Nothing ruins Dr. Robert Bibb's day like having to tell the mother of an 8-year-old her child has cancer.
At Waccamaw Dermatology & Plastic Surgery, the practice he opened in 1984, Bibb has witnessed melanomas steadily rising in younger people, including the type usually found in 40-somethings who've been grilling themselves outdoors for decades. It's enough to convince any environmental dermatologist with a passion for cancer prevention that over-the-counter sunscreens aren't living up to their hype.

"They do protect against ultraviolet B rays that cause sunburns and increase the risk of some cancers," Bibb wrote in the spring edition of Women & Cancer magazine. "The bottom line is that while sunscreens have disabled the body's early warning system - namely sunburn - and have created a false and dangerous sense of security in the minds of consumers, they're all we have for now."

According to the Skin Cancer Foundation, more than 1 million skin cancers are diagnosed in the U.S. every year. Ultimately, skin cancer affects one in five Americans. While most cases caught early are highly treatable, this year more than 8,100 people will likely die of melanoma, the most deadly form of skin cancer.

That doesn't sit well with Bibb, 59, who lost his dad to lymphoma after an 11-year fight. So after a typical day of seeing some 50 patients in his office, he hits the weights, bikes 25 miles, serves up a vegan entree and spends the rest of the evening probing the culpability of sunlight, hormones and pollution in degenerative disease.

Fortunately, his batteries recharge on about five hours of sleep a night.

For Bibb, research is not only a hobby, it's an obsession. He doesn't hesitate to query other researchers, even those with seemingly bulletproof credentials, about their theories.

"Most people think they're unapproachable," said Bibb, who has little patience with ivory-tower snobs. "I track people down through university Web directories. Just pose a question to them. There are no stupid questions."

Bibb does nothing halfway, including sports.

"I ran until eight years ago, I ran 8 to 15 miles every day - completed eight marathons. It was a compulsion, the endorphins, the runner's high. I thought something bad would happen if I stopped running," said Bibb, who took up the sport in medical school, when his bike broke and he couldn't afford to fix it.

This month, working out the kinks in his new glow-in-the-dark sunblock tops his perpetual "to-do" list. The active ingredient is a nontoxic, inorganic crystal that's used in children's toys and made from silicone dioxide (sand). It's insoluble in water and oil while remaining stable to 800 degrees Fahrenheit. Just walk in a dark room to see if you missed a spot.

"In theory, if skin didn't slough, you'd never have to reapply it. The crystals don't absorb or enter the skin. There are concerns now about chemically based sunscreens," Bibb said. "We have to get Food and Drug Administration approval [on the crystals], but it's already being used in other stuff. Kids are chewing on them."

The new product won't be something you'll be able to slather on junior next week. Development takes time. It's a painstaking process of trial and error.

"The challenge is the particle size. We've got to fill the gaps. Below a certain size - 7 microns - they lose the efficiency to absorb ultraviolet light. If you grind it, it loses its crystal properties, you have to filter it, screen it to 8 to 20 microns."

Pharmacologist Jim Dews mixes the crystals, imported from Germany, in a waterproof base at his Dallas research lab.

"They hire us to do the formulating. The big problem so far, when you put [the crystals] into the base most sunscreens use, they separate. They're not even throughout the lotion," Dews said. "What would give you better shade, a tin roof or chicken wire? We need even distribution. We're talking about little teeny, tiny particles."

If testing goes well and Food and Drug Administration approvals move quickly, the final product could be on shelves in about two years. But when it comes to sunscreens, speed hasn't been the FDA's forte. They've been tweaking industry standards for almost 30 years. Bibb says they don't enforce the ones they have now. And he's not alone.

Dangerous claimsIn June, the Environmental Working Group, a nonprofit devoted to protecting human health and the environment, unveiled a disturbing report on 785 commonly available sunscreens. More than 84 percent with SPF ratings of 15 and above failed to provide adequate protection from the sun's rays or contained potentially problematic ingredients. The group found that many claims of "waterproof" and "lasts all day" were misleading.

"In response to FDA's failure to set enforceable standards for sunscreen, citizens have filed nine class-action, false-advertising lawsuits in California; the Connecticut state attorney general has petitioned the agency to set standards; and six senators have written FDA, urging the agency to issue sunscreen regulations to protect the public from skin cancer," the group reported on its Web site.

The study also found that in sunlight, sunscreens often break down in a matter of minutes, which is what Bibb has been saying all along.

For now, he recommends a new product: Anthelios SX with Mexoryl, SPF 15 (if you are in a car all day) or 30, to patients for the best protection against UVA and UVB rays. But at about $29 a pop, it's pricey. For adequate coverage of four adults spending a week at the beach, that's about $580 - or more for larger folks. Bibb knows most families can't afford that kind of protection.

