Summer Skin Care Tips and More from Mount Auburn Hospital Dermatologist

With official start of summer last weekend, Dr. Cheryl Gray, a Marlborough resident and Dermatologist at Mount Auburn Hospital in Cambridge, offers advice on how to protect your skin this summer and general skin health tips and cancer prevention.

Q: Is there such a thing as a “safe tan”?
A: No tan caused by exposure to UV is safe.  Tanning is the body's response to DNA damage from ultraviolet radiation, and DNA damage is directly linked to skin cancer, wrinkles, and other signs of aging.  Spray and other artificial tans are generally considered safe.

Q: Are certain areas of the skin and body more susceptible to sun damage than others?
A: Areas that are more exposed are more susceptible to sun damage, and are therefore more common places to develop skin cancer.  The scalp, ears, and nose are particularly vulnerable.  It is also important to be aware of lips being exposed to the sun, as we often do not use sunscreen on our lips, but they can be damaged and can develop skin cancers.

Q: Are certain sunscreen products, brands and types better than others? How often should sunscreen be reapplied?
A: Look for sunscreens that are broad spectrum, meaning broad coverage of UVA and UVB.  The SPF of a sunscreen only refers to its coverage of UVB (the primary cause of sunburn), but we know that UVA is an important contributor to skin cancer and premature aging.  There is some controversy over the safety of chemical sunscreens.  If you are concerned about chemicals in sunscreens, look for the active ingredients of zinc oxide and titanium dioxide. Sunscreen should be re-applied every 2 hours, more often if sweating or after swimming.

Q: What is the ideal SPF to use? Is it 15? 30? Does it make sense to use SPF 100?
A: An SPF 15 sunscreen blocks approximately 93 percent of UVB radiation, while an SPF 30 sunscreen blocks nearly 97 percent and SPF of 50 blocks approximately 98 percent.  Thus there is minimal benefit above an SPF of 30 (from a UVB perspective).  However, most of us do not apply enough sunscreen to get the full SPF value and thus only get 1/3 to 1/2 of the stated SPF value.  Thus there is an advantage to using a higher SPF.  Again, keep in mind that the SPF value is only a measure of coverage for UVB.  Without adequate UVA coverage, there is still DNA damage and increased risk of cancer and aging.

Q: Besides sunscreen, what other preventative actions would you recommend?
A: Even more important than sunscreen is the use of broad brimmed hats, sun protective clothing, sunglasses, and shade. Some clothes such as rash guards have tested SPF values. In terms of clothing, tightly-woven fabric offers better protection.  If you can see through clothing, it is less protective.  Darker clothing is also more protective, so white t-shirts often do not provide enough protection. Finally, tight clothes that are more stretched when worn are more likely to let UV radiation through.

Q: What times of day should you absolutely stay out of the sun if possible. What are the safest tanning times of the day?
A: The most intense sunlight occurs between 10am and 4pm. 

Q: What should be done to treat a sunburn?
A: Get out of sun immediately!  It can take up to 6 hours to get the full effect of the burn, so getting out of the sun at first signs of a burn is important. Stay hydrated with plenty of water, as burns can cause you to lose fluid. Moisturize your skin with an ointment (such as Vaseline) or thick cream. Do not scrub or pick at your skin. Take Ibuprofen for a couple of days can calm inflammation and may help prevent damage.  Ibuprofen (Advil) is more effective than acetaminophen (Tylenol). If significant blistering, fever, or chills, seek immediate medical attention, and do not re-expose burned skin to the sun.

Q: What are some other skin health tips you can provide us with?

• Most of your sun exposure does not occur at the beach.  Day to day sun, even just a few minutes at a time, contribute more to your cumulative sun exposure and risk of UV damage.

• Although car windshields are partially treated to filter out UVA, the side windows let in >60%of the sun's UVA radiation.  UVB is the radiation associated with sunburn, but UVA contributes to skin cancer and premature aging.  So you may not get a burn in your car, but you are getting a lot of damage.

• Apply 1 ounce (about a shot glass full) 30 minutes before sun exposure to allow the ingredients to fully bind to the skin.  Most of us do not use enough sunscreen to get the full SPF value, especially if we are relying on the sunscreen in a daily moisturizer.

• Remember to reapply sunscreen daily.  If you put on a moisturizer with a sunscreen on in the morning, it has worn off by the end of the day when you are getting back in your car to drive home.  Keep sunscreen in your car.

• Eighty percent of a person's lifetime sun exposure is acquired before age 18.

Q: How can we identify a dangerous mole? When is a mole a sign of skin cancer?

A: Here are the ABCDEs of melanoma:

A - Asymmetry

B - Borders (uneven, notched)

C - Color (multiple colors, color variation, especially blues and blacks)

D - Diameter (larger than a pencil eraser)

E - Evolving (probably the most important, any changing moles or moles that itch, hurt, or bleed)

Mount Auburn Hospital was founded in 1886. A teaching hospital of Harvard Medical School, its mission is to deliver healthcare services in a personable, convenient and compassionate manner, with respect for the dignity of patients and their families.