from Niacin. Skin Therapy Letter. STL Volume 25 Number 5.

2 Ngan, Vanessa (2003). “Pellagra”. DermNet New Zealand.

3 Donald L.B., et al. (2005). Niacinamide: A B vitamin that improves aging facial skin appearance. Dermatologic Surgery. Jul;31(7 Pt 2):860-5; discussion 865. doi: 10.1111/j.1524-4725.2005.31732.

4 Wohlrab J., Kreft D., (2014). Niacinamide – mechanisms of action and its topical use in dermatology. Skin pharmacology Physiology. 27(6):311-5. doi: 10.1159/000359974.

5 Jian R., et al. (2002). Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA. 2002 Nov 27;288(20):2554-60. doi: 10.1001/jama.288.20.2554.

6 Joris P.J., Mensink R.P., (2016). Role of cisMonounsaturated Fatty Acids in the Prevention of Coronary Heart Disease. Current Artherosclerosis Report. 2016; 18: 38.

7 Kirkland J.B., Meyer-Ficca M., (2018). Advances in food and nutrition research. ;83:83-149. doi: 10.1016/bs.afnr.2017.11.003.

Alcohol – All You Need To Know

Posted on by antonellovona

Humans have a long and complicated relationship with alcohol. Whether it is part of a social moment, relaxing alone, as part of your meal, celebrating for a special achievements and occasion, alcohol is rarely missing and it is very sought after. 

It is a psychoactive (mind-altering) substance with depressiveeffects (slows down heart rate, breathing, thoughts and actions). The common denominator of all the alcoholic beverages is a chemical component called ethylic alcohol or ethanol. This is the only type of alcohol we can ingest without being poisoned.

Ethanol is the bio-product of a process called alcoholic fermentation, a process that takes place when certain microorganisms called saccharomyces attack rotten fruits eating their sugar and releasing ethanol and CO2 as a waste product.

When we drink alcohol, it flows from your mouth to your stomach where 20% of it will be absorbed entering into your blood. The rest of it will be absorbed by your small intestine. Once into the blood stream the ethanol will make its way to the liver which will try to get rid of it. To do so, the liver needs to break the ethanol molecules down using an enzyme called alcohol dehydrogenase, which will oxydise ethanol that will then turn into a highly toxic component called acetaldehyde. The latter will then be metabolized by the liver using an enzyme called acetaldehyde dehydrogenase.

If the liver is exposed to more alcohol than its enzymes can handle in order to metabolize it safely, molecules of ethanol and acetaldehyde will continue their journey in the blood stream circulating in your whole body.

Alina Insta: @zvandrei
Photo by Andrey Zvyagintsev / Unsplash

The first sign of alcoholic effect is an increased blood flow to the skin, that’s why highly vascularized areas of your body (such as the face) turn red, as well as feeling hot resulting in sweating and stinking of alcohol.

Another effect is the decreased release of the hormone vasopressin, which helps the kidney to regulate the amount of water in your body. This leads to a failure to absorb the amount of water that the kidney receive resulting in an increased urination and contributing to dehydration.

When the alcohol reaches the heart it expands and relaxes blood vessels (a phenomenon called vasodilation), resulting in a drop of blood pressure.

The heart will also pump the alcohol to your lungs, where it will be expelled from your body together with the CO2, giving that lovely, distinct, stinging and appealing smell to your breath.

But the real fun starts when alcohol reaches the brain. As for all the drugs (Yes! Alcohol is a drug), alcohol alters the normal functioning of the neurotransmitters in the brain and this leads to all the classic behaviors of a drunk person.

It increases the production of a neurotransmitter called GABA, which causes sleepiness, slow movements and thoughts, and delayed reaction times.

It decreases the production of the neurotransmitter Glutammate, which is responsible for disinhibition and the exaggerated emotional response. It also decreases our attention and compromises our memory.

It increases the production of Dopamine, which causes a sense of happiness and gratitude, as well as hyperactivity and euphoria.

When you wake up the following morning the real fun starts: headache, dry mouth, clumsiness, upset stomach, nausea, and most importantly a huge sense of regret.

The Hangover

man in white long sleeve shirt
Photo by Sammy Williams on Unsplash

As mentioned before, alcohol diminishes the production of vasopressin, which leads to dehydration. When our body is dehydrated, it tries to take water from whatever source possible, and one of the places where your body will source water is your brain. This leads the brain to shrink in size, creating a lot of tension between the membranes that line your brain and keep them attached to the skull (meninges). The dehydration is also made worse by vomiting, which is extremely common when people go way over the limits. 

Also, alcohol il extremely aggressive for you stomach inner lining (mucosa) and can cause irritation. The following morning it is very possible that you wake up with an upset stomach, heartburn, andstomach pain. The intoxicating effects of the acetaldehyde will cause the sense of nausea.

The only remedy out there that is 100% effective against hungover is: TIME. There tons of fake remedies out there that will try to sell the best solution for an hangover: coffee, cold shower, eating, going for a walk, and God knows what else. They certainly help, but the truth is that there is no scientifically proven method that is valid against the hangover. All you can do is to take care of the symptoms: pain killers for headaches, plenty of water, eat something nutritive and not too demanding for your stomach.

The organ that is damaged the most for alcohol is your liver, and this damages can lead to conditions such as hepatic cirrhosis, cancer, or hepatitis. Cancer can also arise in the digestive tract as a result of alcohol consumption.

In the heart, it increases the chances of having hypertension, strokes and heart attack. It also affects the reproductive system with decreased sex drive, infertility and erectile dysfunctions (in men).

Alcohol can lead to addiction too, and it can give rise to mental health problems such as depression, psychosis, and eating disorders.

Can It Be Good For Your Health?