"In the lab, sunscreen is tested at 2 milligrams per square centimeter of skin, so covering the average bikini-wearing woman takes at least an ounce. Bigger people need more," Bibb said. "But the labels don't tell you that."

Bibb's sunscreen will have a dosing pump, and while the price isn't set, it should be affordable for most families.

Miami Herald dispute
In November, Bibb wrote a column that was featured on the Miami Herald's op-ed page. He expressed his concern that higher melanoma rates may be paradoxically linked to increased reliance on sunscreens and a subsequent sense of invulnerability.

One week later, the paper printed a response signed by several University of Miami faculty members, including the chairman of the dermatology department, retorting that Bibb was "incorrect," blaming other culprits for melanoma's rise.

Among one's left-brained peers, that's the intellectual equivalent of mud wrestling. Bibb suspects he sparked a turf war and has been drafting a fully documented response fit for a scientific journal.
"[Their response] is not the official position statement of the American Academy of Dermatology," Bibb said.

Ironically, both parties agree on the key issue that skin cancer is on the rise and sunscreens aren't perfect, but no one should leave home without them.

The FDA has been under considerable pressure to incorporate some rating system for UVA rays. Bibb expects them to adopt measuring critical wavelength, which would arm buyers with more information to compare sunscreens.

Trial and error
"I filed a patent for a dog bar with raspberry seed extract. Pitched it to Artemis, a small dog-food manufacturer," Bibb said. "The No. 1 cause of death in dogs, besides cars, is cancer."
He readily acknowledges that no one may be interested. But Bibb's been fascinated with the protective properties of raspberry seeds for at least a decade, primarily in people.

"I went to a lecture by Dr. Daniel Nixon [at Hollings Cancer Center] about his work with raspberries fighting cancer," Bibb said. "He had people consume raspberries and then studied their blood. He showed the cancer-fighting properties."

In Bibb's hands, that knowledge led to Raspberry Rejuvenation Creme, part of the dermellage Skin Care Regimen he launched in 1999, and Razz-Tabs, a raspberry seed nutraceutical tablet offering chemopreventative benefits of ellagic acid.

"My husband had a high PSA [prostate-specific antigen] level and went on them. We won't do without our Razz-Tabs. I believe in it so much," said Barbara Reynolds, a nurse on Bibb's staff, who attributes her husband's lower PSA to the antioxidant.

Bibb said the cream "dramatically reduces the effects of sunburn in hours and prevents peeling." He recommends using an antioxidant cream under sunblock for better protection.
Peer reviewKnown to friends as "The Bibbster," Bibb likes to dazzle the doctor crowd with his latest theories, but even his peers can be overwhelmed. Bibb says they express their awe with comments such as:

"What's he talking about ... raspberries?"
"Bob's off on that dairy thing again."
"Bob says 'blah, blah, blah, blah.'"
"Bob, I have absolutely no idea what you're talking about."

His friend and colleague of 30 years, Dr. Jeff Eggart, a Surfside Beach lipidologist who once worked with him in a Walterboro emergency room, says Bibb's curiosity is insatiable.

"He's always been like that. He wakes up in the morning at 5, and his mind is racing," Eggart said. "He's brilliant, and he's very interested in molecular biology of aging. It's unusual to have a person of that caliber in the community.

Reynolds, his nurse of 20 years, wanted to retire but ended up returning to Bibb's office part time.
"He spoiled me. I just felt like I was missing out staying home. He's such a great teacher, and his mind never stops - it's constantly going. If you give him a cup of coffee with a little caffeine, we have to run to keep up with him."

At 68, Reynolds has been around doctors in hospitals, offices and medical university settings when things get tense. But she's never seen Bibb in a bad mood.

"He never puts you down. I've seen other doctors interact with their staff when they get ugly. You never ever experience anything like that here," Reynolds said. "You won't find anybody who worked with Dr. Bibb who doesn't love him."

His girlfriend, Barbara Busse, 47, who has a permanent makeup business in Bibb's Little River office, has never witnessed his mood change, either. She says dating him is the most fun she's ever had.
"I wish that I had energy like that. His brain never stops - the scientific information just keeps coming," she said. "But he likes to have fun, too."

Bibb, who has been married three times, was worried that his obsessive-compulsive side - running around scooping up crumbs and a tendency to straighten magazines in other doctors' waiting rooms like TV detective Adrian Monk - might make her uneasy, but after raising four kids, Busse counts it as a plus.
"I'm not used to a man doing that, but it's wonderful," she said. "And he's a great cook. It's always extremely healthy and has to be an artistic creation."

She's taken on the role of head gardener in Bibb's backyard vegetable patch, which even has some tiny pumpkins for his two grandchildren.

His art-filled home is every bit as antiseptic and clutter free as his dermatology office. Bibb's study is neatly layered in perfectly perpendicular piles of research studies and chapters of the book he's writing, all aligned with geometric precision on a lint-free mocha area rug.

"I suppose I could change, but I hate dirt," he said.