Lisa
Drage, M.D., a dermatologist at Mayo Clinic, Rochester, Minn.,
answers some common questions about the sun's effects on your
skin and what you can do to protect yourself.
What
causes sunburn?
Sunburn
is the result of overexposure to the sun's ultraviolet (UV)
radiation. Repeated exposure to UV radiation both tans and
damages your skin.
The UV
content of sunlight varies. It's greater at higher elevations
because it's unfiltered by clouds or haze. But reflected
ultraviolet light from snow, sand, water and other highly
reflective surfaces can burn as severely as direct sunlight.
You can also get a sunburn on a cloudy day.
Two
types of ultraviolet radiation ultraviolet A (UVA) and
ultraviolet B (UVB) have an effect on your skin. UVA
penetrates into the deeper layers of your skin and can impair
your skin's immune system, which may contribute to cancer. UVA
usually causes the leathery, sagging, brown-spotted skin of
those who spend a lot of time in the sun. The longer waves of
UVA can also penetrate window glass, including car windows.
Tanning beds are a source of high doses of UVA.
UVB
causes sunburn and plays a significant role in superficial
skin cancers called basal cell carcinomas and squamous cell
carcinomas. The relationship between sunlight and melanoma
the most serious type of skin cancer is less clear-cut.
Studies suggest that those exposed to occasional periods of
intense sunlight, such as indoor workers who spend vacations
lying on a beach, are at greater risk of melanoma than are
farmers, roofers and others who regularly spend long hours in
the sun.
How
important is sunscreen in protecting you from UVA and UVB
radiation?
Protection from the sun is very important in the prevention of
skin cancer. To be most effective, protective steps should
begin in early childhood. But all people, regardless of age,
should practice sun protection. It's the sensible thing to do.
Regular, proper use of broad-spectrum sunscreens those that
offer protection from both UVA and UVB radiation is key in
preventing sunburn, sun damage and skin cancer.
How do
you choose a sunscreen?
Shopping
for skin products that offer protection from the sun can be
confusing. And labels that feature superlatives such as
total sunblock, waterproof, all-day protection and
deep-tanning provide little solid information for those
seeking the best protection for their skin type.
Sun
protection factor (SPF) ratings refer only to UVB protection.
It's important to check sunscreen labels to ensure that the
product is a broad-spectrum sunscreen. Products containing
zinc oxide or titanium dioxide are among those that provide
protection against both UVA and UVB.
SPF
ratings are based on how much longer someone may be protected
from sunburn than he or she is if no sunscreen were applied.
For instance, if you normally burn in 20 minutes, a product
with SPF 15 will allow you to stay out in the sun 15 times
longer. You'll be able to stay out in the sun without burning
for five hours, assuming you applied the sunscreen properly.
The SPF number doesn't refer to a sunscreen's strength. For
example, an SPF 30 is no stronger than an SPF 8 it doesn't
filter out more harmful rays than an SPF 8 does but it does
protect you longer.
What is
proper application?
Most
people use sunscreens too sparingly. Labels of most sunscreens
call for liberal and frequent applications. A liberal
application is 1 ounce the amount in a shot glass to cover
all exposed parts of the body. Timing is important, too. To
have the best effect, sunscreens need to be applied 30 minutes
before you get to the pool or beach, not after you arrive.
Because
of sweating, swimming and toweling off, sunscreen should be
reapplied throughout the day. Even water-resistant sunscreens
need to be reapplied every 90 minutes. Always use a sunscreen
with an SPF of at least 15.
Tanning
salons often advertise tanning beds as a good way to get a
base tan before lengthy exposures to direct sunlight. Is this
a safe way to prepare for a trip to Hawaii, for example?
There's
no such thing as a safe tan. Avoid tanning beds they aren't
safe, and they may cause skin cancer. They're also associated
with other nasty skin problems, such as infections and warts.
We know
that UVB and sunburns are associated with increased skin
cancer and melanoma risk. But that doesn't let the UVA
radiation in tanning beds off the hook. UVA probably has an
effect on your skin-based immune system and its ability to
prevent melanoma. UVA radiation isn't safe. The tanning salon
operators might say that UVA is good and UVB is bad, but
research doesn't support that. UVA may actually increase the
risk of skin cancer or melanoma.
What
about so-called bronzers that make the skin look tanned?
I think
that's an excellent way to get the tan look without paying the
price. They're safe. The one caveat is that many don't have
sunscreen in them, and the tan you get with them won't protect
you from the sun. You still need to wear sunscreen. But
overall, they're a much healthier way to achieve the look
without the risk. With experimentation, you can find a level
of color that looks best on you.
Should
you avoid the sun altogether?
We don't
want to scare people, but at the same time, behavior does have
an effect on health whether it's cigarette smoking, eating
habits or sunbathing. You don't need to stay in a cave. Get
out, be active and have a healthy life. However, be smart
about your sun exposure wear a broad-brimmed hat and
light-colored clothing that covers your exposed skin, and use
a broad-spectrum sunscreen. Limit outdoor sports and other
activities for the early morning or late afternoon whenever
possible.
Applying
sunscreen to exposed areas is a good year-round habit in most
localities. Make it a part of your daily routine, just like
brushing your teeth.
Do
certain medications affect your risk of sunburn?
Many
drugs increase your sensitivity to sunlight and your risk of
getting a sunburn. Some common ones include thiazides and some
other diuretics, tetracycline and sulfa antibiotics, and
nonsteroidal anti-inflammatory drugs, such as ibuprofen, in
dosages used to treat arthritis. Ask your doctor about any
medications you might be taking.
If you
do develop a sunburn, take aspirin or ibuprofen (Advil,
Motrin, others) for pain, apply cold compresses and avoid
further exposure until the burn goes away. A sunburn spray may
help relieve pain. A severe sunburn may require and will
likely benefit from medical attention.
How can
you tell if something is skin cancer?
Be on
the lookout for new or nonhealing growths on your skin, which
may indicate skin cancer.