It was our friend’s birthday, and we celebrated with a few bottles of wine from Longshadow Ranch in Temecula, CA.
Photo by Kelsey Knight / Unsplash – Red Wine

Red wine, when consumed in moderation, is actually thought to be good for your heart and health in general. This is due to polyphenols, antioxidants present in red wine, specifically Resveratrol, an antioxidant which might help to prevent damage to blood vessels, reduce low-density lipoproteins (LDL) cholesterol and prevents blood clots.

The reason why Resveratrol is more present in red wine is because this antioxidant comes from the skin of grapes used to make wine, and red wine is fermented with grape skin longer than white wine, hence red wine contains more Resveratrol.

The scientific consensus on this is quite mixed and more research is needed to prove or disprove the positive effects of Resveratrol.

How Long Does it Take To Metabolize Alcohol

Personal work; product shot of a bottle of Orphan Barrel Barterhouse bourbon and a Waterford Crystal tumbler.
Photo by Ryan Parker / Unsplash

Your body generally takes one hour to process one standard drink, or more conveniently one unit, which equals to 10ml or 8g of pure alcohol.

In the table below you can find some references on what 1 standard drink can be equal to. 

N. Of Standard DrinkDrinkoz/ouncesml% of Alcohol
1Beer12oz3405
1Wine5oz14712
1Liquor1.5 ounces4240

Units

It can be hard to keep track of the alcohol ingested, especially because it comes in different glasses and different servings. A simple way to measure alcohol is through units, which is usually expressed by the standard measure of alcohol by volume (ABV). It indicates the amount of pure alcohol as a percentage of the total volume of liquid in a drink.

It is simple to work out how many units of alcohol are there in a drink. You simply have to multiply the total volume of a drink (in ml) by its ABV (in %) and dividing the result by 1000.

               Strength (ABV) x volume (ml) / 1000 = units

For example, if I want to find out how many units of alcohol are contained in my small glass of red wine, knowing that it has a strength of 12% and I am drinking 140ml:

                    12 (%) x 140 (ml) / 1000 = 1.68 units

For How Long Alcohol Is Detectable In Your Body?

Vital test
Photo by Hush Naidoo / Unsplash

Alcohol stays in your body longer than you think. You can find below how long alcohol can be detectable for with these different tests.

Type of testTime After Consumption Alcohol is Detected
Urine Test14-48hr
Breath Test24hr
Hair Test90 days

How much alcohol consumption is considered a safe limit?

According to the NHS, to keep health risks from alcohol to a low level if you drink most weeks, men and women are advised not to drink more than 14 units a week on a regular basis.

Vitamin D – All You Need To Know

Posted on by antonellovona

Vitamin D (also referred to as “calciferol“) is a nutrient you need for good health. It is one of the four fat soluble vitamins (Vitamin A, D, E, and K), which are nutrients absorbed along with fats in the diet, and stored in the body’s fatty tissue and in the liver.

Vitamin D is necessary for the absorption of minerals (calcium, magnesium and phosphate), and it is also important for many other biological functions.

Apart from being present in a few foods and being available as a dietary supplement, Vitamin D is also produced endogenously when ultraviolet (UV) rays from sunlight strike the skin triggering vitamin D synthesis. The two most important forms of vitamin D in humans are  vitamin D3 (also known as colecalciferol) and D2 (also known as ergacalciferol). However, the form of vitamin D obtained from foods, supplements and sun exposure is pretty much useless in its actual form, as it is inert and must undergo an activation process that will turn the inactive form of calciferol in its active hormonal form called calcitriol.

Disclaimer:

All medical-related content and media on the Antonello Vona Website is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.

Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional, or delay in seeking it because of something you have read on this website.

If you think you may have a medical emergency, call your doctor, go to the nearest hospital emergency department, or call the emergency services immediately. If you choose to rely on any information provided by Antonello Vona, you do so solely at your own risk.

External (outbound) links to other websites or educational material (e.g. pdf’s, websites…) that are not explicitly created by Antonello Vona are followed at your own risk. Under no circumstances is Antonello Vona responsible for the claims of third party websites or educational providers.

Happy Face
Photo by Lidya Nada / Unsplash

Why is vitamin D important?

Once activated, the vitamin D (calcitriol) circulates in the bloodstream as a hormone, playing a crucial role in homeostasis, calcium and phosphate metabolism, bone health, regulation of the immune system to fight off invading bacteria and viruses, neuromuscular functions, and reduction of inflammation.

To date, researches have shown that vitamin D can have a lot of health benefits. Studies have found links between low blood levels of vitamin D and increased risk of depression, multiple sclerosis, and osteoporosis. The latter happens when long-term shortages of vitamin D and calcium cause your bones to become fragile and break more easily.

Levels of vitamin D in the blood

To know whether you are getting enough vitamin D you need to have a blood test to measure a form of vitamin D known as 25-hydroxyvitamin D. This is measured in either nanomoles per liter (nmol/L) or nanograms per milliliter (ng/mL). One nmol/L is the same as 0.4 ng/mL.

Levels below 30 nmol/L (12 ng/mL) are too low and can be classified as a deficiency.

Levels of 50 nmol/L (20 ng/mL) or above are considered as being normal for most people.

Levels of 125 nmol/L (50 ng/mL) are too high and can be considered as being too high and hence they are toxic.

Not everybody is the same, and some people are more likely to struggle to get enough vitamin D. These include:

  • Older adults;
  • People who never go out in the sun;
  • People with dark skin;
  • People with conditions that limit fat absorption, such as Crohn’s disease, celiac disease and ulcerative colitis;
  • Obese people or people who have undergone gastric bypass surgery;
  • Pregnant women;
  • Menopausal women;
  • Breastfed infants;
Vital test
Photo by Hush Naidoo / Unsplash

What are consequences of too little vitamin D?

