Sun Safety: How to Protect Your Skin This Summer

Duke Assistant Professor of Dermatology Meenal Kheterpal explains why sun protection is about more than sunscreen

An umbrella in the sun.

As summer approaches, we’re spending more time outside. And with that comes more exposure to the sun.

If not properly managed, too much sun can have damaging health effects. According to the American Cancer Society, cancers of the skin are the most common of all types of cancer with an estimated 5.4 million skin cancers diagnosed each year in the United States. Most cancers of the skin are caused by repeated and unprotected skin exposure to ultraviolet rays from sunlight or sources such as tanning beds.

With summer vacation season gearing up with Memorial Day weekend, the National Council on Skin Cancer Prevention hopes to raise awareness for the importance of protecting skin from the sun with Don't Fry Day, which is Friday, May 28.

How can you enjoy time outdoors while keeping your skin safe from the sun’s harmful effects?

Working@Duke talked with Duke Assistant Professor of Dermatology Meenal Kheterpal, who directs Duke Dermatology’s skin cancer research programs and sees patients at Duke South and Duke Lightner Dermatology at Wakefield, about sun risks and how to keep you and your loved ones safe.

What can the sun do to our skin?

In addition to the visible light that we see, the sun emits two types of ultraviolet (UV) radiation – Ultraviolet A (UVA) and Ultraviolet B (UVB) – which are absorbed through our skin. UVA radiation, which is also emitted from tanning beds, is the more damaging of the two.

Duke Assistant Professor of Dermatology Meenal Kheterpal.Kheterpal said that, while absorbing excessive amounts of both types of UV radiation damages skin cells, your body has ways to repair itself. One example of this is a tan, which is the result of your body producing more melanin, a substance that adds a darker pigment to the skin while protecting cells from UV radiation.

Occasionally, this repair process can result in mutations that turn into skin cancers. Kheterpal said that the more you ask your skin to repair itself, the more opportunities you have for potentially cancer-causing mutations to occur.

While people with fair skin are at greater risk of developing skin cancer, the American Cancer Society warns that people of all ethnicities can be affected by sun exposure.

“I tell people all the time to think of your skin as an empty bucket,” Kheterpal said. “You’re slowly filling it every time you’re getting sun exposure. If you’re very fair, you only get a small bucket. If you have darker skin, you have a larger bucket. So, depending on what bucket you’re given and how often you fill it, at some point it will overflow and you’re going to be at risk of developing skin cancers.”

How can we protect our skin from the sun?

According to Kheterpal, the best approach for protecting your skin should involve multiple measures. Those include seeking shade whenever possible through shelter, wide-brimmed hats or umbrellas; wearing clothes that shield your skin and using sunscreen.

When it comes to clothing, Kheterpal recommends wearing comfortable garments that cover as much of your skin as possible. While ballcaps can provide some protection, Kheterpal said that since they don’t cover your ears or the sides of your head, they aren’t as effective as wide-brimmed hats. 

And for skin that isn’t covered, sunscreen is a must. In fact, Kheterpal recommends using facial sunscreen, which often doesn’t have ingredients that can clog pores, on your face and hands every day. 

“You can get some level of ultraviolet A all year round,” Kheterpal said. “Even when the UV index is pretty low, sun protection can help keep you looking younger by preventing skin spots and wrinkles. So if not for skin cancer, wear it for vanity.”

What should we look for in sunscreen?

The thing most people notice about their sunscreens in the SPF, or sun protection factor, which measures how much protection from UV radiation the product provide. 

Applying sunscreen to your face and hands each day can help prevent sun damage.Kheterpal recommends using products with an SPF of at least 30. Higher SPF products are available, which may be more expensive and boast longer-lasting protection. But with most sunscreens only lasting on the skin for about 80 minutes at most – or considerably less if you spend time in the water – simply reapplying lower-SPF sunscreen can be a smarter, and just as effective, alternative.

Kheterpal also points out that there are two types of sunscreens, ones that use chemical reactions to filter UVA radiation and others that use ingredients such as zinc oxide or titanium dioxide to create physical barriers on the skin for UVA and UVB rays. While both are effective, Kheterpal said that the sunscreens with zinc oxide or titanium dioxide are considered to do a better job preventing skin damage and are considered the safer choice. These are also the preferred choice for use on children.

Most brands offer multiple kinds of sunscreen, so it’s important to look for zinc oxide or titanium dioxide among the ingredients to be sure you’re getting the best protection.

And Kheterpal said that spray sunscreens are effective but are likely best used in concert with cream sunscreens.

“In general, we think the cream-based sunscreens do stay on the skin a little bit better,” Kheterpal said. “So my personal recommendation to patients is that your first application should always be a cream sunscreen and then, if you want to use a spray for reapplication, I’d rather you use the sunscreen every 90 minutes than not use sunscreen.”

What should we do for kids?

Children need special attention when it comes to skin safety. Skin damage accumulates over your lifetime, so excessive exposure to the sun at an early age increases the risk of problems later in life.

Because of this, Kheterpal recommends that children wear sun-protective clothing and stay in shade whenever possible and that they wear sunscreen whenever they’re outdoors. For infants, sun protection is complicated. The Food and Drug Administration recommends consulting your pediatrician before applying sunscreen and doing your best to keep them out of the sun.

Kheterpal also recommends that parents should have their children apply their own sunscreen when they’re old enough to do so to help them make the routine a habit.

When should you see a dermatologist?

Kheterpal said that there isn’t a one-size-fits-all approach to when you should see a dermatologist. If you have a history of skin cancer, or a history of it in your family, you should see a dermatologist regularly. Likewise, if you are a longtime smoker or if you had excessive exposure or the sun or tanning beds, you should consider visiting a dermatologist for a check-up.

The National Council on Skin Cancer Prevention will celebrate #DontFryDay on Friday, May 28. Visit the website listed above for more information on protecting your skin.And regardless of your risk factors, dermatologists recommend examining your skin on a monthly basis. If you see any moles, freckles or marks that appear to be large, irregular or changing, it would be wise to get a dermatologist to check it out.

“There are lots of benign things that can have these symptoms, but if you’ve never been to a dermatologist, they can help you differentiate the benign things versus something that needs more attention,” Kheterpal said.

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