Fun in the Sun? Not So Fast!
by Alan Kronhaus, M.D., Health and Welllness Editor

As we head for fun in the sun this summer, the nags are in hot pursuit. “Protect yourself from the sun!” they say. And they’re right. In fact, if you don’t protect yourself from the sun, not only will you burn, but you’ll dramatically increase your risk for getting skin cancer, the most common form of cancer in humans. If that’s not enough to get your attention, consider that you’ll also cause premature aging of your skin!

More than 90% of skin cancers are caused by exposure to solar radiation, type A (UVA) and type B (UVB) ultraviolet light rays, to be exact. We used to believe that UVB was the bad actor – think “B” for “Bad” – but more recently we’ve realized that UVA also increases the risk of skin cancer. This fact is the basis of a lawsuit filed this past March against various sunscreen manufacturers. The suit suggests that the manufacturers promote sun exposure by claiming to protect users from harmful UV rays. It says while the products might protect users from type B rays – which in fact they do when used properly – they fail to protect them from type A UV rays. That failure not only leaves people vulnerable, but actually increases their risk of skin cancer by creating a false sense of security. 

UVB rays are stronger than UVA rays. The midday sun is about 90% UVB, while UVA makes up a higher percentage of sunlight earlier and later in the day, which is why it’s particularly important to avoid exposure to the sun from 10:00 a.m. to 4:00 p.m. UVA rays, however, are not filtered by glass to the same extent as UVB rays, and they penetrate deeper into the skin. As evidence that UVA rays also produce skin cancer, consider that most skin cancers in the U.S. occur on the left side of the body, while in Great Britain they occur mostly on the right side! Think about it.

Environmental factors strongly influence the extent of your exposure to harmful radiation. Snow and ice reflect UVB radiation, thereby doubling your exposure. Light colored sand reflects about 1/3 as much radiation as snow, so you’re more vulnerable to the harmful effects of sunlight at the beach, but not as much as on the slopes. Water does not reflect UVB radiation. It allows it to penetrate and cause harm to a depth of a couple of feet. Clouds filter 20% to 30% of sunlight, which is not as much as most people think, so you may be quite vulnerable to the harmful effects of UV rays on cloudy days, again because of a false sense of security.

So what’s a sun worshipper to do? One option is to wear protective clothing when you’re outdoors. That means tightly woven cloth, a wide-brimmed hat, long-sleeve shirts and long pants. I’m a great believer in the “no hat, no play” rule, especially for children and bald men like me.

Sunscreens afford excellent protection from harmful solar radiation if you choose them wisely and use them properly. Here are a few “golden rules” for using sunscreens properly:

• Use “waterproof/sweatproof” sunscreen which protects against both UVA and UVB radiation, and has an SPF of at least 30+.
• Apply sunscreens to dry skin 15–30 minutes BEFORE going outdoors.
• Remember to apply sunscreen to your ears, neck, top of head (if bald or have thinning hair), tops of your feet, and behind your knees. The ears are a common place to get skin cancer, and a very tough place to treat. 
• Use at least one ounce of sunscreen, the size of a golf ball or shot glass, to cover the exposed areas of the body completely.
• REAPPLY sunscreens every two hours or immediately after swimming or strenuous activity, even if you are using a “very water resistant” sunscreen.
• Use sunscreens that say “all day protection.”
• Avoid midday sun and deliberate tanning.

The choice of a gel, cream or lotion type of sunscreen depends mostly on your skin type and it’s a cosmetic issue. People with oily skin might prefer a water-based or alcohol-based product, probably a lotion or gel, whereas people with dry skin will probably prefer a cream. Another consideration is that gels may not be the best bet for the face as they tend to clog the pores and may produce more acne in susceptible individuals. Spray-on sunscreens have the advantage of being very easy to use, especially for kids who won’t sit still, but it’s hard to gauge how much you are using.

Research by a prominent Duke dermatologist, Sheldon Pinnell, M.D., has recently demonstrated that topic antioxidants – specifically vitamins C and E – combined with ferulic acid, afford terrific protection from harmful solar radiation when used with traditional sunscreens. A sunscreen containing these ingredients is available from a company called SkinCeuticals.

So as you head outdoors this summer, enjoy yourself to the fullest but make sure you protect yourself from the damaging effects of solar radiation. If you follow these suggestions, I guarantee that your skin will look younger longer, and you’ll greatly reduce the risk of developing skin cancer, a potentially dangerous problem later in life.

Caring for the Caregiver is edited by Alan Kronhaus, MD, owner of Doctors Making Housecalls. The number is 919.384.5017 or visit www.doctorsmakinghousecalls.com

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