Too little vitamin D can lead to a bunch of health problems, these include:

  • Serum reduction of calcium and phosphorus;
  • Secondary hyperparathyroidism;
  • Inappropriate mineralization of the bones (leading to rickets in children, and osteomalacia in adults);
  • Muscular weakness;
  • Abdominal pain;

What are consequences of too much vitamin D?

As anything in life, all the excesses can have a negative impact, and getting too much vitamin D is no exception to this rule, and it can be harmful.

Vitamin D blood levels (greater than 375 nmol/L or 150 ng/mL) can cause nausea, vomiting, muscle weakness, confusion, loss of appetite, weight loss and anorexia, hypercalcaemia (increased levels of calcium in the blood) and hypercalciuria (increased level of calcium in the urines), pain, soft tissue calcification, dehydration, kidney stone, and excessive urination and thirst. This can lead to kidney failure, irregular heartbeat, and even death!

You cannot get too much Vitamin D from sunlight because your skin limits the amount of Vitamin D it takes.

Photo by Micheile Henderson / Unsplash

What are the sources of vitamin D?

As mentioned above, vitamin D is found in supplements and a few foods. These include:

  • Fatty fish (mackerel, tuna, trout and salmon) and fish liver oils are the best source natural source of vitamin D;
  • Beef liver, cheese, and egg yolks – provide small amounts of vitamin D;
  • Mushrooms – minimal amounts of vitamin D;

In young and healthy adults, ten minutes of daily sun exposure is enough to get the amount of vitamin D that you need on a daily basis.

The amount of vitamin D that you need daily depends on many factors (age, underlying medical conditions, etc.).

In the table below you can find the daily recommended amounts of vitamin D according to the age range. These are expressed in mg (micrograms) and IU (International Units).

1 UI = 0.025µg of calciferol

1µg of calciferol = 40 UI of vitamin D.

  • 0 – 1 year = 10 µg (400 IU)
  • 1 -70 years = 15 µg (600 IU)
  • 71+ years = 20 µg (800 IU)
  • Pregnant and breastfeeling teens and women = 15 µg (600 IU)

Can vitamin D interfere with other medications?

Vitamin D can indeed interact with some medications:

  • Steroids such as prednisone – can lower your blood levels of vitamin D;
  • Orlistat is a weight loss medication – It can reduce the amount of calciferol your body absorbs from food and supplements;
  • Cholesterol-lowering statins such as atorvastatin, simvastatin etc., might not work as well if you take a high dose of vitamin D supplements.
  • Thiazide diuretics could raise your blood calcium level too high if you take vitamin D supplements.

Take-home points

  • Vitamin D (calciferol) is an important nutrient that we need in order to have a good bone health, metabolism, immune system and overall health;
  • Vitamin D can be found in certain foods, supplements and it is also produced by the body when the ultraviolet rays strike the skin;
  • Optimum levels of vitamin D vary between different age groups and its absorption can be affected by many factors;
  • Low levels and high levels of vitamin D can cause serious health problems;
  • In normal circumstances, you can get your optimal amount of vitamin D with 10 minutes daily sun exposure.

Caffeine & Productivity

Posted on by antonellovona

C8H10N4O2 , or also known as caffeine, is a bitter, white crystalline purine, a methylxanthine alkaloid, and is chemically related to the adenine and guanine bases of our double-stranded genetic material deoxyribonucleic acid (DNA) and single-stranded genetic material ribonucleic acid (RNA).

OK, enough with the biochemical mouthfuls needed for proper introduction. Now let’s talk about some interesting staff.

Caffeine is psychoactive drug that stimulates the Central Nervous System (CNS). In fact, it is the most common psychoactive drug consumed in the world as it is legal and unregulated, unlike other psychoactive substances. It is found in the seeds, leaves, or nuts of a number of plants native to Africa, South America and East Asia, but the well known source of caffeine is in the coffee bean, seed of Coffea plant.

It has a number of uses in the medical world to help treat and prevent a number of medical conditions, but we all know it for its energy boost that it gives us when we drink beverages containing it.

Fun Legend

Legend has it that, in the 19th century, a goat herder called Kaldi found out that his goats were hyperactive and behaving weirdly after eating some berries from a tree. Kaldi was eager to find out what was making his goats so energetic, and he decided to eat some of those berries. His heart started to beat faster, he felt more energized and he could not sleep at night. He then decided to tell the abbot of the local monastery about this, and the abbot came up with an idea: drying and boiling the berries to make a beverage. He soon found out that drinking that beverage kept him and his monks awake, and this was particularly useful when they had to pray at night. Those berries are what today we know as coffee beans.

How Does it Work

The longer we are awake the more a substance called “Adenosine” accumulates in our brain. Adenosine is the waste product of the breakdown of the energy molecules called ATP (Adenosine-Tri-Phosphate).

Adenosine then binds to the adenosine receptors and slows down our brain activity. This will make us feel more tired as we go through the day as more adenosine will accumulate the longer we stay awake.

Caffeine shares a similar molecular structure with adenosine, and this will help caffeine fit perfectly in the adenosine receptor, hence preventing the adenosine to slow down brain activity. It also prevents the reabsorption of a neurotransmitter called dopamine, and this makes you feel happy. This is probably why coffee can be so addictive, just like cocaine (but to a lesser degree).

Caffeine stimulates the production of adrenaline, which plays an important role in the fight or flight response. This will result in an increased heart rate, boost in energy, as well as opening up your airways, dilating your blood vessels, increasing your blood pressure.

