Summer sun protection is much more than just picking the right sunscreen by Cynthia Bailey, MD

Summer sun protection is much more than just picking the right sunscreen;

Protecting your skin means physically keeping as much sun off your skin as possible when outdoors for long periods of time

As a California dermatologist, I spend most of my time treating people with skin cancer. I teach my patients to enjoy being outdoors and keep their skin safe. Today, sun protection information is complicated by vitamin D information such that even doctors are confused.

Here’s what I tell my patients: Before you decide that your skin can safely handle sun exposure with little or no sun protection, first figure out how sensitive your skin is to the sun you will be exposed to.

· To do this, I say, “think about your ancestors.” Where in the world did they live, how intense is the sun there, and how exposed to that sun were they? Is the sun more or less intense where you want to be outside? For example, if you are a very dark skinned African American (your ancestors lived in a hot and high UV intense environment and wore very little sun protective clothing to protect their skin) and you live in Seattle (cold weather with low intensity sun and you usually wear a sweater and pants even during the summer) your skin can probably handle the sun with minimal sun protection effort. If however, you are a really fair Irish descendant (cold climate and lower intensity UV rays, people covered head to toe in wool and hats) and you live in sunny California, your skin doesn’t stand much of a chance. You know you will burn and freckle within minutes of mid day summer sun.

· Next, find out if there is a family history of skin cancer since this risk can be genetic. Anyone with a family history of skin cancer needs sun protection, no matter what their skin pigment and no matter where they are in the world.

The second issue is sun protection itself; how do you sun protect your skin without being entirely uncomfortable or stuck in the shade all day?

· This is where you get inventive. The best sun protection is physical; keeping the rays from ever touching your skin in the first place. That means hats and clothes; hats with a full brim (3 to 5 inches) and clothes that block the sun. You can buy garments made from special sun protecting fabric or turn your existing wardrobe into sun protective clothing using a product that washes into the fabric (SunGuard, available on my web site at www.otbskincare.com). Seek the shade. Don’t, for example, watch your grand kids soccer game sitting in the full sun. Sit under the tree or pitch a canopy. Watch, all your friends will join you.

· Put zinc oxide sunscreen on all the skin not covered by clothing. Science clearly points to zinc oxide as being the best sunscreen ingredient, bar none. It’s been micro sized and now rubs onto the skin clear. If you are having trouble getting it to rub on clear, see the application tips on my web site. Click on the Ultimate Sun Kit and then look at my tips for success. Zinc Oxide is not a chemical and does not get into your body.It doesn’t break down in the bottle; all the other sunscreen ingredients do except for zinc oxide and titanium dioxide and it blocks the broadest range of harmful UVA and UVB rays. Dependable, high quality zinc oxide sunscreens made by trusted companies can be found at the web site, too. My favorites are Citrix for every day facial protection and SolbarZinc for sweaty, wet activities. The Ultimate Sun Kit contains these sunscreens in addition to SunGuard and LipCotz which, in total, provides almost everything needed but the hat for summer sun protection.

I’ve also created an easy reference card to carry with you that summarizes my sun protection guidelines. It's available at the sun protection kit page.

So what do we do about vitamin D?

· Research scientists haven’t gotten that fully figured out yet. We know some people have low levels of vitamin D and have health problems related to vitamin D deficiency such as osteoporosis. There are also people with low levels and no health related problems, and then there are people with normal levels of vitamin D. We also know that vitamin D plays many important and complex roles in our body like strengthening our immune system and fighting cancer. Add to that the thinking that oral vitamin D supplements may or may not be equal to sun produced vitamin D and it becomes really confusing. We just don’t have all the answers yet. Some doctors are recommending regular face and hand sun exposure for vitamin D production. I don’t agree. I can guarantee that there will be a lot more skin cancers for the medical profession to treat if people listen to that advice.

What do I think, what do I personally do, and what do I tell my patients? It's pretty simple: Have your vitamin D level measured. If it is low, ask your doctor about prescribing oral vitamin D supplementation first. If that doesn’t raise your vitamin D level and your doctor feels strongly that you need natural sun-produced vitamin D, use your abdomen skin and the noon sun.

Don’t burn, especially if you are at increased risk for melanoma because of a personal or family history. I recommend the abdomen because it does not have years of excessive sun exposure waiting to sprout skin cancer, and when it wrinkles and acquires sun spots (liver spots) you won’t care as much. The sun has to be the mid day, big cancer rays (UVB) because those are the only rays that make vitamin D. Knowing how long to expose your abdomen is much harder because your natural skin pigment, and where you are on the earth, determine how well the sun works.

I usually recommend 5 minutes 3 times a week to start when out in the sun. Ask your doctor when to recheck your vitamin D level to see if what you are doing is working. Remember, any sun exposure is cancer causing and will accelerate the aging look of your exposed skin, so there is a down side to this activity.

To summarize, healthy summer sun exposure means:

1. Physically keeping as much sun as possible off your skin.

2. Applying a zinc oxide sunscreen to all uncovered skin when outdoors during the day light hours.

3. Having vitamin D levels measured and thinking twice about making a vitamin D factory out of those parts of your skin that have already had too much lifetime sun exposure.