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The do's and don'ts of sunscreen

With summer right around the corner, everyone is dreaming of their upcoming beach vacation or just spending more time outside soaking up the sun. This time of the year, many of my patients show up with sunburns. I can see the terror in their eyes as I'm examining their skin, and they sheepishly explain to me how "it" happened.

The story always goes: "Doc, I put sunscreen on…" or, "I only thought I was going to be out there for just a few minutes," or "it was a cloudy day."

Let's take some lessons from my patients so you can enjoy the outdoors this summer while protecting your skin at the same time.

Sunscreen DON'Ts:

  1. Don't grab the mega-size bottle of "NO-AD" sunscreen that's been on your shelf for 5 years. This is your skin we are talking about! If it's been sitting on the shelf for a few seasons, it's time to get something new. The ingredients in sunscreen do expire, especially oxybenzone, avobenzone, and homosalate. Most bottles will have an expiration date, and if they don't, 3 years is a safe rule of thumb. It's a good idea to write the date of purchase on the bottle. And if you are using an SPF regularly, then a bottle shouldn't last you more than a season.
  2. Don't wait until you are in the sun to apply your protection. When we were kids growing up in Florida, we would burn to a crisp. Then our mom would give up a white T-shirt to put on over our burned skin. This is exactly why patients from my generation have so many skin cancers. It takes only 5 minutes on a sunny day for the damage to begin. Chemical sunscreen ingredients take 30 minutes to fully bind to the skin and become effective. This is why you must put your first layer of sunscreen on before leaving for the beach. Reapply one hour after you get there, and again every 90 minutes. It doesn't matter how high the SPF is; it only lasts 90 minutes. Sunscreen works. You just have to use it correctly and reapply often. And don't even think of throwing on a white T-shirt for protection! It barely offers a UPF (ultraviolet protection factor) of 5. Instead, look for sun protective clothing with a UPF of 50+ or greater.
  3. Don't assume, "I don't need sunscreen because I never burn." All skin types develop damage from the sun. We diagnose skin cancers and melanoma in all skin types. If you have skin, you can get skin cancer! Despite fewer overall skin cancer cases in darker-complected patients, the survival rate of melanoma for African Americans is 73% compared with 91% for Caucasians.
  4. Spray sunscreens miss a lot of areas. I suggest a first layer with a good SPF, either a full physical block (ingredients to look for: zinc, titanium dioxide) or a mixture of a physical and chemical block. As a second coat, you can reapply with the sprays but keep in mind that the coverage is usually insufficient. I suggest alternating between creams and sprays to make sure you maintain adequate coverage.

Sunscreen DO's:

  1. Do make sure you apply sunscreen to the nooks and crannies that often get missed. There are hot spots for cancer that I always look at during my skin checks. We often forget the eyelids and eyebrows, back of the neck, scalp, tops of hands and feet, and lips.
  2. Do apply a daily SPF under your makeup. Most makeups contain an SPF, but that is not enough for daily protection. Your SPF needs to cover the face, neck, and exposed chest area.
  3. Do use sunscreen every single day. Over 70% of our lifetime sun exposure comes from the times when we don't realize we are in the sun. UV rays are everywhere around us - when we are driving in the car, in our homes, even getting the mail out of the mailbox. Even on a cloudy day, UV radiation is only reduced by 20%
  4. Do use sun-protective clothing. Hats, long sleeves, big sunglasses, etc. Think of sunscreen as just a part of your skin protection plan. The more you can keep covered up, the safer you will be when you are enjoying yourself outdoors.
  5. Do use the waxy sunscreen sticks on the face, ears, eyebrows, and nose when swimming. When we get out of the water, everyone wipes their eyes to get the water off, and with that wiping, so goes the sunscreen.
  6. Do apply sunscreen before you put on your swimsuit. Most of the burns I see are along the edge of the swimsuit where the sunscreen didn't get applied.

Remember to get out and enjoy these wonderful, longer days safely while following the proper do's and don'ts of sunscreen use!

Dr. Melinda Greenfield is a board-certified dermatologist with 22 years of experience. She is available to patients in Colorado, Florida, Georgia, Idaho, and Montana.

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