Welcome to the first of a summer bioethics blog series on drugs. In each of my bi-weekly blog posts, we will take a look at some myths and facts about chemicals, drugs, or pharmaceuticals that are widely used in the United States. The goal is not to offer medical advice, but to 1) help people be better informed and practice discernment in regards to medical care, and 2) address the medicine-as-salvation perspective that our culture perpetuates in a very practical way. I invite medical health professionals to make any comments since my background is in chemistry.
Disclaimer: I am not a medical doctor; I am trained as a chemist and bioethicist so DO NOT use this information in lieu of seeing a doctor. Overall, these posts are meant to be descriptive, not prescriptive.
I believe it is important that we are cognizant of how the drugs we are taking work, what they are meant to do, and what they can potentially do, including side effects. With this information, we can ask our doctors the right questions about medical care, and give them proper personal information to avoid drug interactions. Here are some assumptions to consider:
- EVERY drug has side effects; even the aspirin that you take for a headache has side effects. Furthermore, different people respond to different drugs and different dosages differently.
- Oftentimes, we must make a decision by weighing the positive effects of a treatment with the potential risks. This means that there is necessarily a different standard when a drug is taken by a perfectly healthy person for cosmetic or lifestyle reasons and a drug that is take to cure a life-threatening disease.
- These blog posts do not promote doctor-bashing, or medicine-is-evil tone. Doctors perform an important service, and my hope is that this helps you and your doctor with your health care. For example, our first topic is on sunless tanner. You may never think to tell you doctor that you used sunless tanner, but that might help him diagnose your symptoms.
- These blog posts do not promote an anti-alternative medicine tone, either. My aim is to promote discernment. Most of these posts will cover over-the-counter or prescription drugs, but I may address supplements or herbal remedies if time permits.
- The pharmaceutical industry has its problems (see my prior posts), and the FDA is not perfect, but compared to other countries, the U.S. has a good, regulated, standardized system. If a drug is FDA approved, I consider that a positive factor because we can assume that a drug has been through a certain level of testing and documentation.
Dihydroxyacetone (a.k.a. sunless tanner)
Based on my unofficial survey, most people are interested in knowing more about pharmaceuticals (or chemicals or alternative medicines) that are used for cosmetic, lifestyle, or symptom relief. For whatever reason, drugs used for curing disease seemed to not concern people as much as these “optional” drugs. However, any drug choices and treatment choices require discernment; just ask anyone who has had to weigh out the risks and benefits of various cancer treatments. The most popular drugs requests were Ambien, Zyrtec, and hormonal birth control. Since summer is in full swing, today’s drug is dihydroxyacetone, or the active ingredient in sunless tanning lotions and sprays. In two weeks, I will cover allergy medicines containing pseudoephedrine (e.g. Zyrtec and Claritin-D) and sleeping aids (e.g. Ambien).
By accident, chemists discovered that dihydroxyacetone (DHA, not to be confused with Docosahexaenoic acid, a common omega-3 supplement also abbreviated DHA) will turn skin a brownish color. By the 1960s, sunless tanning lotions were on the shelves, although they did not sell very well because the formulation had not been perfected, leaving people a bit more orange instead of brown. Modern formulations usually have a more brown-ish, “natural-looking” color, although coloration still depends on the user’s skin tone.
DHA is a ketone that reacts with the amino acids on the surface of your skin. The FDA reports that DHA does not penetrate past the skin’s outer layer. However, studies that were recently reported on ABC News indicate that a small percentage of DHA may penetrate below the first layer of skin. If DHA penetrates below the first epidermal layer, then it may go into the blood stream. Scientists are unsure of the effects of DHA in the blood stream, and while the very small amount that may enter the blood stream doesn’t pose a problem with a single use, the concern is for people who use the product on a regular basis.
The FDA has approved dihydroxyacetone for topical use only, but has not approved it as a spray because of the lack of data and testing. The FDA says contact with eyes and mucous membranes, including nose and mouth, should be avoided. The ABC report indicates that DHA may pose a risk to DNA and to lungs if inhaled or if it enters the blood stream, but these reports are still speculative. Spray tanning, particularly the kind where you stand in a booth, usually involves a high pressure spray that blasts the person all over his or her body. Very few salons offer the appropriate eye protection, nose plugs, or mouth covers, and few have regulations on whether you wear a swimsuit or not inside the tanning booth. Additionally, the FDA does not regulate spray tanning salons, which do not have to report the ingredients in their sprays. Any over-the-counter lotion must report all ingredients, so if someone has a reaction to one of the ingredients, he or she can bring the lotion to the doctor, but cannot say what is in the salon’s proprietary formulation.
As a final note, the FDA has received some reports from people who have had adverse effects from sunless tanners. As stated from their web site:
FDA has received reports from consumers stating that they have experienced adverse events associated with sunless tanning, including rashes and, primarily in the case of spray tanning booths, coughing, dizziness, and fainting. It is uncertain what, if any, ingredient or combination of ingredients in the sunless tanning products might have caused these adverse events, whether an individual’s allergic reaction might have played a part, or whether factors unrelated to the sunless tanning products may have been involved, such as pre-existing medical conditions.
See this FDA web site for good information on sunless tanners and bronzers.
As with most of these drugs or chemicals, I am not in a position to give a medical recommendation. If a drug or a chemical poses an ethical dilemma or is ethically problematic, then, as is appropriate for a bioethics blog, I will address that here and welcome comments. The immediate ethical issue I see here is the lack of data regarding the effects of DHA as a spray tanning solution. According to reports, many tanning salons are not knowledgeable on their products and some have given consumers inaccurate information. Furthermore, sunless tanner is a cosmetic product, which is important to consider when weighing risks and benefits. With cosmetic products it is important to honestly assess your personal motivations as to why you are using them, and to understand that the cosmetic industry is a lucrative business that seeks to profit from people’s personal insecurities. This isn’t to say using sunless tanners or getting a spray tan (or wearing make-up, or dying your hair, or using many other over-the counter cosmetic products) is bad, but it is certainly important, both for yourself and as an example to other young men and women, to carefully walk that line with integrity and discernment.