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The sun and your skin

Jul 28, 2023

Sensible sun protection will help prevent skin damage

Basking in the sun's rays used to be considered healthy and was widely popular for the coppery tan it gave people before we learned about the dangers of ultraviolet rays. We all need to avoid overexposure to the sun (especially people with fair skin). Too much of sunlight on skin can cause sunburn, wrinkles, freckles, skin texture changes, dilated blood vessels, skin cancers and premature skin ageing. It may also cause different types of rash problems on the face and the body.

The sunlight consists of both visible and invisible rays. The invisible rays, known as ultraviolet-A (UVA) and ultraviolet-B (UVB), cause most of the problems. Both cause suntan, sunburn and sun damage. The UVA produces more ageing and the UVB causes burning. The ultraviolet-C (UVC) fortunately is stopped by the ozone layer and thus does not reach the earth surface. However, with the threats of ozone layer depletion, they may also soon become an important factor in skin damage. There is no "safe" UV light. Harmful UV rays are more intense in the summer, at higher altitudes, and closer to the equator. The equatorial regions can have 2 or 3 times higher intensity of sunlight. The sun's harmful effects are also increased by wind and reflections from water, sand, and snow. Even on cloudy days UV radiation reaches the earth and can cause skin damage. The UV index is a prediction of ultraviolet intensity in a given location. It can be found in the weather section of some big daily newspapers and some television weather forecasts in Europe and the U.S.

Sensible sun protection will help prevent skin damage, skin ageing and reduce the risk of cancer. Sun protection should always start with avoiding peak sun hours and dressing sensibly. Most clothing absorbs or reflects UV rays, but white fabric like loose-knit cotton, and wet clothes that cling to your skin, do not offer much protection. The tighter the weave, the more sun protection it will offer. The American Academy of Dermatology recommends that you avoid deliberate sunbathing, wear a wide-brimmed hat, sunglasses, and protective clothing. If you must be in the sun, use a sunscreen with a sun protection factor (SPF) of at least 15, even on cloudy days. Sunscreens work by absorbing, reflecting, or scattering the sun's rays on the skin. They are available in many forms, including ointments, creams, gels, lotions, sprays, and wax sticks which can be used on the lips. All are labeled with SPF numbers. The higher the SPF, the greater the protection from sunburn, caused mostly by UVB rays. Some sunscreens, called "broad spectrum," block out both UVA and UVB rays. These do a better job of protecting skin from other effects of the sun. Few of them have separately labeled the percentage of UVA and UVB block. It is extremely important to know the SPF and the chemicals present in the sunscreen before using. A non-comedogenic, hypoallergenic sunscreen lotion would be suitable for allergenic or acne prone skin.

However, sunscreens are not perfect. Sunscreens protect the skin from burning rays. Sunscreens should be applied about 20 minutes before going outdoors. Even water-resistant sunscreens should be reapplied about every two hours, after swimming, or after strenuous activities. Beach umbrellas and other kinds of shade are a good idea, but they do not provide full protection because UV rays can still bounce off sand, water, and porch decks. Remember, UV rays are invisible.

1. Sunburn

Your chances of developing sunburn are greatest between 10am and 4 pm, when the sun's rays are strongest. It's easier to burn on a hot day, because heat increases the effects of UV rays, but you can get burned on overcast days as well.

Sun protection is also important in the winter. Snow reflects up to 80 percent of the sun's rays, causing sunburn and damage to uncovered skin. If skin is exposed to sunlight too long, redness may develop and increase for up to 24 hours. Severe sunburn causes skin tenderness, pain, swelling, and blistering. Additional symptoms like fever, chills, upset stomach, and confusion indicate serious sunburn and require immediate medical attention. If you develop severe sunburn or begin to develop a fever, your dermatologist may suggest medicine to reduce swelling, pain, and prevent infection. Unfortunately, there is no quick cure for minor sunburn. Cool, wet compresses, baths, and soothing lotions may provide some relief.

