AAMC Magazine

Summer 2003

Protect Your Skin from Sun Damage

“Wear sunscreen,” Mary Schmich of the Chicago Tribune advised in a 1997 column. “If I could offer you only one tip for the future, sunscreen would be it.” Schmich also said to travel, dance, keep your old love letters, and “do one thing every day that scares you.”

Schmich is right, local dermatologists suggest — at least about the sunscreen.

If Stephen Dalton, M.D., could convince his patients to do only one thing differently, it would be to reapply sunscreen when outdoors. “They think that because they applied it once, they have license to stay in the sun all day. But sunscreens are not fully effective unless you reapply them,” says Dr. Dalton.

Experts generally recommend a broad-spectrum sunscreen with a Sun Protection Factor (SPF) of 15 or higher and reapplying it every 2 hours. But a recent study found that sunscreens do not work to their full potential unless you apply them 20 minutes before going outside, 20 minutes after arriving outside, and then every 30 minutes, Dr. Dalton notes.

And studies show that people don’t put on enough sunscreen, says dermatologist Angela Peterman, M.D. “It takes a lot to cover your whole body — a couple of ounces. For a week at the beach, my family goes through two or three bottles,” Dr. Peterman says.

The ABCDs of Melanoma
A		Asymmetry— One half doesn't match the other half.
B		Border irregularity— The edges are ragged, notched or blurred.
C		Color— The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance.
D		Diameter— The width is greater than six millimeters (about the size of a pencil eraser). Any growth of a mole should be of concern.

Reprinted with permission from the American Academy
of Dermatology. All rights reserved.

A common question that Drs. Dalton and Peterman field is, “What’s the best sunscreen?” Their advice:

• Never use anything less than SPF 15, no matter what your skin type.
• Be sure that your sunscreen protects against both UVB (the burning rays) and UVA (rays that cause long-term aging, wrinkling, and skin spots). SPF numbers refer only to a product's UVB blocking power. To effectively block UVA, the sunscreen should contain Parsol 1789 (avobenzone).
• Choose the right sunscreen for your skin type. For dry skin, use a lotion or cream. If you have acne, avoid oily products that clog pores; look for the words "noncomedogenic" on the label. Because gels and liquids spread easily and are nongreasy, men favor them.

Dr. Dalton sees far more skin cancer in Anne Arundel County than he did in California and, he points out, “I think the high incidence in this area has to do with the popularity of sailing, boating and golf. People are indoors all winter and as soon as nice weather comes they’re outside.”

Dr. Peterman sees more skin cancer in her practice than she used to, which she speculates is partly because “the baby boomers, with their culture of sunning themselves, are aging.” Cases of melanoma, the most deadly form of skin cancer, more than tripled among Caucasians in the U.S. between 1980 and 2003. More than one million cases of non-melanoma skin cancer are diagnosed in the U.S. each year. Overall, the risks of overexposure to the sun include painful sunburn, premature aging, skin cancer, cataracts, and immune system suppression.

To enjoy the sun safely, experts advise the following:

• Limit time in the midday sun — between 10 a.m. and 4 p.m. — all year round, even on cloudy days.
• Seek shade whenever possible.
• Apply sunscreen before you leave the house and reapply often if you sweat, towel off, or keep getting in and out of the water. Remember to coat your face, ears, nose, lips, neck, hands and any exposed scalp.
• Wear a broad-brimmed hat.
• Cover up in tightly knit long-sleeved clothing and slacks.
• Wear sunglasses that block at least 99% of UVA and UVB radiation. Wrap-arounds are best.
• Keep babies younger than 6 months out of the sun, but use sunscreen if sun can't be avoided.
• See your doctor if a mole changes in size, shape, or color or you develop a sore that refuses to heal. Most skin cancers are curable when caught early.

Quiz: Dispelling Myths about Sun Protection

How much do you know about keeping your skin safe? Take our True or False quiz.

Questions:

1. Getting a tan is healthy and protects your skin.
2. Since most skin cancer appears after age 50, younger people needn’t worry about skin protection.
3. Straw hats and baseball caps are the best head coverings.
4. The radiation from sunlamps and tanning parlors is safer than the sun.
5. Only fair-skinned people are at risk for skin cancer.
6. Wear sunscreen only when you plan to spend time in the sun.
7. Sunscreens stay good indefinitely.
8. Women are more likely to wear sunscreen than men.

Answers:

1. F There is no truth to the belief that a “base tan” is good. A tan is a signal that skin cells have been damaged.
2. F Protection must start in childhood to prevent cancer later in life.
3. F It’s best to wear hats of tightly woven fabric, such as canvas, with a 3-inch brim all around. Baseball caps leave the ears and neck exposed; straw hats have too many holes.
4. F Despite tanning parlors’ claims, artificial UV radiation is as damaging as the sun.
5. F The greatest risk is among people with blond or red hair, blue, green, or gray eyes, a history of blistering sunburns in childhood, many moles, or a family history of skin cancer.
6. F Protection from sun exposure is important year round, regardless of the temperature, clouds, or haze. And UVA rays can penetrate windows.
7. F Sunscreens have a shelf life of about two years. If the expiration date is past or the product seems gritty or separated, throw it away.
8. T To help men remember to apply sunscreen it should become a morning ritual, like shaving.

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