It is important to understand that this does not mean you should not be out in the sun as sun also provides a number of benefits to your body. The key is in not being in the sun too much. Sun protection comes in many forms. The type of program that you use all depends on your individual needs and the way that you respond to these treatments. For instance, some skin conditions, such as lupus, worsen due to a large amount of ultraviolet rays.
On the other hand, certain conditions like psoriasis can actually improve by taking in a good amount of these rays. In both instances, sun protection is needed but at varying levels. Typically, medications and sunscreen can be utilized for skin protection, both of which work very well. By scheduling an appointment with us, we can identify the skin protection program that is best for your needs.
In general, you should consider such factors as the price, if you like the feel of it on your skin and whether it fits the intended occasion. People with sensitive skin typically prefer ointments or lotions while others may prefer liquids and sprays. Those with acne should use sunscreen without oil. It is also important to understand that the higher the SPF, the better protection you receive from ultraviolet rays. If you are going swimming, you will want a water-resistant sunscreen.Is there such a thing as too much sun protection?
Probably. But don't use that as a an excuse – most get too much sun.
Sunlight has good effects and bad effects. Especially the visible parts of sunlight (the part you see) plays a significant role in your sense of well-being. Did you know that the inside of your body is not dark? There is actually light (mostly red) inside your entire body when you are out in sunlight or in artificial light. We know of some beneficial effects of that light such as mood elevation, improvement of certain disease such as acne, and more rapid repair of cell damage (as may occur in the brain after a stroke). There may be other benefits we do not know about at our present state of knowledge. Medically, when we are talking about sun protection we are talking about the invisible rays (so-called ultraviolet) that are not associated with those beneficial effects.
Even some of the invisible rays do good things for your body as well. Probably one of the most important that we know about is the production of vitamin D. Certain ultraviolet rays (called UVB) are critical to your body's production of vitamin D. We are now learning that vitamin D is may be important not just for healthy bones but for a healthy immune system, a healthy heart, and for the reduction of risk for certain cancers as well as diabetes (www.scientificamerican.com/article.cfm?id=vitamin-d-deficiency-united-states
). In Florida probably just 10 or 15 minutes of sun a day will fulfill your need for vitamin D. But if you are at risk for skin cancer or don't want to look old before your time, adding those few extra minutes may not be worth it – especially on your face. The American Academy of Dermatology (www.aad.org
) recommends taking oral supplements of vitamin D rather than trying to get your daily requirement with a daily dose of future skin cancer and wrinkles. In those practicing sun protection the American Academy of Dermatology recommends 1,000 international units a day in adults. The American Academy of Pediatrics (www.aap.org
) recommends a daily dose of 400 international units daily beginning in the first few days of life for all children. Just for the record I take 1,000 international units of vitamin D daily (as well as another 400 international units in a daily multivitamin).
But if you do decide to get your vitamin D with a daily dose of sunlight instead of an oral supplement, why not use a sunscreen to protect areas like your face and ears that are highly susceptible to skin cancer
? The other areas of your skin produce plenty of vitamin D just fine. skin diseases
, certain medications, and certain inherited conditions (such as xeroderma pigmentosa or one of the porphyrias) present special needs that dictate very personalized strategies for sun protection. If you have special needs, the following general advice should still be helpful but it will need "tweaking."
Everyone should assess his or her risk factors in designing a sun protection program. Important factors that make sun protection more critical include fair skin, growing up in a sunny part of the world, an outdoor lifestyle or occupation, relatives with skin cancer, increasing age, or a personal history of skin cancer. The more any of these factors play a role in your own makeup, the more important it is to develop and adhere to a conscientious sun protection program.
The final ingredient in designing your personal sun protection program is the one that you and only you can determine – priorities. Patients often think that because I am a dermatologist that I must be sun vigilante. I tell them my job is not to be your mother. It is to alert you to risks and help you develop strategies to minimize those risks. I use this story to explain what I mean.
