Pale is the New Tan? by Dr. Elise Rackoff

By Janet Oppenheimer | Jul 10, 2012
Elise Rackoff is a board certified dermatologist at Advanced Dermatology & Skin Surgery in Asheville and  a member of the Western Carolina Medical Society.  She and her husband, a gastroenterologist practicing in Hendersonville live in Arden with their daughter and son.

This is the time of year when dermatologists see the most sunburns. “Well, I thought I would only be gardening for a few minutes…” or “I didn’t get sunburned at the beach last year.”  The scariest? “I thought the tanning bed was safer than regular sun”.

Most people want to protect themselves from aging, diabetes, cancer, heart disease... The good news is that protecting yourself from skin aging and skin cancer is easy.  Sun exposure is the most preventable risk factor for skin cancer ~ use a broad spectrum sunscreen, wear protective clothing, and seek shade.

A little science review:  Sunlight consists of several types of rays that reach the earth’s surface. Ultraviolet A (UVA) and ultraviolet B (UVB) rays are the two types of light that primarily harm the skin.  UVB rays are the primary cause of sunburn and are blocked by window glass.  UVA rays, however, are not blocked by window glass and cause most of the deeper damage to skin: wrinkles, age spots and skin cancer.  See for yourself by googling the New England Journal of Medicine sun damaged truck driver...

Avoiding sunlight all together is, of course, hard to do.  But, avoiding prolonged exposure between 10 a.m. and 4 p.m. helps.  Another way to think of it- if your shadow is shorter than you are, seek shade.  Water, snow and sand also reflect those UV rays so extra caution is needed even when in the shade and even during winter or cloudy days.

Sunscreens are currently getting a makeover by the FDA which should help make it easier to pick the best product for you.  The most important factor in a sunscreen is “broad-spectrum” which means it will block both UVA and UVB rays.  The best common ingredients to look for are titanium dioxide, zinc oxide, and mexoryl.  These actually block, instead of filter, the sunlight and are more important than the SPF number.   However, it is also important to apply sunscreen to dry skin at least 15 minutes before going outdoors and to reapply hourly.  An SPF of 30 is plenty when following these rules.

Sun protective clothing is also fantastic- pull that on and you’re done. Look for a high ultraviolet protection factor (UPF). It may be more investment up front, but the fabric dries quickly, lasts years, and comes in fun colors and patterns. And better yet, there’s no reapplying.  Additionally, tinosorb (bisoctrizole) can be added to the laundering of clothes to bind fabric, making it highly UV protective for up to 25 wash cycles.  Wide-brimmed hats and sunglasses should go without saying.  Melanoma on the eyeball?  It happens. Ask some of our patients.

Why are tanning beds so bad?  Tanning beds emit both UVA and UVB rays and have been declared a known carcinogen (cancer-causing substance) by the World Health Organization.  There is a 75% increase in melanoma, the most deadly form of skin cancer, from using tanning beds.  I tell the teenagers and parents in my practice that much as we wouldn’t recommend smoking or getting in a car with a drunk driver, we don’t recommend getting in a tanning bed.  If you want to look tan, apply (but don’t inhale) a sunless tanner

Check your skin. On your birthday, look at your birthday suit, or have us look at it with you. See a dermatologist if you have new spots, particularly if you see anything bleeding, changing or growing.

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