Staying Fit
Years of soaking up the sun can lead to unfortunate results: brown spots, wrinkles, broken capillaries, uneven skin texture and freckles — and even skin cancer. And although wearing sunscreen daily plays a big role in protecting your skin, there are other ways to keep your skin healthy and still enjoy the sun.
To help guide you, here’s our AARP Smart Guide to Sun Protection, including a primer on SPF, how to find products that will work best for your skin tone and type, and what to discuss with your dermatologist at your next annual skin exam.
SKIN HEALTH BASICS
1. Visit your dermatologist regularly
Just like your annual physical or eye exam, you should schedule an annual skin check with your dermatologist for skin cancer prevention. During your exam, the doctor may refer to sun damage as photoaging, photodamage and solar damage. “During these appointments, your dermatologist will check your skin for any unusual lesions that require medical attention,” says Sumayah Jamal, M.D., a dermatologist with the Schweiger Dermatology Group in New York City. Early detection is key for catching skin cancer, and these screenings allow the physician to view every inch of your skin for moles, rashes and any changes from year to year.
2. Be prepared for your appointment
Arrive at your appointment with your hair loose and no nail polish. And if you’re wearing makeup, bring a makeup wipe to remove it so that it’s not covering up your face. In between appointments, take photos of any suspicious spots so you can show your doctor the changes. When melanoma is detected early, the five-year survival rate is 99 percent, according to the American Academy of Dermatology. If you are researching photos of skin cancer, keep in mind that it can look very different based on whether you have melanated skin or not. The American Cancer Society says that if you notice your skin has a rough patch that crusts, bleeds or oozes or if you’ve developed a mole or spot that changes in size, shape or color, you should pay your dermatologist a visit as soon as possible — even if it falls between your annual checkups.
3. Know what to look for
Skin cancer — the abnormal growth of skin cells — is the most common cancer in the United States and worldwide, according to the Skin Cancer Foundation. “Skin cancer” is an umbrella term for many types, and treatment can involve surgery to remove the cancer cells. The three major types of skin cancer are:
Basal cell carcinoma (BCC) is the most common type of skin cancer and occurs when UV radiation triggers basal cells to grow uncontrolled. A nonmelanoma, BCC can range widely in appearance and present as open sores, white waxy scar-like lesions, red or brown scaly patches, shiny bumps, scars or growths with slightly elevated and rolled edges and/or a central indentation on areas of the skin that are typically sun-exposed. Because it grows slowly, BCC is directly related to sun exposure and has a high detection rate — and most are curable, according to the Skin Cancer Foundation.
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Squamous cell skin cancer (SCC) is the second-most common skin cancer and occurs where there is cumulative sun damage to the skin. A nonmelanoma, SCC is characterized by the abnormal, accelerated growth of squamous cells. They look different on everyone, appearing as scaly red patches; open sores; rough, thickened or wart-like skin; or raised growths with a central depression. They can occasionally itch, bleed and crust over. Although most are found on common sun-exposed areas of the body, SCC can also show up inside the mouth, on the genitals, inside the anus and beneath a nail. SCC can also be brought on by too much sun exposure, but it is more associated with smoking, drinking too much alcohol and a weak immune system. Most SCCs can be treated and cured.
Melanoma is a serious form of skin cancer and begins in cells known as melanocytes. Less common than BCC or SCC, melanoma can spread to other organs if it is not caught and treated early. A melanoma often presents as a change in an existing mole, so use ABCDE as a guide: A is for asymmetry. (One half of the spot is unlike the other half.) B is for border. (The spot has an irregular, scalloped or poorly defined border.) C is for color. (It has varying colors from one area to the next.) D is for diameter. (It is 6 millimeters — the size of a pencil eraser — or larger). And E is for evolving. (The spot changes in appearance.) If you notice any spots have changed, talk to your dermatologist. Melanoma is typically curable if caught early — but if not, it can spread fast on the skin or other parts of the body, becoming more difficult to treat.
4. Avoid sunburns
According to the Skin Cancer Foundation, having five or more sunburns doubles your risk for melanoma, and even one blistering sunburn in childhood or adolescence more than doubles your chances of developing melanoma later in life. You can’t help what happened in the past, but you can make sure to avoid additional sunburns later in life. Keep in mind though, even if you avoid sunburns, sun damage to your skin can still happen.
SUNSCREEN BASICS
5. Understand the difference between UVA and UVB rays
The sun produces three types of ultraviolet (UV) rays: UVA, UVB and UVC rays. UVC rays are blocked by the atmosphere, so we don’t have to worry about those. UVA rays are the most powerful and are present during daylight hours. These rays reach the epidermis of our skin (top layer) and into the dermis (the middle layer of our skin) and cause wrinkles and fine lines. UVB rays cause damage to the epidermis and are the chief culprit behind skin reddening and sunburn. Too much exposure to UVA and UVB rays can lead to skin cancer, which is why it’s imperative to use a sunscreen that is labeled broad-spectrum — meaning that it blocks both UVA and UVB rays. Most active ingredients in sunscreen shield against UVB, but far fewer have UVA coverage, so look at the bottle carefully.
6. Decipher SPF ratings
SPF stands for “sun protection factor.” It refers to how much solar energy (UV radiation) it takes to result in a sunburn on your skin with sunscreen applied, relative to skin with no sunscreen applied. For example, SPF 15 blocks about 94 percent of rays, SPF 30 blocks 97 percent, and SPF 50 blocks about 98 percent. As a base, use at least SPF 30, which is what most dermatologists recommend. No sunscreen can offer 100 percent protection, but higher SPF numbers allow you to be protected out in the sun longer.
