It’s August, but just because the summer is going to be winding down soon, that doesn’t mean it’s time to put the sunscreen away!
Too much exposure to the sun’s harmful rays can lead to sunburn, rash, and cumulative sun damage in the form of age spots, fine lines and wrinkles, changes to skin tone and texture, and skin cancers that may show up years later. Sunlight is made up of UVA and UVB wavelengths. UVA rays primarily contribute to premature aging, while the UVB rays are responsible for sunburns, and both can contribute to the formation of skin cancers. A broad-spectrum sunscreen can help protect your skin.
Did you know that sunscreen is not just for summer vacations and beach days? The sun’s radiation can reach you in the fall, winter, and spring as well. Even on cloudy days, you get quite a bit of UV radiation from some common, yet unexpected places.
When do I need sunscreen?
Any time you are exposed to the sun! Prepare to slather on the SPF when you find yourself in these situations.
The great outdoors: Wait a second, these were supposed to be surprising places…
“We all know we are supposed to wear sunscreen to the beach. Not only do we tend to have more exposed skin, but reflection of light by the sand amplifies the amount of UV radiation we receive. It also means the sun’s light is hitting from below, so a hat won’t be enough to protect you from all angles.”
Like the sand, snow also reflects light. I lived for many years in the mountains out west and know from experience that sunburns happen often on the ski slopes. Even if you aren’t a skier, activities such as sledding, outdoor play, even chores like shoveling lead to significant sun exposure. Sunscreen is a must on any exposed skin all winter long!
The great indoors: You need to wear sunscreen every day when you are venturing outside. But you wouldn’t think you need it indoors, right?
Surprise! You can be exposed to UV rays in these indoor spots…
At the nail salon: Gel manicures look nice and can last longer than traditional polish, but they need to be set with UVA-emitting nail lamps. The American Academy of Dermatology suggests applying sunscreen to your hands prior to your appointment. If you choose gel manicures, consider saving them for special occasions.
Seated by a window: Most building windowpanes do block the majority of UVB rays, but more than 50% of UVA rays pass through the glass. If you are seated next to a window, or even a few feet from it, apply sunscreen. If your office or favorite spot is by a window, consider installing a broad-spectrum UV-blocking window film for extra protection.
Driving in the car: Car windows require special consideration. While the windshield is formulated to block an average of 96% of UVA rays, the side windows typically block just 71%. Frequent drivers get a lot of cumulative sun exposure to the left side of the face and the left arm, even with tinted windows. This can help explain why skin cancers are more common on the left side of the body, but sunscreen can help reduce this risk. As a word of caution, don’t store your sunscreen in the car long-term. The intense heat that can get trapped in your car breaks down the chemicals in sunscreen making it less effective.
Airplanes: So the windows of buildings and cars can put you at risk of UV exposure, what about planes? At cruising altitude, the sun is much stronger than at ground level. The risk of sun damage and skin cancer is higher for pilots, flight crews and frequent fliers, but everyone should take the precaution of slathering up before take-off.
Who needs sunscreen?
The short answer is…almost everyone!
“From kids to seniors, sunscreen is a must. The caveat to this is young infants. Once your baby is 6 months old, you can introduce sunscreen. Until then, other proactive measures like hats, sun protective clothing, and seeking shade are the way to go.”
People of all skin tones need sunscreen too! Those with darker skin are more susceptible to acral lentiginous melanoma, a rare type of skin cancer that shows up on the hands and feet (including the palms, soles, fingers, toes, and nails).
What kind of sunscreen should I be using?
Your daily skin care routine should include a mineral based sunscreen (such as zinc or titanium) of at least SPF 30. Mineral sunscreens create a physical barrier to the sun’s rays, and now come in sheer formulations which are less noticeable and more comfortable for everyday use. I prefer these over a chemical barrier such as oxybenzone.
Make sure your sunscreen is broad-spectrum, so it will protect you from both UVA and UVB rays. Ideally, sunscreen should be the last step in your skincare routine. It should also be reapplied every two hours, and even more frequently when participating in sweaty activities or swimming.
Where should I be sure to put sunscreen on my body?
If you are wearing sunscreen, chances are you are applying it on your face. This is great, because in addition to preventing burns and sun damage, you are also protecting yourself from premature aging.
There are additional parts you shouldn’t skip sunscreen on!