The more you are exposed to caffeine the more adenosine receptors your body will create over time, meaning that you will need more caffeine to have the same results. Likewise, if you would abstain from caffeine for a few weeks, the adenosine receptors in excess will disappear.

The Timeline

Once ingested, 99% of the caffeine will be absorbed in your small intestine within 45 minutes entering your blood stream. Peak plasma concentration is reached within 1-2 hours.

In medicine we use the term “half-life” to indicate the time that the body takes to reduce by half the amount of an ingested drug. In case of caffeine, its half-life is approximately 5 hours – so, if you were to ingest 150mg of caffeine, it would take 5 hours for your body to eliminate 75mg of caffeine, and after 5 hours it will eliminate 50% of 75mg, which is 37.5mg, and so on and so forth.

Know the difference

For those of you looking to cut down or cut off their caffeine intake, it is very convenient to go for decaffeinated drinks thinking that they contain no caffeine at all, right? Wrong. Decaffeination process removes around 97% of the caffeine leaving that 3% the chance to still take an effect on your body. This is not really convenient if, like me, you like an after-dinner coffee, and you go for the decaf thinking that it has no caffeine to keep you awake. So, we blame our partner snoring like a tractor if we can’t fall asleep. Whenever you see on the label “decaf“, remember that it still contains caffeine and it carries its potential to knock out the adenosine molecules in your brain If you want to be certain that it does not contain caffeine, then you have to look for “caffeine-free” on the label of the beverage.

Can a caffeine overdose kill you?

Theoretically, the lethal dose of caffeine is 150mg/kg, which means that for an individual weighing 80kg it would take 12000mg of caffeine to kill him/her. A cup of coffee contains approximately 150mg of caffeine, which means that someone would have to drink at least 80 cups of coffee all at once for it to be lethal. It is impossible, because the stomach does not have the capacity to contain 80 cups of coffee, and you would experience delirium and hallucination way before it can kill you. So, the short answer to this question is: No!

Side-Effects of Caffeine

Consuming caffeine within moderate and recommended ranges is good for your productivity and general health. However, as per any other drug, excessive consumption can lead to some side effects:

Insomnia: One of the main reasons of taking caffeine is because it helps us to stay awake and alert when we need to be productive and focused. But too much caffeine can lead to insomnia, which is difficulty in getting enough restorative sleep. This can result in an increased time to fall asleep, disturbed sleep, and either waking up early angry and sleepy, or waking up late angry and sleepy.

Anxiety: The DSM (Diagnostic and Statistical Manual of Mental Disorders) includes caffeine-induced anxiety as one of the four caffeine-induced syndromes. In fact, continuous and elevated doses of caffeine can make you feel nervous or jittery and it can well lead to anxiety.

Digestive problems: Some people find their morning coffee a blessing because of its indirect effect to promote bowel movement. This laxative effect might be due to the release of the hormone “gastrin”, which is secreted by the stomach to speed up activity in the colon. High doses of caffeine though can lead to an excessive peristalsis (the bowel motion that permits the ingested food to move along the digestive tract), that could result in loose stools or diarrhea. Also, it can worsen a condition called gastro-esophageal reflux disease (GERD). It is also important to know that drinking caffeine on a empty stomach is a bad idea as it stimulates the acid productions (which are usually used to digest food) which are too aggressive for the gastric mucosa (internal lining of the stomach).

Addiction: As stated before, caffeine prevents the reabsorption of dopamine, which makes you feel happy – this also happens with cocaine and amphetamines too. This is why caffeine can cause a degree of psychological and physical addiction, but not like the other recreational drugs do.

Hypertension: Albeit temporary, caffeine does have an effect on blood pressure due to its effects on the nervous system. This results in a temporary rise of the blood pressure, which is not really ideal in people who suffer from high blood pressure, and are at risk of cardiovascular diseases.

Tachycardia: One of the many effects of caffeine is to make your heart beat faster. Again, in high doses this can lead to a condition called tachycardia and, as a study shows, it is linked to atrial fibrillation in young individual consuming energy drinks with high doses of caffeine. This effect does not occur in everyone, some people can be exposed to high doses of caffeine with no effect on the heart.

Fatigue: This is quite a paradox since we use caffeine to beat fatigue and boost our energy. However, excessive doses of caffeine can create a rebound fatigue effect that can make you feel more tired than usual the following day.

How to use caffeine to boost productivity

Caffeine can be a great friend when you need a boost of energy to be productive during the day. However, if you don’t know what you are doing and plan your caffeine consumption wrongly, it can be your worst enemy at night, preventing your sleep and affecting your productivity the following day.

So, my advice is: be strategic and do your math.

Try to delay your first caffeinated drink first thing in the morning. High cortisol levels and a good night sleep should make caffein obsolete as soon as you wake up, even though you feel like no one should dare to talk to you before you have finished your coffee. Instead, start your day with a full glass of water to re-hydrate yourself, as well as eating a well-balanced breakfast to start activating your metabolism, this already will give you enough energy to cope with people.

Try not to have high doses of caffeine past 3pm. Remember, your body will get rid of half of the amount ingested in 5 hours, and the last thing you want to happen is caffeine to interfere with the quality of your sleep. You can always choose decaffeinated or small doses of caffeine to maintain the levels of alertness, in this case green tea is a great option. Three cups of green tea replaces one cup of coffee in terms of quantity of caffeine.

You also need to identify when you need to be productive the most. I know that after lunch my energy levels drop drastically and I crave for a nap, but at the same time lunch time is a peak-time for my full-time job and I need all my energies and focus to in order to function. For this reason I try to have a cup of coffee between 11:00am and 1:00pm to keep my energy levels and productivity up for the rest of the afternoon.

How much caffeine is considered “moderate”?

