The link between alcohol consumption and skin cancer is still being uncovered.
Some view drinking within the context of skin cancer as another high-risk behavior, which leads those who drink to participate in other risky behaviors, such as poor sun protection. Others, such as a group of researchers from Berlin, suggest that the consumption of alcohol tends to reduce the amount of factors in the skin, like antioxidants or carotenoids, which offer natural sun protection.
In the study of six men, researchers determined the carotenoid concentration in the skin and the minimal erythema dose before and after consuming alcohol or alcohol and orange juice combined. They showed a significant decrease in the carotenoid concentration in the skin and the minimal erythema dose after alcohol consumption, but no significant decrease after consuming a combination of alcohol and orange juice.
As the link to alcohol consumption and skin cancer is continually being revealed, should you talk to your patients about their alcohol consumption?
Healio Dermatology interviewed Anne Chapas, MD, founder and medical director of Union Square Laser Dermatology in New York City, about this link and how she approaches the topic with patients.
Should physicians talk to their patients about drinking alcohol outdoors and the need for sun protection?
Chapas: Especially in my expertise as a skin cancer physician, we generally talk to patients about general sun protective behaviors. We don’t typically tell patients not to drink outside.
The bigger concern is that someone is actually protecting their skin from the sun, habitually, by wearing SPF 30 or higher and reapplying often, and also avoiding direct sunlight from the peak hours of 11 a.m. to 2 p.m. Additionally, we encourage wearing sun protective clothing like hats and long sleeves with sun protection.
The alcohol component is one of the things that can help, but to practice sun protective behaviors on a regular basis is more important.
The German study showed a significant decrease in the carotenoid concentration and the minimal erythema dose after alcohol consumption, but no significant decrease after a combined intake of alcohol and orange juice. Do you have any thoughts on these results?
Chapas: I thought that was a novel way to look at what was happening. This study was a small sample of only five people, so it’s hard to extrapolate.
Certainly, people who drink regularly or have a problem with alcohol often have other nutritional deficiencies. The study doesn’t address that, but it seemed to suggest that the consumption of alcohol itself tends to reduce the number of factors in our skin that help to protect our skin in the sun, like antioxidants or carotenoids. So, if you’re drinking alcohol and going out in the sun, you’re going to be less able to prevent sunburn naturally.
The study seemed to suggest that if you have alcohol with high antioxidant foods, like orange juice, then you can mitigate some risk, but I don’t think that it’s enough. People should be wearing sunscreen and sun protective clothing and all of those things and not worrying about drinking orange juice with their alcohol.
What areas within alcohol consumption and skin cancer risk need more study?
Chapas: This was really a small study of just six people, all men. Certainly, women have a different manner in which they metabolize alcohol. The more recent studies in alcohol consumption show that there is little health benefit and advise consuming as little as possible.
It’s another piece of the puzzle and goes to show that your overall health and well-being is important, like what you eat and drink and how you protect yourself not just in skin cancer, but in how well people age.
Darvin ME, et al. Skin Pharmacol Physiol. 2013;doi:10.1159/000343908.
Disclosure: Chapas reports no relevant financial disclosures.