To Sun Or Not To Sun: Is There A Safe Way?

A question we get asked time and time again is, “What is the best treatment for aging?” Of course, there are many tips and tricks in the realm of anti-aging, and it may sound boring and mundane, but by far the best agent to have in your regimen is sunscreen. With sunnier days and warmer temperatures fast approaching, it’s important to understand how sun protection works and what you need to do to keep your skin healthy and safe. Sunscreen is a dermatologist’s best friend, and some dermatologists will go as far as to say that no tan is a safe tan, but do you really know what exactly is in that beautiful sun that you’re protecting your skin from?

Although the sun emits ultraviolet radiation at all wavelengths as well as visible light, the ozone layer (or what is left of it) absorbs UVC waves nearly completely. So the sunlight that reaches the surface of the earth and our skin is in the form of basically two different ultraviolet rays, UVA and UVB, where UVA makes up the bulk of the ultraviolet rays that reach the earth’s surface.

UVA rays are long waves that penetrate deep into the skin’s thickest layer, the dermis, which is also the second layer in the skin. Most of the UV rays that reach the earth are of the UVA type. Since UVA rays penetrate the skin so deeply, these rays are a major factor when it comes to wrinkling, sagging, leathery texture, and uneven pigmentation of the skin. Aside from the more cosmetic photoaging that UVA rays cause, studies reveal that UVA rays damage the bottom-most layer of the skin’s epidermis and thus damage the keratinocytes, which ultimately accelerate and trigger the development of skin cancer, especially malignant melanoma.

Since we are mentioning UVA rays here, we can’t forget to talk about tanning booths or beds, because the bulk of these artificial tanning rays are actually these terribly damaging UVA rays. We have blogged about this before several times, but more notably here in “Melanoma and the Myth of a Healthy Tan.” Quoting from our blog post, According to the Melanoma Research Foundation, ‘Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29 years old.’ It has placed tanning booths in the highest cancer risk category, where tanning booths are simply straight-out carcinogenic to humans. It states, “The use of indoor tanning devices (outside of medical practice) represents one of the most striking examples of an avoidable cause of lethal cancer in humans.’ In fact, studies have found that tanning booth use can increase your risk by 60-75%!” These deceivingly unassuming tanning bed rays will provide a tan glow to the skin, but will markedly increase one’s risk of melanoma and other skin cancers. Plus repeated exposure in a tanning bed is cumulative. Dr. Honet is always telling our patients that the skin never forgets all of these ultraviolet insults. And with UVA, you don’t even have to burn to accumulate the negative effects from it.

UVB rays are shorter waves emitted from the sun that more readily penetrate the superficial epidermal layers of the skin. UVB rays are the ones that cause most of the actual sunburns and reddening of the skin, although both UVA and UVB rays can cause sunburn. UVB is also a bad player in that it similarly contributes to the development of all forms of skin cancer. It is also responsible for the sustained, longer lasting tanning of the skin because it is the ray that actually increases melanin production in the skin, as opposed to UVA. The UVA in tanning beds causes immediate tanning of the skin, which only lasts for up to week because it is only causing an oxidation of existing melanin stores with a temporary release of these stores, rather than any increased production of melanin. And unless there is repeated and regular UVA exposure, there cannot be sustained tanning. In fact, unless the tanning bed has UVB rays as well or if you get a tan the natural way from the sun, the sustained tan from a tanning bed cannot be achieved. Only UVB can produce a lasting tan because UVB actually increases melanin production. Also, ironically, even though the skin appears tanner, studies have shown that tanning-bed tans do not offer any improved protection to the sun in any appreciable degree. Wow! Mind blown! Tanning beds are true scams, offering only temporary tanning, and are extremely dangerous as well.

Finally, did you know that tanning beds are addictive because the process increases the release of the body’s natural endorphins? That is why tanning beds can be addictive. And tanning actually weakens your immune system, impeding your body’s natural ability to defend itself and fight off inflammation and infection. It is ironic to think that the healthy look of tanned skin is actually masking a weaker immune system. And if you need more vitamin D in your system, best to take a supplement rather than trying to get your doses through the sun. (See Myth #3 in my blog post “Top 10 Myths About Skin.”) Adding all this to increasing your risk for melanoma and skin cancer, I am sure you are wondering why anyone in their right mind would continue to do tanning beds. We often wonder that ourselves. And our patients who have already been diagnosed with melanoma and skin cancer do as well, and very regretfully so.

