Here Comes the Sun

BY Stephanie Miller

Okay so you’re armed with SPF 15 a UNCW baseball cap a colorful beach towel and a big umbrella … you’re ready to enjoy the surf and sand and still stay safe from the sun’s harmful rays right? Not so fast. Azalea Coast dermatologists say you need to tweak the goodies in your tote bag to make sure you’re really protected as beach season begins.

Starting with the basics you and everyone you know — your boyfriend wife children husband friends cousins in-laws Aunt Mae and Grandpa Joe — need a palm full of sunscreen. Yes a palm full (one ounce or a shot glass worth) and no less.

When choosing a sunscreen check the fine print on the back of the tube say our local dermatologists. The sun emits both UVA and UVB rays and both of them are our enemies. The UVB rays cause sunburns and the UVA promote premature aging. Both can cause skin cancer. The higher the SPF (sun protection factor) numbers on the sunscreen the longer and better the protection. The problem is that the ratings on the cream give you only the UVB protection levels. In order to get protection from UVA as well you need to look for the ingredient zinc oxide or titanium dioxide on the label. A third critical ingredient is avobenzone (Parsol 1789) which blocks both the UVA and UVB rays. Don’t waste your time slathering on sunscreen that doesn’t measure up.

Dr. Jonathan Crane of Atlantic Dermatology Associates PA recommends Neutrogena Sunblock Lotion for Sensitive Skin with an SPF of 30. This sunscreen has titanium dioxide as the main ingredient. “You have to be careful ” warns Crane. “Neutrogena makes several SPF 30 sunscreens but not all of them have titanium dioxide as the main ingredient.”

Two of the hottest new sunscreen technologies for protecting our exposed epidermis are Helioplex in the Neutrogena brand and Active Photobarrier Complex in the Aveeno product line. Both technologies stabilize the critical ingredient avobenzone (Parsol 1789) promoting maximum protection. Dr. Kimberly Edwards of Dermatology Associates PA suggests a sunscreen that uses this new technology. Neutrogena’s Ultrashear SPF 70 is her sunscreen of choice and she recommends that you make sure the words “broad spectrum” are written on the tube so you can protect against the wrinkling effects of the sun as well.

So you’re at the beach and you’ve got the right sunscreen in your tote bag. Now what? Lather up 30 minutes before you even hit the rays so your sunscreen has a chance to react with your skin. Once lathered be sure to reapply every couple of hours especially after a dip in the Atlantic a splash in the pool or a Frisbee battle on the beach.

And learn the Shadow Rule: If your shadow is shorter than you the sun’s rays are at their strongest. Before 10 a.m. and after 4 p.m. are the safest times to be catching rays. “Staying out longer because you’re using sunscreen just means you’ll end up getting the same amount of UV light as you would otherwise ” says the American Cancer Society. Don’t lie play or stay in the sun all day. Keep track of the time. Friends don’t let friends fall asleep on the towel.

As for beach attire replace the baseball cap with something that covers your ears and neck. Wear wraparound sunglasses with 99-100 percent UV absorption. Clothing as a rule doesn’t have good sun protection Dr. Crane admits. A white T-shirt might give you a SPF of 8 or so and if the shirt gets wet he warns it drops to a 6. But there are clothes out there that can do the job. Dr. Edwards is a firm believer in taking the time to find and wear clothing that gives great protection against the sun. She puts swimsuits with high UPF ratings (ultraviolet protection factor) on her children before they head off to the beach or the pool.

It may not be what you’re putting on your body but what you’re putting in it that can make you more susceptible to the sun’s rays. Certain antibiotics acne medications and medications for high blood pressure can make your skin more sensitive to the sun says Dr. Edwards. Check with your doctor; if you’re taking any of these medications and planning a day at the beach take the proper precautions to protect yourself.

But the beach is not the only place where UV rays are waiting to attack your skin. According to the American Cancer Society the UVA rays found in tanning beds and sun lamps penetrate the skin more deeply than UVB rays and increase the risk of skin cancers including the more serious type of cancer melanoma.

Whatever the cause of skin cancer the disease is on the rise in our area say local dermatologists. Dr. Michael Sullivan of Carolina Dermatology and Skin Cancer Surgery says one in five Americans — and one in three Caucasians — will develop skin cancer in his or her lifetime. Exposure to the sun is the cause of 90 percent of these cancers. Dr. Crane’s practice is seeing about 50 percent more cases than it did when he first opened Atlantic Dermatology in 1994. Much of the increase is due to acceleration in the number of young women with the disease says Dr. Crane.

The good news is that more people are coming into dermatologists’ offices much sooner than they did in the past to check out an unusual mole or other skin change. Many are getting annual skin checks. If melanoma is caught early the five year survival rate is 99 percent.

Those most at risk have fair skin freckles red or blond hair moles a family history of the disease and those who have had five or more sunburns as children.

Skin cancer usually falls into one of three types. Basal cell and squamous cell cancers are less serious and usually appear on the parts of the body exposed to the sun. Melanoma is far more dangerous than other types of skin cancer and is responsible for most skin cancer deaths.

There is ongoing research in the field. Dr. Sullivan says early-stage research is showing an interest in topical antioxidants such as the polyphenols in green tea and red wine. Topical caffeine is showing similar benefits. Though “that doesn’t mean I recommend a merlot or espresso facial just yet ” Sullivan says.

When it comes to skin cancer the best defense is a good offense. Awareness of the sun’s power and tools to thwart its detrimental effects are critical. Self-examination is an important tool too. And when in doubt there is wonderful medical care in our area.

An ounce of prevention (and an ounce of good sunscreen) is worth a pound of cure.

Signs and symptoms of skin cancer

  • Any change on the skin especially in the size or color of a mole or other darkly pigmented growth or spot or a new growth

  • Scaliness oozing bleeding or change in the appearance of a bump or nodule

  • The spread of pigmentation beyond its border such as dark coloring that spreads past the edge of a mole or mark

  • A change in sensation itchiness tenderness or pain

ABCD rule to tell a normal from an abnormal mole:

Asymmetry: One half of the mole does not match the other half

Border irregularity: The edge of the mole is irregular ragged blurred or notched

Color: The color over the mole is not the same all over. There may be shades of tan brown or black and sometimes patches of red blue or white.

Diameter: The mole is larger than ¼ inch – about the size of a pencil eraser – although doctors are now finding more melanomas that are smaller

Protective Clothing

UPF (ultraviolet protection factor) is the standard for rating UV resistance in clothing. The highest possible rating of 40-50 UPF is considered excellent protection. With an SPF rating of 50 1/50th of the sun’s UV rays can pass through. That means only 2 percent of the UV rays will get through the garment.

General rules of thumb according to the Skin Cancer Foundation:

  • If you can see through the garment the sun’s rays can get through it.

  • Dark is more protective than light.

  • If a garment gets wet or stretches it loses its effectiveness against the sun. When clothing gets wet it can lose as much as 50 percent of its protection.