If you made it to this point you have come across some statements like “moderate consumption of caffeine is good for you”, or “moderate consumption of caffeine is not associated with side effects”, and you might righteously starts to wonder “what the heck is moderate?”, “how much is it?”.

Well, the Food and Drug Administrator (FDA), the European Food Safety Authority, and Health Canada reached the unanimous consensus that 400mg/day of caffeine is considered as a moderate consumption, which is not associated with side effects in healthy adults. You can get this amount of caffeine with 4 cups of coffee.

Caffeine containing drinks

Here is a list of some drinks and their caffeine value. The first value in round brackets indicates the serving size, the second value in square brackets indicates the amount of caffeine expressed in mg.

                                            For example: Caffeinated products (ml) [mg]

Starbucks Coffee, Blonde Roast – Grande (470) [360]

Americano – Grande (470) [225]

Mocha – Grande (470) [175]

Espresso (25) [75]

Chai Latte – Grande (470) [95]

Green Tea (236) [35]

Herbal Tea (236) [0]

Pepsi Zero Sugar (590) [115]

Diet Coke (590) [76]

Red Bull (236) [80]

Conclusion

As for everything in life, moderation is the key, and caffeine consumption is not an exception to it. Know how to use it and it can be your greatest friend to help you out, abuse it and it will be your greatest enemy.

Sunscreens – Your Ultimate Guide

Posted on by antonellovona

Being outside in the sun makes us happy, it gives us vitamin D and it makes us look nice by giving us a nice tan. It also gives us freckles, moles, dark spots, burns, accelerates skin aging, creates wrinkles, disrupts collagen, and it is a well known risk factor for skin cancer.

As any other thing in life moderation is the key, and sun exposure is no exception. There are only two ways to avoid the damaging effects of the sun: you can either avoid it, or be exposed to it sensibly by protecting yourself with a sunscreen. Actually the truth is way more bitter than this: no single method of sun defense can protect you perfectly.

This is the perfect time of the year to talk about sunscreen, even though you should apply it whenever your skin is exposed to the sun, regardless of the time of the year.

But there is a problem, if you go to the pharmacy, supermarket, or even worse online, you will be inundated by the plethora of sunscreens you can choose from, coming in different bottles, different brands, different colors, different ingredients, different types, different prices and different SPFs.

Don’t worry! Antonello comes to rescue you, helping you to have a little bit more of understanding about the different ultraviolet rays, what to look out for when choosing a sunscreen, what to avoid, how to use it, and as usual, my favorite myth debunking.

Before I move on I need to highlight a very important concept: There is no gold standard rule to safely stay in the sun. Applying sunscreen is one of the many things you should be doing, but this is NOT the only thing you should be doing to protect yourself from the sun.

You are probably applying it in the wrong way anyway, so continue reading!

But first…. disclaimer time!

All medical-related content and media on the Antonello Vona Website is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.

Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional, or delay in seeking it because of something you have read on this website.

If you think you may have a medical emergency, call your doctor, go to the nearest hospital emergency department, or call the emergency services immediately. If you choose to rely on any information provided by Antonello Vona, you do so solely at your own risk.

External (outbound) links to other websites or educational material (e.g. pdf’s, websites…) that are not explicitly created by Antonello Vona are followed at your own risk. Under no circumstances is Antonello Vona responsible for the claims of third party websites or educational providers.

Ultraviolet Rays (UVR)

Before we jump into the core section of this article, it is important to shed some light on ultraviolet light as this is the agent we are protecting from when applying the sunscreen. Ultraviolet (UV) rays are electromagnetic radiation that come from the sun or man-made devices like sun-beds.

There are three types of UV rays:

UVA – Are the weakest form of UV rays. They penetrate into the deeper layer of the skin and are responsible for accelerated skin cell aging and indirect damage to cells’ DNA. They are responsible for long-term skin damage (like wrinkles), but they may play a role too in skin cancer.

UVB – They have a bit more of energy compared to the UVB. They are responsible for sunburns as they affect the outer layer of the skin (epidermis), as well as directly damaging cells’ DNA. They are thought to cause most types of skin cancers.

UVC – These types of UV rays are the strongest of the three, and because of their high energy they react with the ozone in the atmosphere and do not reach the ground. That’s why you probably never heard about them or read them on a sunscreen bottle because they do not cause skin cancer. However, these rays are often created by man-made tools like UV sanitizing bulbs to kills micro-organisms (in water, air, food, etc…).

UVA and UVB causes irreversible, cumulative damage to the skin cells. This means that if I go out in the sun today without a protection the UV rays will irreversibly damage my skin, and if I were to go on holiday in 5 years to the Maldives (I wish) and be out in the sun again with no protection, my skin will be irreversibly damaged and this will add up to the damage created by today’s unprotected sun exposure.

Are tanning sunbeds safe?

The short answer to this question is a big and loud: NO!

It is a very common misconception to think that tanning sunbeds are a valid alternative to the natural sun because it is safe(r) and that it can “prepare” the skin to the actual sun when you go in hot countries. The reality is that tanning sunbeds are more harmful than the sun itself, because 1 hour tanning session will expose you to 50% more UV rays than the midday sun. According to the BBC, it is estimated that 20 minutes on a sunbed is equivalent to four hours in the sun.

SPF

You have probably come across these three letters very often, especially when buying a sunscreen. Probably this is the only factor you take into account when choosing one, and probably you are also thinking “the higher the better”.

But what is it? SPF stands for Sun Protection Factor and it is a relative measure of how long the sun screen you are applying will protect you from UVB. That’s right! SPF does not apply to UVA, but it only applies to UVB, hence protecting your skin from sunburns and cancer.

