As the weather becomes warmer, the sun brighter, and all of the flowers and trees bloom, we all want to spend more time in the beautiful outdoors.  It is extremely important to protect your skin from the sun year round, especially when the sun is at its strongest. Sun protection is important regardless of whether you are taking medications that cause sensitivity to sunlight or not. The immediate effects of excessive sunlight include painful sunburns and blisters or sun poisoning. The long term effect is premature aging as manifested by discoloration and uneven tone (both dark and light spots and patches), blood vessel formation, sun-induced acne (solar comedones), loss of elasticity, uneven or rough texture of the skin, and wrinkles. Most worrisome of all is the development of skin cancer which is the most frequently occurring of all types of cancers in the United States.

The damaging rays from the sun peak between 10 AM and 4 PM. These damaging rays are in the invisible form of ultraviolet light known as UVA and UVB. The ozone layer in our atmosphere protects us from much of the UV light. Due to depletion of the ozone layer by greenhouse gases and also due to seasonal variations, the amount UV radiation that we are exposed to varies. UV radiation can be high even on cloudy days. The UV Index was created by the National Weather Service and the Environmental Protection Agency to indicate the strength of the solar UV radiation on earth. It is rated on a scale from 1 (low) to 11+ (extremely high). You can check your local weather forecast or go to www.epa.gov/sunwise/uvindex.html to find out the UV index in your neighborhood on any given day.

The best protection from the damaging sun rays comes from either avoiding prolonged outdoor activity during these hours or by taking measures to protect yourself and your loved ones.

One method of protecting yourself when you are in the sun includes employing physical means such as protecting clothing. For the pool or at the beach you can also easily find fashionable swim shirts for men, women, and children that have an Ultraviolet Protection Factor or UPF to protect against the sun. Using an umbrella, wearing a solid wide brimmed hat, large UV protective sunglasses, and tightly woven clothing with long sleeves, long skirts, or long pants would be one of the best ways to protect yourself. But this isn’t always comfortable or practical, and may not be the look that you’re going for.

Another method involves application of sunscreen. It has often been said that it does not matter whether the SPF is 15 of 100. If the application of the sunscreen is liberally applied every two hours, then this is technically correct. A typical 4 ounce bottle of suncreen should last the average sized adult two full applications. Since most people do not apply the sunscreen in this manner and since most do not reapply every two hours, you are better off using the product with the higher SPF. Be sure to reapply your sunscreen every two hours no matter which SPF you are using, especially if you have been perspiring or swimming. Also remember to apply the sunscreen in the less obvious places such as behind your neck and ears, tops of your feet and toes, the backs of your legs.

Many sunscreens protect against the so-called “burning rays” but still allow the “tanning rays” to go through. In order to be fully protected, be sure to purchase sunscreens that specifically state on the front label that the protection is against UVA and UVB rays. You can also check the ingredients list to make sure that the product contains Parsol 1789.

For those with sensitive skin, the choice of sunscreen active ingredients is between titanium dioxide and zinc oxide. Zinc oxide covers the full spectrum of UVA and UVB rays better than titanium dioxide, but it is difficult to find and feels thick and sticky when applied.

New sunscreen label guidelines were released by the Food and Drug Administration in May. These guidelines will specifically rate the UVB protection in the form of SPF and the UVA protection in the form of a number of stars and make it simpler to choose the product that suits your needs. It is not yet known when sunscreens in the stores will reflect these changes.

If you do accidentally develop a sunburn, cover and remove yourself from the sun as soon as possible, keep yourself well hydrated, use ice or consider taking an anti-inflammatory medication such as ibuprofen if needed and call your doctor. It has been suggested that antioxidants may reduce some of the inflammation and damage that occurs after sun exposure. The best sources of the antioxidants are from natural sources such as fruits and vegetables.

So how can you protect yourself without looking like an alien or feeling sticky and gooey? A combination of both protective clothing such as a large hat, sunglasses, and a cover up that you might wear at the beach along with sunscreen that is reapplied frequently works best. Enjoy the beautiful weather!

Diana Sun, MD, FAAD
Diplomate, American Board of Dermatology
Clinical Assistant Professor of Dermatology, State University of New York at Stony Brook
Consultant Dermatologist, Veterans Administration Medical Center at Northport

Here is a suggested article for winter skin care, written by Diana Sun, M.D., F.A.A.D.

Your skin may need extra care when you are receiving chemotherapy or radiation during the winter months.   The amount of oil that your glands naturally secrete to lubricate and protect your skin may be reduced when you are taking some chemotherapy medications. In addition, the cold winter air and the hot dry air from heaters can further reduce the moisture of your skin.  This can cause dryness, itching or flaking, and may sometimes lead to rashes.

There are some simple steps that you can take to not only keep your skin soft and supple, but also make it beautiful and radiant as well.

Maintain good health.  Be sure to keep yourself well hydrated and be sure to eat nutritious foods.  Drink plenty of fluid, especially water.   Unless your medications or medical condition requires the restriction of certain food groups, be sure to have a diet rich in whole grains, fruits and vegetables of all different colors (greens, reds, oranges, yellows, blues), and protein from a wide variety of sources (fish, poultry, beef, pork, lamb, beans and legumes, nuts, dairy).  Exercise regularly if you are feeling up to it.  And seek the emotional support of your family and friends and support groups.

Keep your showers short and avoid very hot water.   If your bathroom is steamy and foggy when you are done, then it is too long and too hot.  Wash your face and body gently each day using cleansers that are free of fragrances or dyes.  You may wish to gently massage your skin with a clean washcloth or gentle body scrub once or twice a week to exfoliate the dead surface skin.   Avoid exfoliating areas where the skin is sensitive, such as recently healed surgical sites, radiation sites, port sites, and the like.  These areas can be gently massaged with just your fingertips.   Check with your doctor about the care of these areas.

Immediately after your shower, apply a generous amount of moisturizer all over your face and body.  For very dry skin, heavy emollients such as Aquaphor ointment, Eucerin Cream, or even Vaseline Petroleum jelly applied lightly to wet skin can “lock in” moisture and leave the skin soft and smooth.  You can also consider natural alternatives such as safflower oil or shea butter, which are available at natural and organic food stores as well as many grocery stores and pharmacies.    For those with normal to dry skin, look for any fragrance-free, dye-free moisturizer.  Some excellent creams include CeraVe cream (which contain ceramides to replenish your skin) and Cetaphil cream.

When going outdoors, be sure to generously apply sunscreen to all of your exposed skin.  Use a sunscreen that has a high SPF number (at least 45) and check the label to make certain that it protects your skin from both UVA and UVB rays.   Look for ingredients such as micronized zinc oxide as the sole ingredient, or if several sunscreen agents are used, then  look for Parsol 1789 (also known as Avobenzone).

Finally, if your skin is very sensitive, protect it from the cold and wind.  Apply a generous amount of moisturizer with sunscreen before heading outside on a windy day.  You can also protect your skin by wearing a hooded coat or jacket, or by wrapping a scarf loosely around your lower face.

Written by:

Diana Sun, Dermatologist
Diana K. Sun, M.D., F.A.A.D.
Diplomate, American Board of Dermatology
Clinical Assistant Professor in Dermatology, SUNY at Stony Brook
Consultant Physician, Veterans Administration Medical Center at Northport