2. Tanning

A tan is often mistaken as a sign of good health. The tanned beauties of today will be tomorrow's prunes. A suntan is actually the result of skin injury and not the sign of a healthy glowing skin. Tanning occurs when UV rays penetrate the skin and the skin protects itself by producing more pigment or melanin. Indoor tanning is just as bad for your skin as sunlight. Most tanning salons use ultraviolet-A bulbs. Studies have shown that UVA rays go deeper into the skin and contribute to premature wrinkling and skin cancer.

3. Ageing

UVR is the main factor speeding the ageing process in white skin. People who work outdoors or sunbathe without sun protection can develop tough, leathery skin, making them look older than they are. This is a problem faced by people in this country where the sunlight is harsh. This can be prevented with adequate sun protection. The sun can also cause large freckles called "age spots," and scaly growths (actinic keratoses), that may develop into skin cancer. These skin changes are the result of sun exposure over the years. Protecting children from the sun is especially important, since most of our lifetime exposure occurs before the age of 20.

4. Wrinkles

Wrinkles are directly related to sun exposure. Wrinkles occur when the dermis loses its elastic recoil, failing to snap back properly into shape. Smoking can intensify this damage. Your dermatologist and dermatologist surgeon can treat these with a variety of surgical methods including chemical peels, laser surgery, dermabrasion, and soft tissue fillers but full reversal of these damages is not possible thus reminding us that prevention is better than cure.

5. Skin Cancer

More than 90 percent of all skin cancers occur on sun-exposed skin. People with very fair skin are very much prone to skin cancer, which occurs very rarely in the darker skinned individuals. The face, neck, ears, forearms, and hands are the most common places it appears. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. Basal cell carcinoma usually develops on the face, ears, nose, and around the mouth of fair-skinned individuals. It can start as a red patch or shiny bump that is pink, red, or white. It may be crusty or have an open sore that does not heal, or heals only temporarily. This type of cancer can be cured easily if treated early. Squamous cell carcinoma usually appears as a scaly patch or raised, warty growth. It also has a high cure rate when found and treated early. In rare cases, if not treated, it can be deadly. Melanoma is the most dangerous form of skin cancer. It usually looks like a dark brown or black mole-like patch with irregular edges. Sometimes it is multicolored with shades of red, blue, or white. This type of skin cancer can occur anywhere on the body and when found early, can be cured. If ignored, this deadly skin cancer spreads throughout the body and can be fatal.

6. Allergic Reactions

Some people develop allergic reactions to the sun. These reactions may show up after only a short time in the sun. Bumps, hives, blisters or red blotches are the most common symptoms of a sun allergy. Sometimes these reactions are due to cosmetics, perfumes, plants, topical medications, or sun preparations. Certain drugs, including birth control pills, antibiotics, blood pressure, arthritis, and depression medications can cause a skin rash with sun exposure. If this occurs, a dermatologist can help. It is important for the patient to mention to the doctor of any perfumes, creams or cosmetics they use.

7. Photoallergic dermatitis Diseases

Some diseases can be made worse by the sun, including cold sores, chickenpox, and a number of less common disorders such as lupus erythematosus (SLE). UV rays also can cause cataracts, a gradual clouding of the lens in the eye.

1. Use a broad-spectrum sunscreen with a sun protective factor (SPF) of at least 15 on all exposed skin, rain or sun, even on cloudy days.

2. Use a lipstick with sun block.

3. If exposed to water, either through swimming or sweating, a water-resistant sunscreen should be used. Reapply sunscreen frequently if outdoors.

4. Wear a broad-brimmed hat and sunglasses.

5. Sit in the shade whenever possible.

6. Wear protective, tightly woven clothing.

7. Target outdoor activities early or late in the day to avoid peak sunlight hours between 10 am and 4 pm.

8. Avoid tanning salons.

9. Do not sunbathe.

10. Help children to protect themselves.

Everyone should be able to enjoy sunny days. By using a little common sense, and the above guidelines adapted from and developed by the American Academy of Dermatology, you can safely work and play outdoors without worrying too much about skin cancer or wrinkles. But if either should occur, your dermatologist has specific expertise in treatment options.

1. Sunburn 2. Tanning 3. Ageing 4. Wrinkles 5. Skin Cancer 6. Allergic Reactions 7. Photoallergic dermatitis Diseases