Let’s say you are applying a sunscreen of SPF 30, it means that the sunscreen will protect you from 30 times more the time it would usually take you to burn. If you would usually burn after 20 minutes in the sun and apply a sunscreen of SPF 30 it will protect you for 10 hours. But again, this only applies to UVB.

At this point you might think “Oh my God, this is great! I am going to buy the one with the highest SPF number that I can find so that I am more protected”. Well… No. I am afraid to tell you that this is not the case, and it is very complicated to explain why, but I will try to keep it nice and short.

A product with an SPF of 30 allows only the 3% of UVB to hit the skin, whereas a product with an SPF of 50 allows the 2% to hit the skin. It is only 1% difference.

However, there might be a false sense of security when choosing a product with a very high SPF. People tend to stay in the sun for much longer and forget about reapplying sunscreen often because they think they are more protected.

There is no sunscreen with astronomically high SPF that offer 100% protection!

UVA star system

So, we know what to look out for in terms of SPF and protection against the UVB. But how can we see whether a product protects us against UVA and how do we choose the best one?

If the UVB uses an SPF index, UVA uses a star system. You will notice that there is a star rating on the packaging that ranges from 0 to 5 indicating the amount of UVA radiation absorbed by the sunscreen in comparison to UVB. It essentially indicates a ratio between the protection afforded by the UVA protection and the UVB protection. If you see a product with low SPF and high UVA stars, it doesn’t mean that that particular product offers higher protection against UVA, but because the UVA/UVB ratio is about the same.

Sunscreens offering protection for both UVA and UVB are sometimes called “broad spectrum”.

According to the EU Recommendation, the marketed UVA protection should be at least a third of the labelled SPF. When this condition is satisfied you will see the UVA logo printed, which is “UVA” in a circle.

Types of Sunscreens

There are mainly two types of sunscreens: chemical and physical sunscreens. The former acts as an organic filter absorbing UV radiations creating a chemical reaction that expels them out from the skin under the form of infrared energy.

The latter contain minerals that literally reflect UV rays making them bounce back from the skin.

An easier way to understand these two different types is to think of chemical sunscreens as sponges, and physical sunscreens as mirrors.

You can also have a combination sunscreen, containing both chemical filters and physical blockers.

Physical/Mineral Sunscreen

Physical sunscreen contain zinc dioxide or titanium dioxide. They are highly effective against both UVA and UVB, and they work instantly as soon as they are applied on the skin. Additionally, these ingredients have been recently proven to be effective in blocking the visible light. Visible light is responsible for skin discoloration like melasma, dark spots, and post-inflammatory hyperpigmentation – just to mention a few. So applying physical sunscreen can protect the skin against the visible light which is responsible for altered pigmentation in our skin.

Chemical/Organic Sunscreen

They contain a variety of “filters” that absorb the ultraviolet rays.

Unlike physical sunscreens, chemical sunscreens are not effective immediately after their application, but you would need to wait 20 minutes before getting exposed to the sun, and this is because they need tis amount of time to create a layer on your skin to protect you from the UV rays.

They work by absorbing ultraviolet rays and converting them into infrared energy expelled from the skin. They offer good protection against the UVB, but unfortunately they do not offer a great deal of protection against UVA. They are also not really reliable as they do degrade with time ad they also does not offer protection against visible light. So, if you are going for the chemical sunscreen, make sure it does cover you for UVA too.

Moreover, they can cause irritation to the skin, and this is not particularly indicated if you have skin conditions like acne, rosacea, seborrheic dermatitis, and eczema.

The good thing about chemical sunscreens is that they are cheaper when compared to the the physical ones.

How do I know if my sunscreen is chemical or physical?

Whilst there are a lot of ingredients that act as organic/chemical sunscreen, you can only find two ingredients that offer physical protection: Titanium Dioxide and Zinc Dioxide.

So, have a look at the ingredients list at the back and if you see either Titanium Dioxide or Zinc Dioxide then it is a physical or mineral sunscreen, if it doesn’t than it is a chemical sunscreen.

Chemical sunscreen ingredients are: Aminobenzoic acid, Avobenzone, Cinoxate, Dioxybenzone, Ecamsule, Homosalate, Mentyl anthanilate, Octocrylene, Octyl methoxycinnamate, Octyl salicylate, Oxybenzone, Padimate O, Phenylbenzimidazole, Sulisobenzone, Trolamine salicylate.

Stop buying high SPF!

People only look at the big, fat number on the bottle to determine whether a sunscreen is good or not. By now you should know that sunscreen quality goes well beyond a high SPF number.

“Dr David Lim, dermatologist and researcher, reports that “a sunscreen with an SPF of 30 is good enough, anything above is either marketing or crap”, he then continues “what really matters is the amount applied and frequency, things that people often forget about.” The recommended amount is 5 grams – which equals to one teaspoon. “

Stick with an SPF between 30 and 50. Anything above might be misleading and overpromising.

Where should I apply my sunscreen?

Sunscreen should be applied in every exposed area of your body.

There are often missed areas I want you to be aware of, these include ears, behind the ears, around the eyes, nose, all around the neck, and upper chest. The ears are a very common site for sun-related skin cancers to grow, especially squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), so make sure to cover them too. For what concerns the neck, you will thank yourself in 30 years time for applying sunscreen today, as it will avoid looking like a turkey.

At this point it is superfluous to say that, if you are in shorts, sunscreen has to be applied on your legs and feet as well and, if you are topless, it should be applied all over the top half of your body.

If you are on a nudist beach, well… you should marinate your font and bac

How often should I apply my sunscreen?

Let’s start by saying that sunscreen should be an integral part of your daily skincare routine (you don’t need to apply in your night skincare routine), regardless of whether you are planning to spend time outdoor in the sun.

