Sun Safety: Save Your Skin

Sun safety is never out of season. Summer's arrival means it's time for picnics, trips to the pool and beach -- and a spike in sunburns. But winter skiers and fall hikers need to be as wary of the sun's rays as swimmers do. People who work outdoors need to take precautions, as well.

The need for sun safety has become clear over the past 30 years, with studies showing that excessive exposure to the sun can cause skin cancer and premature aging of the skin. Over time, sun exposure harms fibers in the skin called elastin. When these fibers break down, the skin begins to sag and stretch. It also bruises and tears more easily, and takes longer to heal.

Spending too much time in the sun can also give your skin freckles, rough texture, white spots, a yellowing of the skin, and discolored patches (which doctors call "mottled pigmentation"). It can also widen small blood vessels under your skin.

Harmful rays from the sun -- and from sunlamps and tanning beds -- may also cause eye problems, weaken your immune system, and give you unsightly skin spots and wrinkles or "leathery" skin.

Sun damage to the body is caused by invisible ultraviolet (UV) radiation, which reaches us as long wavelengths known as UVA and shorter wavelengths known as UVB. UVB radiation can cause sunburn. But the longer wavelength UVA is dangerous too, as it can penetrate the skin and damage tissue at deeper levels.

Tanning is a sign of the skin reacting to potentially damaging UV radiation by producing additional pigmentation that provides it with some -- but not nearly enough -- protection against sunburn. In fact, tanned skin is damaged skin.

No matter what our skin color, we're all potential victims of sunburn and the other harmful effects of excessive exposure to UV radiation. Although we all need to take precautions to protect our skin, people who need to be especially careful when outside are those who have:

• Pale skin
• Blond, red, or light-brown hair
• A history of skin cancer
• A family member who's had skin cancer

If you have an illness and take medications, ask your doctor about extra sun care precautions, because some drugs may increase sensitivity to the sun.

Cosmetics that contain alpha hydroxy acids (AHAs) also may increase sun sensitivity and susceptibility to sunburn. Look for the FDA's recommended sunburn alert statement on products that contain AHAs. Choose cosmetics that offer UV protection. You still need to use sunscreen with broad-spectrum sun protection.

Reduce Time in the Sun

This is especially recommended from 10 a.m. to 4 p.m., when the sun's burning rays are strongest. Even on an overcast day, up to 80% of the sun's UV rays can get through the clouds. Stay in the shade as much as possible throughout the day.

Dress With Care

Wear clothes that protect your body. Cover as much of your body as possible if you plan to be outside. Wear a wide-brimmed hat, long sleeves, gloves, and long pants. Sun-protective clothing is now available in stores. But, the FDA does not regulate such products unless the manufacturer intends to make a medical claim. Consider using an umbrella for shade.

Be Serious About Sunscreen

Wear sunscreen every day, in all weather and every season. Check sunscreen labels to make sure you get:

• A high sun protection factor (SPF). SPF represents the degree to which a sunscreen can protect the skin from sunburn. The higher the number, the better the protection. Consider a sunscreen with at least an SPF of 30, and reapply every hour. More often if you're sweating or swimming.
• Broad-spectrum protection. Sunscreen that protects against UVA and UVB rays. Zinc oxide is the best UVA blocker sold in the U.S. Look for at least a 7% concentration.
• Water resistance. Sunscreen that stays on your skin longer, even if it gets wet; "water-resistant" does not mean "waterproof." Water-resistant sunscreens need to be reapplied as instructed on the label.

Don't Forget the Eyes

Sunlight reflecting off snow, sand, concrete, or water further increases exposure to UV radiation, increasing your risk of developing eye problems such as cataracts and eye cancer. The right sunglasses such as polarized or blue blockers can protect your eyes.

Long hours on the beach or in the snow without adequate eye protection also can result in a short-term condition known as photokeratitis, or reversible sunburn of the cornea. This painful condition -- also known as "snow blindness" -- can cause temporary loss of vision.

• When buying sunglasses, look for a label that specifically offers 99% to 100% UV protection. This assures that the glasses block both forms of UV radiation.
• Eyewear should be labeled "sunglasses." Be wary of dark or tinted eyewear sold as fashion accessories that may provide little or no protection from UV or visible light.
• Don't assume that you get more UV protection with pricier sunglasses or glasses with a darker tint.
• Be sure that your sunglasses don't distort colors and affect the recognition of traffic signals.
• Ask an eye care professional to test your sunglasses if you're not sure of their level of UV protection.
• People who wear contact lenses that offer UV protection should still wear sunglasses.
• Consider that light can still enter from the sides of sunglasses. Those that wrap all the way around the temples can help.
• Children should wear real sunglasses -- not toy sunglasses -- that indicate the UV protection level. Polycarbonate lenses are the most shatter-resistant.

Sunlamp Products

Sunlamp products are not recommended by dermatologists and in many states are banned for use in minors without parental permission.

Sunlamps emit UV that is similar to, or more powerful than, that emitted by the sun. Therefore, exposure to sunlamp products can also lead to skin cancer. Some experts argue that artificial tanning is less dangerous, because the intensity of light and the time spent tanning are controlled. There is limited evidence to support these claims. On the other hand, sunlamps may be more dangerous than the sun because they can be used at the same intensity every day of the year -- something that is unlikely for the sun because of winter weather and cloud cover. They can also be more dangerous because people can expose their entire bodies at each session, which would be difficult to do outdoors.

The FDA requires manufacturers of sunlamps to develop an exposure schedule and establish a maximum recommended exposure time based on the UV emission characteristics of their products.

UV and the intense visible light emitted from sunlamp products can also damage the eyes, so it is important to wear proper protective eyewear while tanning indoors.

Tips for Tanning Indoors

If you use indoor tanning equipment, follow these steps to reduce the dangers of UV exposure:

• Wear the goggles provided. Make sure they fit snugly and are not cracked.
• Start slowly and use short exposure times to build up a tan over time.
• Don't use the maximum exposure time the first time you tan, because you could get burned, and sunburns lead to an increased risk for developing melanoma.
• Because sunburn takes at least 6 hours to develop, you may not realize your skin is burned until it's too late.
• Follow manufacturer-recommended exposure times on the label for your skin type.
• Stick to your time limit.
• After a tan is developed, tan no more than once a week.
• Know that even one tanning bed session before the age of 35 doubles your risk for developing melanoma, a skin cancer that can be deadly.

So-Called 'Tanning Pills'

No tanning pills of any kind have been approved by the FDA.

However, there are companies that market products they call "tanning pills." Some of these pills contain a color additive known as canthaxanthin, which, when ingested, can turn the skin a range of colors from orange to brown. Canthaxanthin is only approved for use as a color additive in foods and oral medications, and only in small amounts.

Dihydroxyacetone (DHA)

Some tanning sprays contain DHA, a color additive that interacts with the dead surface cells in the outermost layer of the skin, to darken skin color. It is commonly used in "sunless tanning" lotions, creams, and spray-on products.

DHA is approved by the FDA for use in coloring the skin, but it is limited to external application. The industry has not provided safety data to the FDA to consider approving it for other uses, such as applying it to your lips or the area of your eyes, or inhaling it. Therefore, the risks, if any, are unknown. The FDA recommends that if you visit a spray tanning salon, take precautions to protect your eyes and lips and avoid inhaling the spray.

Some tanning products on the market do not contain sunscreen. The FDA requires these products to carry a warning statement.

Check for Skin Cancer

Check your skin regularly for signs of skin cancer. Look for changes in the size, shape, color, or feel of birthmarks, moles, and spots. If you find any changes or find sores that are not healing, see your doctor.

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