So it’s common knowledge that sunscreens are topical lotions, creams, or sprays that contain a mixture of ingredients that protect your skin from the harmful UV rays from the sun. And with the recent FDA regulations in place, you’ll find an SPF number associated with these sunscreens that accurately reflect the amount of protection you will get. The key to keeping your skin healthy and safe while enjoying the great outdoors is understanding what SPF actually stands for and means. Sun Protection Factor or SPF measures the amount of time one can stay in the sun before the UVA and UVB rays start to damage and burn the skin. For example if your favorite sunscreen has an SPF of 40, that sunscreen will protect your skin from reddening and burning 40 times longer than your skin would last without protection. In order to be most effectively protected from the sun, a broad-spectrum sunscreen or multi-spectrum sunscreen is your best option, because this type of sunscreen will protect you from both UVA and UVB rays. It is also important to keep in mind that there are two broad categories or forms of sunscreens, namely chemical and physical. Chemical sunscreens contain ingredients that efficiently absorb the damaging rays and contain the UVA/UVB rays, thereby preventing the rays from reaching and damaging your skin cells. On the other hand, physical sunscreens contain active minerals that deflect the suns harmful rays away from the skin like a shield. Dr. Honet recommends both chemical and physical sunscreens equally, because the choice is truly a personal decision, but whichever one you choose, it must be broad-spectrum with an SPF of at least 30. For those with a history of skin cancer, dysplastic nevi, or a skin condition that predisposes to elevated sun sensitivity, Dr. Honet ups the ante and suggests an SPF of 45-50. And if you are at all vain in any way, protecting your skin from UV damage by applying an SPF of 45 or higher every day is essential. Note that using an SPF that is greater than 45-50 may seem like a good thing, but this is where more may not be actually better. An SPF higher than 45-50 may not really confer much more extra protection than an SPF 45-50 itself.

Another must-know sun protection tip comes in the form of sun protective clothing. Sun protective clothing is made from fabrics that contain active sunscreen ingredients, where the level of protection is measured by an Ultraviolet Protection Factor, UPF. According to the Skin Cancer Foundation, a typical white cotton t-shirt averages an ultraviolet protection factor (UPF) of only 5-7, meaning that your favorite cotton t-shirt protects you from only 1 out of 5 or 1 out of 7 UV units, which translates to a 80% or 85% protection respectively. And if the t-shirt gets wet, the UPF gets drastically ratcheted down to as low as a UPF 3 or only 67% protection. That’s how wearing a plain white cotton t-shirt swimming may result in a severe sunburn on the back and shoulders. A UPF rating of 30 means that the rated clothing will give 96.7% protection from the sun, while a UPF of 50 gives a whopping 98% protection. Some of our favorite brands include Solumbra®Coolibar® and Mott50® whose fashionable lines have clothing items for men, women and children ranging from beachwear, sportswear, hats, and accessories.

Before heading out to enjoy the great outdoors, be sure to remember these helpful sun-safe tips:

  1. Wear a broad-spectrum sunscreen with an SPF of 30-45, which is preferably water resistant as well.
  2. Apply sunscreen at least 10-15 minutes before sun exposure.
  3. Reapply frequently, about every 1 ½ -2 hours, because sunscreen wears off.
  4. Apply more often if sweating or being in contact with water.
  5. Don’t forget to apply SPF to your lips, ears, neck and scalp.
  6. Wear UPF clothing, like shirts and hats, as much as possible for added protection.
  7. Seek shade whenever possible.
  8. Don’t forget to protect your eyes. Your eyes are just as vulnerable as your skin to sun.
  9. Remember peak sun is between 10AM and 4PM, when most of the sun damage can occur.
  10. Babies younger than 6 months of age should not be exposed to the sun at all. Keep in mind that sunscreens have not been tested in babies in this age group either.
  11. Avoid tanning booths/beds completely. They are a known carcinogen and greatly increase your risk for the deadly skin cancer, melanoma, by up to 75%.

Let’s hope that spring and summer are really around the corner, and that all of us will be using these sun-safe tips a whole lot very, very soon.

Happy, Healthy Skin!

–Senada and Dr. H

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