7. Don’t rely on high SPF only
“Higher SPF doesn’t always mean better protection,” says board certified dermatologist Corey L. Hartman, founder of Skin Wellness Dermatology in Birmingham, Alabama. “At minimum you should be using a broad spectrum SPF 30, and even going up to SPF 50 can add an additional layer of protection.” According to Hartman, once you go above 50, the higher SPF ratings only offer marginal improvements in sun protection. It’s more important to apply sunscreen properly and reapply often.
8. Choose between mineral or chemical sunscreen
There are two main types of sunscreen — mineral-based (physical) and chemical-based. Both shield your skin from the harmful effects of the sun’s UV rays, but they work in different ways. Mineral sunscreens sit on the surface of the skin and physically prevent UV rays from penetrating. They contain ingredients such as zinc oxide and titanium dioxide, and they tend to be thicker than their chemical sunscreen counterparts. Mineral sunscreens are also less irritating for sensitive skin. Chemical sunscreens work by absorbing UV rays. They use ingredients such as oxybenzone, octinoxate, avobenzone and octisalate to attract UV rays like sponges and then turn them into heat that’s released from the skin. Dermatologist Geeta Yadav, M.D., of Facet Dermatology in Toronto, Canada, says they “work by creating a chemical reaction that absorbs energy from the sun [to] protect the skin.” There are several benefits to chemical sunscreens: They go on transparent, work for a range of skin tones, are more lightweight and tend to be more breathable. The downside to chemical sunscreens is that they can cause skin irritation and inflammation for some, especially those with sensitive skin. In this case, a mineral sunscreen may be best.
9. Look for ‘reef-safe’ ingredients
You’ve probably seen “reef-safe” or “reef-friendly” labels on sunscreens. Although the phrases aren’t regulated, this typically means the sunscreen doesn’t contain oxybenzone or octinoxate — both of which protect against the harmful effects of UV rays but have been found to cause damage to coral reefs, one of the most diverse ecosystems on the planet. When you swim or shower, this chemical can enter our waterways. Some beaches — such as those in Hawaii, Palau and the U.S. Virgin Islands — have even moved to ban oxybenzone-containing sunscreens.
10. Plan for sun exposure
Chemical sunscreens are lighter but take time to absorb into your skin before they offer protection. Mineral-based sunscreens offer immediate protection — no waiting needed. In the past, mineral sunscreens could leave a white cast or residue on your skin, but more recent iterations are easier to blend in. “If you’re wearing a physical sunscreen that contains actives like titanium dioxide and zinc oxide, you are protected as soon as you’ve completed your application,” says Melissa Urban, a licensed aesthetician at the SkinForYou spa in Colorado. “If you’re wearing a chemical sunscreen that contains oxybenzone, octinoxate, avobenzone or homosalate, you should wait [at least] 15 minutes before sun exposure.” Because chemical sunscreens work by absorbing the sun’s energy, this extra time is necessary to ensure your skin absorbs the formula before it’s exposed to the sun. No matter which one you choose, it’s always best to apply to dry skin before you get to your destination. You can use a mirror and/or get a friend to help with those hard-to-reach spots.
11. Reapply SPF after two hours
SPF only provides protection for roughly two hours when outdoors. This means that reapplication is just as necessary as — and perhaps more crucial than — your initial application. And this is the case whether you’re using a chemical or mineral SPF. The rule of thumb is to reapply SPF every two hours when you’re outside as well as after swimming or sweating, according to the American Academy of Dermatology (AAD). Karen Fernandez, a lead aesthetician at the SkinSpirit spa in California, says mineral SPF relies on the physical barrier of zinc oxide and titanium dioxide to provide coverage. But after two-plus hours, it’s likely that “the product has been wiped off or is no longer evenly applied,” she says, noting that sweat — even the slightest amount — can also diminish a formula’s efficacy. It’s slightly different when it comes to chemical sunscreens, but the timing remains the same. “With a chemical sunscreen, the [active ingredients] have literally been used up after two hours,” Fernandez adds.
12. Rely on water-resistant formulas
If you know you’ll be spending time in or around water (or expect to sweat), always choose a water-resistant sunscreen. This is not to be confused with waterproof. You should always still reapply sunscreen every two hours or more often if you’re swimming or sweating. Still, the benefit of water-resistant sunscreens is that they’re designed to keep your skin protected even while wet. “With physical SPF, the active ingredients will be the same as non-water-resistant versions, but the base will be different. It will be much thicker and oil-dense, which takes longer to dissolve in water,” Fernandez says.
13. Choose based on skin type
If your skin is on the drier side, look for creamy textures that’ll nourish the skin as it protects. Yadav recommends hydrating ingredients that help quench dryness (like hyaluronic acid) as well as ceramides, which prevent moisture loss, and moisturizing emollients like jojoba oil, shea butter and squalane. If you have oily skin, avoid formulas that contain heavy oils and plant butters (like coconut oil, shea butter or cocoa butter), and stick with a mineral (physical) sunscreen, which is less likely to irritate. If you have sensitive skin, Yadav recommends formulas that contain soothing ingredients to help quell any existing irritation or redness, such as aloe, chamomile, green tea and niacinamide.
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