Just in time for your summer vacations, the docs tackle your questions about protecting your skin from sun damage:
Q: I know there have been some changes to sunscreen recently, but I’m a little confused. What should I be looking for now?
A: If it seems like there’s been more action in the sunscreen world in the last three years than in the Kardashian household, that’s because it’s true. We’ve got new labeling regulations, courtesy of the Food and Drug Administration, as well as more ingredient innovation, thanks to the recent signing of the Sunscreen Innovation Act into law, to speed up the FDA approval process for better, more effective skin-protecting chemicals. The good news: All of this should make it easier, not harder, to find the right sunscreen for you.
Let’s start with the basics: If it doesn’t say “broad spectrum,” forget it. Some sunscreens block only the sun’s ultraviolet B rays, which cause sunburn, but leave you vulnerable to UVA rays, which penetrate deeper into the skin and can induce not just sunburn but also premature skin aging and cancer—a sunscreen labeled “broad spectrum” protects against both. Next, aim for a sun protection factor (SPF) between 30 and 50. If the SPF is lower than 30, you won’t be getting as much bang for your buck (and if it’s lower than 15, you won’t be protecting against cancer); on the other end, there isn’t much evidence that an SPF above 50 provides additional benefit.
Finally, avoid buying products that say they’re “waterproof” or a “sunblock”—these specific terms are no longer FDA-approved, so you’ve managed to find a money-wasting dud. That said, sunscreens can still be water-resistant, so those are wise choices if you plan to sweat or swim (just make sure to reapply after swimming or in the time frame specified on the bottle—probably 40 or 80 minutes).
Our favorite sunscreen ingredient right now is micronized zinc oxide. We like it for its effectiveness and safety—it fits all the criteria above. Feel free to ask your dermatologist for a recommendation, too, because even better ingredients could be in the pipeline. Most important, use lots of it, and daily—even if it’s cloudy. Currently, one in five Americans will develop skin cancer at some point in their lives, and protecting from harmful UV rays is an important step to being one of the lucky four.
Q: I was diagnosed with melanoma recently. It was caught early, but I face difficult treatment. My family and friends aren’t very supportive; they think this cancer was “my fault.” Do skin cancer patients frequently face this problem?
A: That’s a tough and, unfortunately, common situation. Many people don’t realize how serious and difficult some skin cancers can be to treat, and because the uninformed assume that all skin cancer is preventable, they think you brought it on yourself. People respond to cancer diagnoses—whether it’s them or someone they love—in different ways, and it’s not unusual to experience regret, guilt, shame or anger. And the truth is that many cancers, skin cancers included, are theoretically preventable. But it’s important to understand that this in no way validates blaming someone for his or her disease.
So what can you do? Forgive yourself, your body and your loved ones, and focus on the future—use these conversations as opportunities to educate the people around you about the seriousness of skin cancer and the lifestyle steps they can take to reduce their risk.
Q: I went to tanning beds occasionally in college without realizing the risk. I am very sun-safe now but worry about the damage I may have done. Is there anything I can do to mitigate it now?
A: It’s great that you tossed that bad habit, because tanning beds emit ultraviolet radiation that results in premature aging and significantly increases your odds for skin cancer. In fact, experts link the recent significant rise in melanoma with the rise in tanning’s popularity.
That said, there are a few things you can do—besides avoiding tanning beds like the plague, staying out of sunlight (especially during the brightest hours of the day), and religiously applying broad-spectrum sunscreen to all exposed skin, including vulnerable spots like your lips, ears, nose and shoulders—to prevent further damage. First, be forthcoming with your dermatologist about the tanning in your past, as tempting as it may be to cover it up, and ask her how often you should be coming in for a skin check. For most people, the frequency is about once a year, but your doc might recommend coming in every six months or even every three months. Second, ask her about laser treatments. Laser technology is now enabling us to eliminate many sun-damaged cells and even treat precancerous lesions.
Finally, although UV rays are responsible for the vast majority of skin cancers, other factors can increase your odds. The biggest: tobacco. Smoking doubles your risk of developing squamous cell carcinoma (in addition to dramatically upping risks for many other cancers). So if you smoke, quit now, and your skin will thank you.
Q: I have dark skin and never burn, but my doctor still wants me to be careful about the sun. Isn’t my risk low enough that I don’t need to worry?
A: It’s true that the darker your skin, the more melanin (pigment) you have and the more resilient your skin cells are after exposure to UV rays. Melanin is like natural sunscreen—in African-American skin of medium darkness, melanin provides an SPF of about 13.4 (compared to 3.4 in white skin). But that’s nowhere near the minimum of 30 that we recommend, and while it might reduce your risk for skin cancer, it doesn’t make you immune. And people of color who contract skin cancer have worse outcomes: Among people diagnosed with melanoma, 52 percent of non-Hispanic black patients and 26 percent of Hispanic patients are at an advanced stage, versus only 16 percent of non-Hispanic whites.
No matter your skin color, it’s smart to limit your time in the sun, use broad-spectrum sunscreen with SPF 30 to 50 (and reapply!), and see a dermatologist yearly to screen for skin cancers.