Made in the Shade: Reducing sun exposure for healthy, younger-looking skin
Dr. Christine A. Liang
Each year, 3.5 million skin cancers are diagnosed in the United States. That means one in five Americans will develop a skin cancer in their lifetime. “The two most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. We know that these are directly caused from sun exposure,” says Dr. Christine A. Liang of the Mohs Micrographic Surgery and Dermatologic Surgery Center at Brigham and Women’s Faulkner Hospital.
Both basal cell carcinoma and squamous cell carcinoma typically arise on the face, scalp and hands. Basal cell carcinoma starts as a pearly looking bump that can easily be mistaken for a pimple. Squamous cell carcinoma produces a rough scaly area. These cancers often grow slowly and can be treated with procedures like Mohs micrographic surgery. With this precise surgical technique, physicians progressively remove and examine layers of cancer-containing skin until only cancer-free tissue remains. It’s an effective means of removing the cancer while preserving as much healthy skin as possible.
A third type of skin cancer, melanoma, is the most dangerous type of skin cancer. Melanoma can appear as a new lesion or develop from an existing mole. Be suspicious of any itching or bleeding lesions, or moles that show one or more of the ABCDE signs of melanoma: asymmetry, irregular border, multiple colors, diameter larger than a pencil eraser, evolving or changing lesion. If you have these symptoms, see your dermatologist right away as early diagnosis and treatment is key. The treatment of melanoma depends on the stage, but when caught early, melanoma is typically treated with surgical excision.
The good news is you can reduce your risk of skin cancer by avoiding sun exposure. Since none of us want to hide away indoors all summer, Dr. Liang offers three simple tips to help you stay safe: Seek shade, Wear sunscreen, and Cover up.
Dr. Liang recommends staying out of the sun completely. She says, "There is actually no healthy tan." That means any color you get equals sun damage. Even if you wear sunscreen or protective clothing, you should never plan to spend a full day outdoors without an umbrella, tent or other shade structure. Dr. Liang warns that sunscreen can give a false sense of security. Staying out of the sun is the only way to get a real break from damaging rays. Plus, it’s the only way to protect newborns. Dr. Liang says, "Infant skin is really sensitive to sun damage and burning. And, since we don’t recommend sunscreen use in newborns, it’s just better to keep them completely out of the sun."
It might be cloudy or raining, but you still need to protect your skin every day. You should start your morning routine with a cosmetic product with sunscreen with at least SPF30. Be sure to apply it to exposed areas of your face, neck, chest and the backs of your hands. "It has been shown that people that use sunscreen not only have less risk of developing non-melanoma skin cancer, but they show significantly less signs of aging. So less wrinkling and less brown spots. Two things that very much bother people," says Dr. Liang.
Cosmetics and moisturizers with SPF are great for daily wear, but when you plan to spend the entire day outdoors, Dr. Liang suggests the use of a broad spectrum sunscreen with SPF30 to 50. A broad spectrum sunscreen is one that protects against UVB rays (the rays that cause burning) and UVA rays (the rays that don’t burn you but do cause cancer and aging). "Most people don’t use nearly enough sunscreen," she says. You should use a whole ounce (enough to fill a shot glass) and reapply every two hours or after swimming or sweating heavily. Rub-on sunscreen is recommended since you can apply a much thicker layer. If you prefer spray sunscreen, it’s recommended that you only use it to reapply and not as your base.
Selecting the right daily moisturizer with SPF and the right broad spectrum sunscreen are important. "We know that if you have products that you don’t like, you’re not going to use them. The biggest thing is to find something that you like," says Dr. Liang. Since everyone’s skin reacts differently to sunscreen, try a variety until you find the one you love. For children, look for products made just for kids that contain physical blockers. These products contain zinc oxide and titanium dioxide which reflect the sun’s rays and are safe for both children and adults. Products containing zinc oxide and titanium dioxide are often not favored by adults since they show white on your skin but Dr. Liang says, "These days they are much more cosmetically appealing and do not look as white as they used to."
Another way to avoid the sun is through the use of protective clothing. If your skin is sensitive and you prefer not to wear sunscreen, try a hat with a very large brim. This will protect you face, scalp, neck and chest from the sun. Rash guards and other sun protective clothing provide even more coverage and they’re great for both kids and adults. "The use of sun protective clothing is another great way to protect yourself from the sun. And it can be much easier to do than actually reapplying the sunscreen, which can be difficult, especially with children," says Dr. Liang. These products are made from materials that are lightweight and breathable, perfect for hot summer days!
Dr. Liang knows that people love the look of a tan. But, "As dermatologists, we do not recommend getting any sun exposure without sunscreen," she says. If you do want the look of a tan, try a self tanner or visit a professional spray tanner. And if you do get a sun burn, know that the damage to your skin is done, but you can alleviate pain with cool compresses or by taking an NSAID like ibuprofen. Dr. Liang warns that if it’s severe or blistering, you might need to see a doctor and you most certainly cannot go back out into the sun before it’s completely healed.
Summer is the time to shed the winter layers and enjoy the outdoors. But it’s also the time to be particularly vigilant about protecting your skin in order to reduce your risk of skin cancer and keep your skin looking younger longer. Seeking shade, wearing sunscreen and covering up your skin with protective clothing are all great ways to reduce sun exposure without passing the summer indoors. And remember, if you do see a spot that’s concerning, see your dermatologist or ask your primary care physician to look at it. Early detection can be life saving.