Sunscreen should be reapplied every two hours if you are out in the sun, or sooner if you are doing activities that make you sweat. Also, it should be reapplied after swimming, and showering – You might say ” Dude, mine is water resistant”. Well, no doubt about that. But let me tell you, it does wash off. They can claim it to be water resistant as a cream, as it stays on you after you shower or swim, but is not thick enough to guarantee nor widespread enough to guarantee a solid protection.

Should I still wear sunscreen even though my make-up has it already?

Yes! This is because it is unlikely that you are going to be covering your entire face, ears, neck and upper chest with make-up, and these are critical areas that are often missed when applying sunscreen. You can apply your make as a follow up layer, but not as a stand-alone method for protecting yourself.

Sunscreen and environment

I have recently engaged in a very interesting conversation where I was told that sunscreen are toxic for the coral reef and the ocean in general.

As I was aware that certain skincare products (not only sunscreen) contain an ingredient called polyethylene, which is a derivate of plastic, and this cause harm to the marine life, since most of the times they are found in the form of micro-beads (like in the case of physical scrubs), that will eventually end up in the ocean and intoxicate the marine ecosystem.

However, upon further research, I cam across some claims that the ingredient Oxybenzone (found in chemical sunscreens) is responsible to bleach and damage the DNA of the coral reef. I must say though that I could not find and quality research paper that could back-up this claim.

But I came across this paper, where it talks about the measurements of this ingredient in the waters of Hawaii, but this was inconclusive and states:

“Overall, the impacts of oxybenzone and octinoxate to intact corals occur at much higher concentrations than this study found in seawater near coral reefs. Currently, there are only five studies that have looked at the toxicity of oxybenzone and/or octinoxate to corals, so much more research on the toxicity to corals is needed,” said Mitchelmore.

Here are some useful resources:

https://www.britishskinfoundation.org.uk/blog/sunscreen-explained
https://www.bad.org.uk/skin-cancer/sunscreen-fact-sheet
https://www.bda.uk.com/resource/vitamin-d.html
https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/sun-uv-and-cancer/how-does-the-sun-and-uv-cause-cancer
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC113773/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543289/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3781714/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004163/

How To Read Skincare Ingredient List

Posted on by antonellovona

By the end of this article I don’t expect you to know every single ingredient that is good and bad for you in a skincare product, it would just be impossible and even expert dermatologists don’t know all of them as there are hundreds of thousands out there. Instead, this article has more the purpose to educate you in how to get oriented in all those weird names, recognize if a product is as good as it says to be, what are the ingredients you should look out for and which ones to avoid, and most importantly to help you to be more of a mindful buyer.

Before I proceed I have to do the disclaimer thingy guys to protect my cheap as* for getting sued just in case you might read this article, which has a pure informative and educative purpose, as a medical advice – so:

Disclaimer:

All medical-related content and media on the Antonello Vona Website is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.

Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional, or delay in seeking it because of something you have read on this website.

If you think you may have a medical emergency, call your doctor, go to the nearest hospital emergency department, or call the emergency services immediately. If you choose to rely on any information provided by Antonello Vona, you do so solely at your own risk.

External (outbound) links to other websites or educational material (e.g. pdf’s, websites…) that are not explicitly created by Antonello Vona are followed at your own risk. Under no circumstances is Antonello Vona responsible for the claims of third party websites or educational providers.

OK, we can move on now.

As producers and pharmaceutical companies are not really legally required to list the concentration of each ingredient (at least for the non-medicated products) to protect their recipe, it might be a little bit difficult to determine at which concentration is a given ingredient. However, there are a few tricks that can help you to figure out if an ingredient is at a higher or stronger concentration than another ingredient.

Generally speaking, the ingredients in a skincare product are listed according to their concentration: the ones that appear at the very top of the list have a higher concentration and the more you progress through the list their concentration decreases – in fact, most commonly you will find Aqua (water) at the top of the list as it is the basic, and most abundant ingredient in all products.

Try to look at the first 7 ingredients, these will give you already some valuable information about the product: if there are ingredients at a higher concentration that you want to avoid, what active ingredients are there, or if there is an ingredient you know you are sensitive or allergic to.

Most products have an ingredient called Phenoxyethanol – this is used as a stabilizer and preservative that limits bacterial growth used in cosmetics (i.e. creams, soaps, and perfumes). The European Economic Community (EEC) Cosmetics Derivative and the Cosmetics Regulation of the European Union approved phenoxyethanol in concentrations up to 1%. This is a very important piece of information because we know that this ingredient can only be used up to 1%, and we also know that ingredients are listed according to their concentration gradient. So, anything above phenoxyethanol is likely to be more than 1% and all the ingredients below phenoxyethanol are more likely to be below 1%.

So, for example, let’s suppose you want to buy a skincare product with a good exfoliative active ingredient (i.e. Salcylic Acid or Glycolic Acid), you go to the supermarket or drugstore and find these two product that have these ingredients, let’s say you are looking for a product with Salicylic Acid:

Let’s say that both products launch the same message through their names “Salicylic Acid for good exfoliation and anti-blemishes”.

But when you turn the bottles over, and you read the ingredient list you see this:

Product 1

Aqua, Methylpropanediol (hydration), Butylene Glycol (hydration), Salicylic Acid (Beta Hydroxy Acid, exfoliant), Polysorbate 20 (stabilizer), Camellia Oleifera (Green Tea) Leaf Extract (skin calming/antioxidant), Sodium Hydroxide (pH balancer), Tetrasodium EDTA (stabilizer), Phenoxyethanol (preservative).