I drive a car. I know that people get killed or severely injured in car accidents. If I did not drive a car or ride in a car, I could completely eliminate that risk. But it is worth it to me to be able to drive and ride in a car. But I drive a car that has many safety features. I try to drive safely. I am not out cruising around when the bars let out at night. I always wear my seatbelt. Those are the things I am willing to do to reduce my risk. So, in terms of sun protection each person has to ask what are they willing to do. Hopefully, the following list of suggestions will help you fashion your own strategy within your own risk and priority parameters. Strategies for sun protection.
1. Never go outside.
This is the most effective, though extreme, strategy. For most people it is ridiculously
extreme. But if you were born with xeroderma pigmentosa this strategy has a lot of merit. (Xeroderma pigmentosa is a skin disease in which sun damage to the DNA of the skin is not repaired by the normal DNA repair mechanisms most of us have. Because of that deficiency, people with this disease develop all kinds of skin cancers during childhood and without aggressive sun protection die of one of those skin cancers before becoming adults.)
2. Reduce your outdoor exposure, especially between the hours of 10 am and 4 pm (Daylight Saving Time) or between 9 a.m. and 3 p.m. (Standard Time).
Because UVB rays are more effectively screened out by the earth's atmosphere, they are less intense in the early morning and evening when the sun's rays have to go through a thicker atmospheric layer. Avoiding mid day sun helps reduce your exposure to UVB. UVB produces the most common kind of sunburn and is generally considered to be a culprit in producing basal cell
carcinomas, malignant melanomas, and squamous cell carcinomas
– the three most common skin cancers. But here is a caveat: UVA (the longer ultraviolet wave) is not effectively screened out by the earth's atmosphere and is just as bad throughout the day. UVA has been associated with increase risk of squamous cell carcinoma and malignant melanoma
3. Be more careful in the summer than the winter. There are more powerful ultraviolet rays during the summer than winter.
4. Wear sun protective clothing when outdoors. If it is covered up, it has some degree of protection. How much protection depends upon what covers it. A fairly thin white cotton shirt might have a sun protection factor of 3 or 4 (which means that it takes three or four times longer to get a sunburn than if there were no shirt at
all). A thick canvas shirt might have many times that protective factor. In general, the thicker the weave, the better the screening. Also, the color of the fabric matters. Red, blue, green screen out more than lighter colors. How it is washed makes a difference. If clothing is washed with a detergent containing optical
brighteners (makes things look... well, brighter), you might pick up an extra sun protection factor. Optical brighteners are molecules that absorb ultraviolet energy (which is invisible) and convert it to visible light energy while giving off any left over energy as heat. The light being produced by that chemical reaction actually makes clothes look brighter. Reduced ultraviolet energy is a beneficial side effect. If you really want to increase a fabric's sun protective qualities, washing clothes in Sun Guard made by Rit.
) impregnates a sunscreen into the fabric. It eventually washes out (the claim is that it lasts 20 washes), but initially anyway it may provide the equivalent of a 30 sun protective factor. It is readily available either from Rit or online retailers such as amazon (www.amazon.com
). The nice thing about Sun Guard is that you can treat the clothes you have – and like. Finally, special sun protective clothing is sold by many retailers. In general, increased sun protection is accomplished either with a special weave in the fabric or by adding sun screen chemicals. Coolibar (www.coolibar.com
) and Solumbra (www.solumdbra.com
) are two well-established brands. Many of my patients obtain their sun protective clothing through Target (www.Target.com
5. Wear sunscreen. Wear at least an SPF 15 broad spectrum sunscreen. No one has ever shown any disadvantage of wearing a sunscreen with a higher SPF, so more might be better. In general, the higher SPF sunscreens provide more UVA protection as well. For more information about sunscreens, go to the sunscreen discussion
on this website. www.aad.org
The Center for Disease Control is another site worth visiting. www.cdc.govDisclaimer:
The medical information published on this Web site is not intended to serve as a substitution for a thorough evaluation from a qualified physician. Furthermore, no one should act upon any of the information (including medical conditions or procedures) contained within this Web site without appropriate medical advice based upon a qualified physician's thorough examination and medical assessment. Patient testimonials on this Web site reflect that person's freely offered individual opinion and experience. Each person's situation is unique, and no two patients should expect to have identical experiences or outcomes.