Systemic Photoprotection in Skin Cancer Prevention: Knowledge among Dermatologists

Abstract

Background: Systemic photoprotection (i.e., administration of substances such as nicotinamide, carotenoids, and vitamin D) may be important to reduce photocarcinogenesis or to support long-term protection against UV irradiation. Clinical trials showed that oral nicotinamide is effective in reducing the onset of new nonmelanoma skin cancers (NMSCs), while other oral photoprotectors failed to achieve the reduction of new melanoma or NMSC formation in humans. The aim of this study was to summarize the current state of knowledge of systemic photoprotection and to evaluate the knowledge and attitude of dermatologists regarding these treatments. Methods: The survey was conducted on a sample of dermatologists recruited according to a snowball sampling procedure. The questionnaire consisted of a first part asking for characteristics of the participant and a second part with 12 specific questions on their knowledge about systemic photoprotection, particularly their knowledge of astaxanthin, β-carotene, nicotinamide, and vitamin D3. Results: One hundred eight dermatologists answered the survey. Most of them (85.2%) stated that oral photoprotectors have a role in the prevention of skin cancer, and responses mainly mentioned nicotinamide. More than half of them (54.6%) had prescribed all the considered oral photoprotectors, but the majority of them had prescribed nicotinamide, mainly for 2 to 3 months during summer, almost invariably (n = 106) associated with topical photoprotectors. Most dermatologists (>80%) were aware of scientific publications demonstrating an effect of systemic photoprotectors on NMSC. Conclusions: Most Italian dermatologists have positive views on oral photoprotection in skin cancer and are aware of the demonstrated potential of nicotinamide in the prevention of NMSCs.

Attitudes among dermatologists regarding non-melanoma skin cancer treatment options

“…The study methods have been described in detail elsewhere [ 17 ]. In brief, dermatologists who agreed to be included in the study signed a written informed consent before entering the study.…”

Carotenoids in Human Skin In Vivo: Antioxidant and Photo-Protectant Role against External and Internal Stressors

“…Currently, the terms “oral photo-protection” [ 279 ] or “nutritional protection” [ 280 ] are widely used, implying an increase in skin photo-protection through the consumption of antioxidant-containing products and/or dietary supplements for antiaging [ 279 ] and skin cancer prevention [ 281 ]. However, the increase of sun protection factor that is induced by endogenous carotenoids is low and skin photo-protection is mainly induced by the antioxidant properties of carotenoids [ 265 ], thus the topical application of sunscreens is recommended for optimal UV protection [ 282 ].…”

Knowledge and the behavioral patterns of photoprotection among Koreans with skin disease

“…Various population surveys of awareness and practices of photoprotection have been conducted mainly in Western countries. 3,[14][15][16][17][18] In the past, the focus of education on photoprotection was relatively less on ethnic groups with darker skin, such as Koreans, due to their lower incidence of skin cancer compared with Caucasians. 19,20 Although the need for photoprotection education has increased with the rising incidence of skin cancer along with increased life expectancy and growing interest in beauty to prevent photoaging, studies involving photoprotection knowledge and behavioral patterns among Koreans have been limited, particularly in people with specific skin disorders.…”

“…Various population surveys of awareness and practices of photoprotection have been conducted mainly in Western countries 3,14–18 . In the past, the focus of education on photoprotection was relatively less on ethnic groups with darker skin, such as Koreans, due to their lower incidence of skin cancer compared with Caucasians 19,20 .…”