Medical Dermatology

There are two sets of factors that determine the health and appearance of your skin. The first one – genetics – is a factor that you have little control over. You did not get to pick your parents. But genetics accounts for only about 40% of the condition of your skin.

How well you care for your skin is the second factor. It is overwhelmingly the most important determinant of your skin’s long-term appearance and health. Good skin care and prevention is responsible for 60% of the condition of your skin.

Caring for Your Skin

When thinking about how to care for your skin, it is important to remember that it is the largest organ of the body. The appearance of your skin mirrors your overall general health. And all of the same factors that harm your health – smoking, too much alcohol or caffeine, poor diet, stress and not enough exercise or sleep - also rapidly age a person’s skin.

Unlike the rest of your organs, however, your skin also faces another threat. Every time it is exposed to the sun, your skin is damaged. Medical research has shown that the risk of skin cancer substantially increases each time an individual gets sunburned.

Sun damage also accumulates over time. In many ways, your skin is like a car’s odometer that records and reflects all of the sun damage you have accrued over a lifetime. Protecting your skin from the sun is an integral part of caring for it. We, at North Dallas Dermatology Associates, recommend that our patients follow four simple rules:

Rule #1. Stay out of the sun and the tanning booth

There is no such thing as a safe tan. Any amount of tanning or sun exposure damages the skin. So when you are outdoors, seek shade. This is particularly important during those times of the day when the sun is strongest (between 10 a.m. and 4 p.m.) – especially if you cannot see your shadow or if it is shorter than you.

There is also a common myth that claims an individual can protect their skin by getting a “base tan” before going to the beach. In reality getting a base tan is analogous to partially damaging your skin before really hurting it.

The sun produces two wavelengths of light that damage the skin – ultraviolet A and B. Most outdoor light is UVB, a shorter wavelength that mostly damages the outer layers of your skin. Most non-melanoma skin cancers are due to UVB (natural sunlight).

Tanning booths are exceptionally bad for your skin because they produce mostly UVA light. UVA is a longer wavelength that penetrates deeper into the skin, causing much more damage that usually appears later in life in the form of wrinkles and sun damaged skin. More importantly, there is new research that suggests that melanoma, the most lethal form of skin cancer, is primarily linked to the UVA wavelength. Even more reason to stay out of the tanning booth!

Rule #2. Always wear sunscreen

While you should try to stay out of the sun as much as possible, it is impossible to completely avoid going outside. Even in the shade your skin is exposed to reflected sunlight, and it is also absorbed through car windows. So the second essential part of caring for your skin is to protect it at all times by wearing sunscreen and not just when you are going outside for an extended period of time. Putting on sunscreen should be as much a part of a person’s daily routine as combing hair and brushing teeth.

It is important to remember that sunscreen reduces but does not prevent sun damage. You can still get sun even with sunscreen on! For example, a SPF 30 sunscreen allows you to stay in the sun thirty times longer than you would without sunscreen before burning. So wearing sunscreen does not completely protect the skin from the sun, but it does help to substantially reduce the level of damage.

When selecting a sunscreen, it is important to look for one that provides “broad spectrum” protection. This means that it protects the skin from both UVA and UVB wavelengths. We also recommend that our patients use a moisturizer that includes sun protection with at least a SPF 15 as part of their daily skin care routine. For outdoor activity, we recommend a sunscreen with SPF 45 or greater and one that is waterproof for sports.

Two common mistakes that people make are not using enough sunscreen to provide adequate protection and failing to reapply it frequently enough throughout the day. If you are going to be outside all day, you will need to reapply it about every two to three hours.

Rule #3. Wear protective clothing

Another integral part of caring for your skin is to wear sun protective clothing, in particular when you go outdoors. We recommend that patients wear sunglasses, lip protection and a hat with a brim that is at least 7.5 cm. It is also essential that any clothing worn in the sun be tightly woven and dark in color in order to block the sun’s rays.

For example, a common misconception is that a T-shirt protects your skin from the sun. A white T-shirt only offers an SPF equivalent of about 4 to 6. If the shirt gets wet, it is even less than that. Darker colored clothing typically provides an SPF of about 8 and a denim shirt is about a 12. To truly protect your skin when wearing a t-shirt, it is a good idea to wear sunscreen under your clothing.

Another option is to wear clothing that is designed to provide high levels of protection from the sun. Two companies – Coolibar and Solumbra – have designed various lines of clothing with a SPF of at least 30 or greater. (See www.coolibar.com or www.sunprecautions.com)

Rule #4. Protect your children

Sun damage is cumulative and the majority of sun damage occurs early in life. One study showed that about 80% of the sun damage to a person’s skin typically occurs by the age of 18.

Thus, it is critical that parents take an active role in protecting their children’s skin. They must make sure that younger children always wear sunscreen and stay out of the sun as much as possible. They also should dress them with protective clothing (including a hat) when they are outdoors and keep them out of the sun during the middle of the day.

As children get older, parents should educate them about the importance of skin care and the long-term consequences of sun exposure. While it is impossible to completely prevent sun damage, the more that is done to protect an individual’s skin at an early age, the healthier it will be for the rest of their life.