Product 2

Aqua, Cetearyl Alcohol & Polysorbate 60 (Emulsifying Wax), Helianthus Annuus (Sunflower Oil), Vegetable Glycerin, Olea Europaea (Olive Oil), Cocos Nucifera (Coconut Oil), Butyrospermum Parkii (Shea Butter), Prunus Armeniaca (Apricot Kernel Oil), Phenoxyethanol & Ethylhexylglycerin, Stearic Acid, Salicylic Acid, Zinc Oxide, Xanthan Gum, Allantoin, Hydrolysed Silk, Tocopherol (Vitamin E), Sodium Hyaluronate, Citrullus Vulgaris, Fragaria Vesca (Strawberry Fruit Extract), Vaccinium Macrocarpon.

Both Product 1 and Product 2 are very well known brands, and both have the same “Salicylic Acid” in the name of the product, and someone might even want to choose one product over the other for the loyalty they have towards a certain brand, but which one do you think it is more effective and less irritating to your skin?

Let’s take a closer look at both of them.

In Product 1, Salicylic acid is the 4th ingredient listed and it appears way before Phenoxyethabol, which means that its concentration is above 1%; in Product 2 it is the 11th of the list and it is listed after the phenoxyethanol, which tells us that it has a concentration of less than 1%.

Also, as you can see from the extensiveness of the ingredient list of both products, Product 2 has way more ingredients than Product 1, and those ingredients in excess (as you will learn later on in this article) can be extremely irritating to your skin as it has a bunch of stuff I usually run away from every time I see them listed (certain oil, fragrances, perfumes etc…).

If you haven’t figured that out yourself already, SPOILER ALERT! Product 1 is the one you might want to go for in this case.

So, which one do you think will be cheaper?

I love this example because it not only shows you how two different brands can claim to do the same thing, having the exact same ingredient, but one is way more superior than the other one once you look at the ingredient list, and it also debunks the myth that quality stuff are way more expensive than crap products. In this case Product 1 is a lot cheaper than Product 2.

I guess that by now I got your curiosity and you want to know what Product 1 is. Well, it is Paula’s Choice. Metti Link

Ingredients you might want to avoid

Some ingredients in skincare products can be really aggressive and irritating for your skin; some of them are really obvious, some others are less obvious. Since the purpose of this article is how to read a skincare product ingredient list and not “what to avoid in skincare products”, I will just concentrate on a few ingredients like fragrances and oils for now. So, here’s some ingredients you might want to be aware of and run away from should you see them on the top of the ingredient list:

Fragrances/perfume

We often associate the quality of a product by its smell, just like we do with food. I mean, if something smells so good that should be good for your skin to, right?

Wrong!

Unfortunately, most of the times what is good for the nose is not good for the skin and as pleasant as it can be to smell, fragrances and perfumes can be very bad for your skin, especially if your skin is very sensitive and delicate.

Pharmaceutical and cosmetic companies are not legally obliged to list every single scented ingredient they use to make their product appealing by making it smell nice, all they need to do is to put “Fragrance/Perfume” in the ingredient list. No matter if that contains 1 or 100 scented crap to make it smell nice.

So, should you see it within the first ingredients, put that down! Its concentration is way too high to be applied on your face or sensitive skin.

This doesn’t mean that if I find an fragrance in a skincare product I really like (because it has a lot of good ingredients) I won’t buy it , as far as it is not listed within the first few ingredients, its concentration is not crazy high, and it does not contain other irritating ingredients, I will buy it. But whenever I have the choice to avoid them, I will.

Essential Oils

Unfortunately, most of the times what is good for the nose is not good for the skin. The nice smell is often given by essential oils, which are volatile essences extracted from pretty much everything that has a smell (i.e. flowers, fruit, and seeds) and these can contain many substances – the majority of which are damaging for the skin.

Some essential oils are good for the skin, as they contain antioxidant (like caffeic acid and rosemarinic acid) and they can also help to fight the topical troublemakers of the skin, acting as antibacterial (fighting bacteria) or antimycotic (fighting fungi/yeast).

You can arguably say that there are some research out there showing that certain amounts (such as 0.1%) of these oils are non-irritating, but these studies don’t really take into account that skincare products contain more than one essential oil, probably at greater concentrations than 0.1%, and these will add up to a higher risk of irritation.

Skin is very good at hiding when it’s being irritated. So, even if you don’t see a reaction, the damage is still occurring beneath skin’s surface, cumulatively leading to problems you will see later on. Irritation is pro-aging, the opposite of what most adults want from skincare.

So the essential oils you might want to avoid and well-known to be aggressive and trouble-makers for the skin are all the citrus oils, like lemon, mandarine, tangerine, grapefruit, etc.; mint oils such as balm mint, peppermint etc.; and camphor oil. Other oils you want to avoid are: oregano oil, ylang ylang oil, sage oil, jasmine oil, ginger oil, eucalyptus oil, lemongrass oil, rosemary oil, neroli oil, and could go on and on for ages. So, my best piece of advice is to avoid all skincare products containing fragrant plant oils and extracts.

How do you do it? Simple! Try to let your nose to the shopping first (the product should’t have any nice smell), and check the ingredients to spot any fragrances/perfume/scented oils in it.

Resources

I know this might sound very overwhelming, and it is. There are thousands of ingredients you have to be aware of, good ingredients and bad ingredients that be have as such at different concentrations. This is why I think it is fair to share with you some resource to go and reference to whenever you feel stuck.

My number one suggestion is Paula’s choice dictionary. This is a very useful and powerful resource that will help you out to determine if an ingredient is bad or good.

Another great resource you can use in INCIdecoder. This will let you put in the brand of the product you want to check, and it will spit out the ingredient list, color coding them, and telling you if they are known to be allergens/irritants or if they are good ingredients for you.

Antonello Vona   ©  2024   –  All Rights Reserved
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