- Your scalp and hairline: If you wear your hair in styles that leave the scalp visible (like buzz cuts, braids or twists or even just a prominent part) or if your hair is on the thinner side, it racks up some sun. A hat is a good option to protect this area, but if you remove the hat at all you are exposed to UV rays. Spray sunscreen can be just the ticket to protecting this vulnerable skin.
- Your ears: Whether your hair is short, in a ponytail, or just tucked behind the ears, chances are your ears will get more sun than you think. Put sunscreen on the tops, sides, lobes, and behind your ears… any part that is visible.
- Your eyelids: The skin of the upper and lower eyelids is thin. Pay special attention to getting adequate sunscreen on and around the eyelids. Sunglasses with broad-spectrum UV protection are also helpful. Sun rays can damage the eyes too so regular exams with an ophthalmologist are recommended.
- Your lips: The lip skin is unique. It forms the boundary between facial skin and the mucous membranes of the mouth. It comes with a thin stratum corneum and no hair or sweat glands. Actinic cheilitis (precancerous growths on the outer layer of the lips) is common. I recommend a lip balm with SPF 30 or greater, or you can use regular sunscreen on the lips instead. Remember it will dissolve more quickly if you are eating or drinking so be sure to reapply!
- Your neck and chest: Lower necklines and wearing hair up or cut short leaves the chest and back of neck open to potential damage. This skin is often forgotten but gets a lot of daily incidental sun exposure!
- Your hands: The backs of the hands are one of the most frequently exposed parts of the body. And while the palms touch sunscreen while applying it elsewhere, the backs are often forgotten. Even if you do pay attention to this spot, frequent hand washing required of cold and flu season can rinse the sunscreen right off so remember to reapply.
- Your shins and back of the knees: The lower leg is the most common site for melanoma to appear in women. Apply and reapply sunscreen to exposed areas of the legs, particularly the shins and back of the knees.
- Your feet (including the soles): Sandals and bare feet leave this area susceptible to sun. When venturing out remember to get the tops and bottoms of the feet with sunscreen. This is especially important for people of color where the melanin differential is greater between the soles of the feet and the rest of the skin.
What about Vitamin D?
Vitamin D is an important substance in the body which aids in the absorption of calcium, which is critical for strong bones, hormone regulation, nerve conduction, and muscle contractions. One way we get vitamin D is through exposure to UVB wavelengths of sun rays. Right now, the American Academy of Dermatology’s official recommendation is that “Vitamin D should not be obtained from unprotected exposure to UV radiation.” It is recommended to use sunscreen and other protective measures such as protective clothing, hats, and sunglasses whenever outdoors, and to limit outdoor time during the peak sun hours.
“While these measures do block some of the vitamin D synthesis which occurs in the skin, it also drastically reduces the risk of skin cancer.”
The good news is that we have other ways to obtain the vitamin D we need. Vitamin D occurs naturally in many healthy food choices such as salmon, tuna, swordfish, and eggs. There are also many Vitamin D fortified foods such as cereals, milk, orange juice and yogurt. Vitamin D supplements are sold over the counter. Adults and children over the age of 4 are recommended to consume 600IU of vitamin D daily, and children under the age of 4 are generally recommended to get 400IU of vitamin D daily (of course, be sure to check with your own doctor or advanced practice provider to ensure these recommendations are right for you).
My advice is to make a broad-spectrum mineral sunscreen part of your daily habit, every day, all year long. No matter how diligent you are or aren’t with sunscreen, always be sure you are seeing your dermatologist once a year for a full body skin exam. They can guide you on the best choices for your skin and are specially trained to identify and treat skin cancers and other skin ailments early on to give you the very best outcomes and keep your skin beautiful and healthy.
Pamela Hoffman is board certified Physician Assistant at Apex Dermatology. Following a successful career in clinical research, Pamela returned to school and graduated with a Master’s degree in Physician Assistant Studies from Case Western Reserve University in 2020. She recently completed Apex’s dermatology internship, where she learned from the finest dermatological providers in Northeast Ohio. She is currently working on her Diplomate Fellowship from the Society of Dermatology Physician Assistants. Pamela sees patients for all skin conditions including adult and pediatric dermatology with the goal of promoting patient health and helping her patients to look and feel their best. Pamela has lived in the Cleveland area since 2013. Her husband is a Cleveland native, and together they enjoy spending time being active outdoors, taking family adventures, and cheering on our Cleveland sports teams.